-Background -Although is complex to identify the factors responsible for the important growth in obesity all over the world, the main causes are increased consumption of energy, highly saturated fats and sugars, and reduced physical activity. Aim -To compare rats with normal and supplemented diet with sucrose in relationship to body mass, weight of gonadal and retroperitoneal fat and Lee index. MethodsForty rats were divided into two groups: 20 in the control group that received normal chow diet and water for three months, and 20 animals in the experimental group who received the same diet but supplemented with sucrose 300 g/l of water. The animals were weighed once a week during 91 days. At scheduled death, they had measured the naso-anal length, body weight and Lee index. After laparotomy, retroperitoneal and gonadal fat were isolated, dried and the percentage of weight in relation to body weight at the date of death was evaluated. Results -There was a statistic significant difference between the 14 th and 78 th day favoring the experiment group indicating that sucrose interferes with weight gain in rats. The average weight was higher in the experimental group in all periods in comparison to initial weight. There was also significant difference in the weight of the gonadal and retroperitoneal fat. There was no significant difference comparing the Lee index. Conclusion -The body mass index was higher in animals treated with diet supplemented with sucrose and had higher gonadal and retroperitoneal fat, but no difference in the Lee index.RESUMO -Racional -Embora seja muito complexo identificar o que levou ao grande crescimento da obesidade, as causas principais são o aumento do consumo de alimentos energéticos e ricos em gorduras saturadas e açucares, e a redução das atividades físicas. Objetivos -Comparar a massa corpórea, o peso da gordura retroperitoneal e gonadal e o índice de Lee em ratos submetidos à dieta normal e à suplementada com sacarose. Métodos -A amostra foi de 40 animais, divididos em dois grupos: 20 do grupo controle que receberam dieta de ração normal e água por três meses e 20 do grupo experimento que receberam a mesma ração suplementada com sacarose 300 g/l na água. Os animais foram pesados uma vez por semana durante 91 dias. Na data da morte foram aferidos o comprimento nasoanal, peso corporal e foi calculado o índice de Lee. Após, foram submetidos à laparotomia e a gordura retroperitoneal e gonadal foram individualizadas, ressecadas e avaliada a porcentagem do peso dela em relação ao corporal na data da morte. Resultados -Verificou-se diferença estatisticamente significativa entre o 14º até o 78º dia, quando comparados os grupos indicando que a sacarose interfere no ganho de peso dos ratos. A média de peso foi maior no grupo experimento em todos os períodos, tendo como referência o peso inicial. Verificou-se diferença significativa a favor do grupo experimento no peso da gordura gonadal e retroperitoneal. Não houve diferença significativa da comparação do índice de Lee. Conclusão -A ...

BackgroundThe association between obesity and gastroesophageal reflux disease has a high incidence and may be present in half of obese patients with surgical indication. Bariatric operations can also induce reflux alone - differently from BMI factors - and its mechanisms are dependent on the type of procedure performed.ObjectiveTo perform a literature review comparing the two procedures currently most used for surgical treatment of obesity and analyze their relationship with the advent of pre-existing reflux disease or its appearance only in postoperative period.MethodThe literature was reviewed in virtual database Medline/PubMed, SciELO, Lilacs, Embase and Cochrane crossing the following MeSH descriptors: gastric bypass AND / OR anastomosis, Roux-en-Y AND / OR gastroesophageal reflux AND / OR gastroenterostomy AND / OR gastrectomy AND / OR obesity AND / OR bariatric surgery AND / OR postoperative period. A total of 135 relevant references were considered but only 30 were used in this article. Also was added the experience of the authors of this article in handling these techniques on this field.ConclusionThe structural changes caused by surgical technique in vertical gastrectomy shows greater commitment of antireflux mechanisms predisposing the induction of GERD postoperatively compared to the surgical technique performed in the gastrointestinal Bypass Roux-en-Y.

Background: Obesity changes the anatomy of the patient. In addition to the aesthetic change, the high percentage of fat determines evident functional changes. Anthropometric normality in measuring abdominal circumference and height can serve as a basis for measuring cardiometabolic risks of obesity. Aim: To verify if it is possible to determine parameters of normality between waist and height in people with normal BMI and fat percentages, to serve as a basis for assessing risks for obesity comorbidities. Methods: A sample of 454 individuals with BMI and percentages of fat considered within the normal range was extracted. It was divided into age groups for both men and women between 18 and 25; 26 to 35; 36 to 45; 46 to 55; 56 to 65. A total of 249 men and 205 women were included. Results: Regarding the percentage of height as a measure of the abdominal perimeter, the total female sample had an average of 44.2±1.1% and the male 45.3%+1.5. For women, this percentage determined the equation of the waist-height ratio represented by X=(age+217) / 5.875, and for men X=(age+190.89) / 5.2222. “X” represents the percentage of the height measurement so that the individual falls into the category of adequate percentage of fat and BMI. Conclusion: Between the stature of adult men and women with normal fat percentage and BMI, there is a common numerical relationship, with is on average 44% for women and 45% for men.

Rational: The metabolic response to surgical trauma is enhanced by prolonged preoperative fasting, contributing to increased insulin resistance. This manifestation is more intense on the 1st and 2nd postoperative days and is directly proportional to the size of the operation. Aim: To compare whether preoperative fasting abbreviation and early postoperative refeeding associated with intraoperative and postoperative fluid restriction interfere in the evolution of patients undergoing gastrojejunal bypass. Methods: Eighty patients indicated for Roux-en-Y gastrojejunal bypass were selected. They were randomly divided into two groups: Ringer Lactate (RL) group, who underwent a 6 hours solids fasting, with the administration of 50 g of maltodextrin in 100 ml of mineral water 2 hours before the beginning of anesthesia; and Physiologic Solution (PS) group, who underwent a 12 hours solids and liquids fasting. Anesthesia was standardized for both groups. During the surgical procedure, 1500 ml of ringer lactate solution was administered in the RL and 2500 ml of physiological solution (0.9% sodium chloride) in the PS. In both groups, the occurrence of bronchoaspiration was analyzed during intubation, and the residual gastric volume was measured after opening the abdominal cavity. In the postoperative period in Group RL, patients started a liquid diet 24 hours after the end of the operative procedure; whilst for PS group, fasting was maintained for the first 24 hours, it was prescripted 2000 ml of physiological solution and a restricted liquid diet after 36 hours. Each patient underwent CPK, insulin, sodium, potassium, urea, creatinine, PaCO2, pH and bicarbonate dosage in the immediate postoperative period, and 48 hours later, the exams were repeated. Results: There were no episodes of bronchoaspiration and gastrojejunal fistulas in either group. In the analysis of the residual gastric volume of the PS and RL groups, the mean volumes were respectively 16.5 and 8.8, which shows statistical significance between the groups. In laboratory tests, there was no difference between groups in sodium; PS group showed a higher level of serum potassium (p=0.029); whilst RL group showed a higher urea and creatinine values; CPK values were even for both; PS group demonstrated a higher insulin level; pH was higher in PS group; sodium bicarbonate showed a significant difference at all times; PaCO2 values in RL group was higher than in PS. In the analysis of the incidence of nausea and flatus, no statistical significance was observed between the groups. Conclusions: The abbreviation of preoperative fasting and early postoperative refeeding of Roux-en-Y gastrojejunal bypass with the application of ERAS or ACERTO Project accelerated the patient’s recovery, reducing residual gastric volume and insulin level, and do not predispose to complications.

Background: The creation of a computerized clinical database with the ability to collect prospective information from patients and with the possibility of rescue and crossing data enables scientific studies of higher quality and credibility in less time. Aim: To validate, in a single master protocol, the clinical data referring to Surgery of Digestive System in a multidisciplinary way, incorporating in the SINPE© platform, and to verify the incidence of digestive diseases based on the prospectively performed collections. Method: Organize in one software, in a standardized structure, all the pre-existing items in the SINPE© database; the theoretical basis was computerized through the MIGRASINPE© module creating a single multiprofessional master protocol for use as a whole. Results: The existing specific protocols were created and/or adapted - they correspond to the most prevalent digestive diseases - unifying them. The possibility of multiprofessional use was created by integrating all data collected from medicine, nursing, physiotherapy, nutrition and health management in a prospective way. The total was 4,281 collections, distributed as follows: extrahepatic biliary tract, n=1,786; esophagus, n=1015; anorectal, n=736; colon, n=550; small intestine, n=86; pancreas, n=71; stomach, n=23; liver, n=14. Conclusions: The validation of the unification and structuring in a single master protocol of the clinical data referring to the Surgery of the Digestive System in a multiprofessional and prospective way was possible and the epidemiological study carried out allowed to identify the most prevalent digestive diseases.