Effect of Size of Intestinal Diversions in Obese Patients With Metabolic Syndrome Submitted to Gastric Bypass

Abstract

Background: There is no consensus on the ideal size of intestinal loops in gastric bypass of bariatric surgeries. Aim: To evaluate the metabolic outcome of patients submitted to gastric bypass with alimentary and biliopancreatic loops of different sizes. Methods: Was conducted a retrospective cohort study in diabetic obese patients (BMI≥35 kg/m2) with metabolic syndrome submitted to gastric bypass. The patients were divided into three groups according to the size of the intestinal loop: group 1, biliopancreatic limb 50 cm length and alimentary limb 100 cm length; group 2 , biliopancreatic limb 50 cm length and alimentary limb 150 cm length; and group 3, biliopancreatic limb 100 cm length and alimentary limb 150 cm length. The effect of gastric bypass with different sizes of intestinal loops in relation to the parameters that define metabolic syndrome was determined. Results: Sixty-three patients were evaluated, and they had a mean age of 44.7±9.4 years. All were diabetics, with 62 (98.4%) being hypertensive and 51 (82.2%) dyslipidemic. The three groups were homogeneous in relation to the variables. In 24 months, there was a remission of systemic arterial hypertension in 65% of patients in group 1, 62.5% in group 2 and 68.4% in group 3. Remission of diabetes occurred in 85% of patients in group 1, 83% in group 2 and 84% in group 3. There was no statistical difference in %LEW between the groups, and waist measurements decreased in a homogeneous way in all groups. The size of loops also had no influence on the improvement in dyslipidemia. Conclusion: Variation in size of intestinal loops does not appear to influence improvement in metabolic syndrome in this group of patients.

The Relation Among the Physical Activity Level During Leisure Time, Anthropometry, Body Composition, and Physical Fitness of Women Underwent of Bariatric Surgery and an Equivalent Group With No Surgery

“…Santos et al developed a prospective study in which were observed statistically significant differences in the adherence to the physical activity practice during the first 12 months post-operation. Although with sensible differences, it could be considered low frequency of physical practice regarding this specific population 22 .…”

Postoperative Changes in Intestinal Microbiota and Use of Probiotics in Roux-en-Y Gastric Bypass and Sleeve Vertical Gastrectomy: An Integrative Review

“…When obesity is severe, bariatric surgery is the treatment with the most consistent results in excess weight loss, remission of comorbidities and improving life quality 1 . Roux-en-Y gastric bypass (RYGB) and sleeve vertical gastrectomy (SL) are the two most used procedures for such cases 1 , 20 . The first consists of a technique that couples the reduction of gastric volume and a detour of the proximal intestine, while the latter is a restrictive technique in which 80% of the greater curvature of the stomach is ressected 1 .…”

The influence of total bowel length on gastric bypass outcomes

“…Many studiesconcur that the CL length and AL length do not affect the amount of potential weight loss that a patient can achieve [25][26][27][28] though Tran et al [29] has suggested the use of a distal bypass is an effective revision for a failed loss of weight on a standard bypass. There is certainly a range of results on whether proximal or distal bypasses have more pronounced effects on the metabolic and endocrine systems as reported by Risstad et al [9] and Ramos et al [30] Distal bypasses may also be related to increased rates of complication.…”