Tratamento cirúrgico da obesidade mórbida

Ferraz, Edmundo Machado; Arruda, Pedro Carlos Loureiro de; Bacelar, Tércio Souto; Ferraz, A.; Albuquerque, Antonio Cavalcanti de; Leão, Cristiano de Souza

doi:10.1590/s0100-69912003000200004

Cited by 29 publications

(33 citation statements)

References 15 publications

(15 reference statements)

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“…Roux-en-Y gastric bypass is the most effective procedure and is recommended as the gold standard to treat comorbid conditions related to morbid obesity. 5,13 Its main benefits to patients are early satiety center stimulation and improvement of the metabolic syndrome cycle with 75% effective decrease in the initial excess weight. 14 Vitamin supplementation is essential to prevent nutritional deficiencies resulting from the surgical procedure, as well as to achieve healthy weight reduction.…”

Section: Introductionmentioning

confidence: 99%

Obesity, bariatric surgery and oxidative stress

Horn

Gelatti

Mori

et al. 2017

Rev. Assoc. Med. Bras.

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Introduction: Obesity refers to the accumulation of fatty tissues and it favors the occurrence of oxidative stress. Alternatives that can contribute to body weight reduction have been investigated in order to reduce the production of reactive oxygen species responsible for tissue damage. The aim of the current study was to assess whether the oxidant and antioxidant markers of obese women before and after bariatric surgery were able to reduce oxidative damage. Method:We have assessed 16 morbidly obese women five days before and 180 days after the surgery. The control group comprised 16 non-obese women. Levels of thiobarbituric acid-reactive substances, carbonylated proteins, reduced glutathione and ascorbic acid were assessed in the patients' plasma. Results: Levels of lipid peroxidation and protein carbonylation in the pre-surgical obese women were higher than those of the controls and post-surgical obese women. Levels of reduced glutathione in the pre-surgical obese women were high compared to the controls, and declined after surgery. Levels of ascorbic acid fell in the pre--surgical obese women compared to the control and post-surgical obese women. Conclusion: Body weight influences the production of reactive oxygen species. Bariatric surgery, combined with weight loss and vitamin supplementation, reduces cellular oxidation, thus reducing tissue damage.

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Section: Introductionmentioning

confidence: 99%

Obesity, bariatric surgery and oxidative stress

Horn

Gelatti

Mori

et al. 2017

Rev. Assoc. Med. Bras.

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“…The guidelines issued by the Centers for Disease Control and Prevention (CDC) in 1999 recommend the prophylactic use of antibiotics, administered intravenously to ensure peak plasma concentrations at the time of incision, maintaining therapeutic blood and tissue levels throughout surgery and up to a few hours after skin closure (9,17) . Drugs are absorbed, distributed, metabolized and excreted differently in obese compared to non-obese patients.…”

Section: Discussionmentioning

confidence: 99%

“…Few data are available in the literature with respect to pharmacotherapy in obese patients and the available data are limited to only a few drugs. As with anesthetics, chemotherapy drugs and certain other drugs, antimicrobials may be significantly affected by obesity and by changes determined by surgical procedures (9,12,14) . The volume and the speed of distribution of drugs are determined by many factors including body mass, blood flow to the tissues, tissue protein binding and the kinetics of drug excretion.…”

Section: Discussionmentioning

confidence: 99%

“…Little is known on the pharmacokinetics of antibiotics in patients whose body mass index (BMI) is >40 kg/m 2 (9) . Even so, the manner in which obese patients absorb, distribute, metabolize and excrete drugs in general is known to be different from that of non-obese individuals.…”

Section: Antibiotic Prophylaxis In Bariatric Surgery: a Continuous Inmentioning

confidence: 99%

“…Indeed, the relationship between body size and physiological and pharmacokinetic variables in the obese population (1,2,6,9) implies that some physiological changes that are characteristic of morbid obesity affect the kinetics of drugs. These changes involve an increase in cardiac output, total blood volume and renal clearance, as well as the occurrence of fat deposits in the liver and changes in plasma proteins.…”

Section: Antibiotic Prophylaxis In Bariatric Surgery: a Continuous Inmentioning

confidence: 99%

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ANTIBIOTIC PROPHYLAXIS IN BARIATRIC SURGERY: a continuous infusion of cefazolin versus ampicillin/sulbactam and ertapenem

Ferraz

Siqueira

Campos

et al. 2015

Arq. Gastroenterol.

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-Background -The incidence of surgical site infection in bariatric patients is significant and the current recommendations for antibiotic prophylaxis are sometimes inadequate. Objective -The aim of this study was to analyze the effect of three prophylactic antibiotic regimens on the incidence of surgical site infection. Methods -A prospective, cross-sectional study was conducted between January 2009 and January 2013 in which 896 Roux-en-Y gastric bypasses were performed to treat obesity. The study compared three groups of patients according to the perioperative antibiotic prophylaxis administered intravenously and beginning at anesthesia induction: Group I consisting of 194 patients treated with two 3-g doses of ampicillin/sulbactam; Group II with 303 patients treated with a single 1-g dose of ertapenem; and Group III with 399 patients treated with a 2-g dose of cefazolin at anesthesia induction followed by a continuous infusion of cefazolin 1g throughout the surgical procedure. The rate of surgical site infection was analyzed, as well as its association with age, sex, preoperative weight, body mass index and comorbidities. Results -The rates of surgical site infection were 4.16% in the group treated prophylactically with ampicillin/sulbactam, 1.98% in the ertapenem group and 1.55% in the continuous cefazolin group. Conclusion -The prophylactic use of continuous cefazolin in surgeries for morbid obesity shows very promising results. These findings suggest that some prophylactic regimens need to be reconsidered and even substituted by more effective therapies for the prevention of surgical site infections in bariatric patients.

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