Vertical Gastrectomy vs. Extended Vertical Gastrectomy: What Is the Impact on Gastroesophageal Reflux Disease in Obese Rats?

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Background: In the last decades, numerous studies have confirmed the importance of lactate - by-product to the nutrient signal of the intracellular redox state - to regulatory functions in energy metabolism. Aim: To evaluate changes in blood lactate in patients with severe obesity and its correlation with body composition and metabolic profile. Methods: Twenty-four people with severe obesity (BMI=40 kg/m2) were evaluated in a prospective case-control study before and six months after Roux-in-Y gastric bypass. The blood lactate, total cholesterol, and fractions, C-reactive protein and HOMA-IR were analyzed after 12 h fasting. Body mass composition was evaluated by bioelectrical impedance and respiratory quotient was measured by indirect calorimetry. Results: The initial lactate level was 2.5±1.1 mmol/l and returned to normal level (1.9±3.6 mmol/l, p=0.0018) after surgery. This reduction was positively correlated with a decrease in BMI (p=0.0001), % free fat mass (p=0,001), % fat mass (p=0.001) and HOMA-IR (p=0.01). There was normalization of lactatemia in 70% of patients. There was no correlation between lactatemia and C-reactive protein. Conclusions: There was a significant improvement of metabolic parameters, normalization of blood lactate, fat mass loss, although these individuals remained with a high BMI.

“…The increasing prevalence of obesity and metabolic syndrome (MetS) has become a concern, mainly due to risk of progression to type 2 diabetes and cardiovascular diseases 15 , 2 , 29 .…”

Section: Introductionmentioning

confidence: 99%

Lactate Can Be a Marker of Metabolic Syndrome in Severe Obesity?

Cleva

Cardia

Gadducci

et al. 2021

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“…Sleeve gastrectomy has advantages such as preservation of the gastroduodenal transit and lower risk of nutritional deficiency; however, some postoperative complications can be evidenced, as its performance promotes the disconnection of the gastric tube from the fundamental ligaments for its fixation, such as the gastrosplenic and gastrocolic. Thus, the remnant stomach becomes more susceptible to a reduction in the diameter of the lumen, causing symptoms such as gastric stasis, gastroesophageal reflux, heartburn and regurgitation 24 . In addition, axial rotation may occur, leading to stomach angulation, triggering an increase in intraluminal pressure and the appearance of stenoses, predisposing to the development of fistulas 1,6,9,10,23 .…”

Section: Introductionmentioning

confidence: 99%

Are There Benefits in Performing Gastro-Omentopexy in Laparoscopic Vertical Gastrectomy?

Souza

Silva

Ferraz

et al. 2021

Background: Gastro-omentopexy promotes the reconnection of the stomach to the gastroesplenic and gastrocolic ligaments and constitutes an alternative for the prevention of complications in laparoscopic vertical gastrectomy. Aim: To demonstrate the benefits of the gastro-omentopexy technique in patients undergoing sleeve gastrectomy, with possible reduction in postoperative complications. Methods: Prospective, non-randomized, case series type study, consisting of a clinical population of 179 patients who underwent the technique in 2018, with follow-up between 6-12 months in the postoperative period. Results: From the participants 71.5% were women, aged between 30-40 years (36.3%). As for the prevalence of complications in the postoperative period, the low prevalence was evident, with emphasis on readmission (1.1%); reoperation (1.1%); wound infection (1.1%); bleeding hemorrhage (0.5%); and stricture (1.1%). However, temporary symptoms were present such as nausea/vomiting, food intolerance, epigastric pain and feeling of fullness, right after surgery. Conclusion: The technique promoted a significant improvement in quality of life and control of comorbidities. In addition, it was associated with a low prevalence of stenosis, and with no fistula, making the method safer.

“…Unfortunately, it is increasing worldwide 22 . Obesity should not be thought of as a single disorder as it is related to many disorders like hypertension, diabetes, obstructive sleep apnea, cardiovascular diseases, metabolic alterations, gastroesophageal reflux and increased risk of malignancies 9 , 13 , 28 , 29 . For years people have struggled with obesity with both metabolic and physical problems.…”

Section: Introductionmentioning

confidence: 99%

Is Body Mass Index and Obesity Surgery Mortality Score Important in Perioperative Complications of Laparoscopic Sleeve Gastrectomy Before Discharge?

Bozan

Kutluer

Aksu

et al. 2021

Background: Morbid obesity surgery and related complications have increased with time. Aim: To evaluate the relationship between perioperative complications before discharge and preoperative body mass index and obesity surgery mortality score in laparoscopic sleeve gastrectomy. Method: 1617 patients who met the inclusion criteria were evaluated retrospectively. The patients were examined in terms of demographic data, presence of comorbidities, whether there were complications or not, type of complications and obesity surgery mortality score. Results: Complications were seen in 40 patients (2.5%) and mortality wasn’t seen in the early postoperative period before discharge. The mean age of patients with complications was 36.3±10.02 years (19-57) and without complications 34.12±9.54 (15-64) years. The preoperative mean BMI values of patients with and without complications were 45.05±3.93 (40-57) kg/m2 and 44.8±3.49 (35-67) kg/m2 respectively. According to BMI groups 40-45 kg/m2, 45-50 kg/m2 and 50 and over, there was not any statistical significance seen in three groups in terms of complication positivity and major-minor complication rates. There was not any statistical significance seen between the patients with and without major-minor complications and obesity surgery mortality score. Conclusion: There was not any relation between perioperative laparoscopic sleeve gastrectomy complication rates before discharge and BMI and obesity surgery mortality scores.