RYGB with long-biliopancreatic and short-alimentary limbs is safe and seems effective in achieving complete control of T2D in patients with BMIs between 30 and 35 kg/m.
Background: Extended vertical gastrectomy is a variation of the vertical gastrectomy technique requiring studies to elucidate safety in relation to gastroesophageal reflux. Aim: To analyze comparatively vertical gastrectomy (VG) and extended vertical gastrectomy (EVG) in rats with obesity induced by cafeteria diet in relation to the presence of reflux esophagitis, weight loss and macroscopic changes related to the procedures. Methods: Thirty Wistar rats were randomized into three groups, and after the obesity induction period by means of a 28-day cafeteria diet, underwent a simulated surgery (CG), VG and VGA. The animals were followed up for 28 days in the post-operative period, and after euthanasia, the reflux esophagitis evaluation was histopathologically performed. Weight and macroscopy were the other variables; weight was measured weekly and the macroscopic evaluation was performed during euthanasia. Results: All animals presented some degree of inflammation and the presence of at least one inflammation criterion; however, there was no statistically significant difference in the analysis among the groups. In relation to weight loss, the animals in CG showed a gradual increase during the whole experiment, evolving to super-obesity at the end of the study, while the ones with VG and EVG had weight regain after the first post-operative period; however, a less marked regain compared to CG, both for VG and EVG. Conclusion: There is no difference in relation to reflux esophagitis VG and EVG, as well as macroscopic alterations, and both techniques have the ability to control the evolution of weight during postoperative period in relation to CG.
To compare the satisfaction levels about the surgery and anesthesia management, and to analyze the postoperative outcomes of patients undergoing Gastric Bypass and Sleeve Gastroplasty surgeries in a private hospital in Sao Luís-MA. Methods: The sample consisted of patients undergoing Bypass and Sleeve bariatric surgeries from August 2018 to August 2019, who were in the range of 18 and 70 years old and had not used drugs or presented cardiac arrhythmias, dilated cardiomyopathy, and conduction disorder heart. Data were collected from the evaluation forms and recorded in a form with closed questions. Results: Most patients were female (Bypass-56% and Sleeve-67.4%) and aged between 30 and 39 years old (Bypass-32% and Sleeve-55.8%). Information (Bypass-92% and Sleeve-86.1%) was the highest satisfaction index found. Sleepiness in the immediate postoperative period (Bypass-92% and Sleeve-93%) was the main side effect. There were no postoperative complications in patients between the two types of surgery. Conclusions: Patients submitted to Bypass and Sleeve were completely satisfied with the perioperative management. There was no statistically significant difference when comparing adverse effects between the techniques.
Background: Among Roux-en-Y gastric bypass complications is the occurrence of intestinal
obstruction by the appearance of internal hernias, which may occur in Petersen
space or the opening in mesenteric enteroenteroanastomosis. Aim: To evaluate the efficiency and safety in performing a fixing jejunal maneuver in
the transverse mesocolon to prevent internal hernia formation in Petersen space.
Method: Two surgical points between the jejunum and the transverse mesocolon, being 5 cm
and 10 cm from duodenojejunal angle are made. In all patients was left Petersen
space open and closing the opening of the mesenteric enteroenteroanastomosis. Results: Among 52 operated patients, 35 were women (67.3%). The age ranged 18-63 years,
mean 39.2 years. BMI ranged from 35 to 56 kg/m2 (mean 40.5
kg/m2). Mean follow-up was 15.1 months (12-18 months). The operative
time ranged from 68-138 min. There were no intraoperative complications, and there
were no major postoperative complications and no reoperations. The hospital stay
ranged from 2-3 days. During the follow-up, no one patient developed suspect
clinical presentation of internal hernia. Follow-up in nine patients (17.3%)
showed asymptomatic cholelithiasis and underwent elective laparoscopic
cholecystectomy. During these procedures were verified the Petersen space and
jejunal fixation. In all nine, there was no herniation of the jejunum to the right
side in Petersen space. Conclusion: The fixation of the first part of the jejunum to left side of the transverse
mesocolon is safe and effective to prevent internal Petersen hernia in RYGB
postoperatively in the short and medium term. It may be interesting alternative to
closing the Petersen space.
The variant technique proposed here for sleeve gastrectomy leaves the stomach homogeneously in a shape of a tube and in small caliber, providing small free gastric cavity and keeping natural functional activity of the sphincters. However, it may lead to unwanted gastroesophageal reflux, which needs to be better measured in future research.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.