Derivações gástricas em y- de- roux com anel de silicone para o tratamento da obesidade: estudo das complicações relacionadas com o anel

Abstract

HEADINGS -Anastomosis, Roux-en-Y. Morbid obesity, Postoperative complications.ABSTRAT -Background -The silicone ring is used as containment factor of the Rouxen-Y gastric bypass to induce greater ponderal loss. However, it may have some inconveniences from this stressed restriction. Aim -To analyze the complications related to silicone ring in patients who underwent Roux-en-Y gastric bypass surgery with silicon ring. Methods -From 1994 to 2005, 7 000 patients were submitted to Roux-in-Y gastric bypass with silicone ring in order to treat morbid obesity. Only 50% were followed from two to 11 years. The mean excess weight loss was around 85%. But ring complications were registered in 160 patients (2,28% of the total and 4,56% of the followed patients). Therefore, this series consist of 38 male patients (23.8%) and 122 female patients (76.2%) with average age of 44 years old and BMI of 54.4 kg/m 2 . Results -Five types of ring complications were found. The most frequent was displacement (61%) causing obstructive symptoms. The second most frequent complication was ring erosion to the lumen (22%) causing epigastric pain and nausea. Conclusions -The ring complications occur in low frequency. Ring removal, either surgical or endoscopically done, is the most usual treatment, but tends to cause partial regain of the weight lost. ABCDDV/815 RESUMO

IMPACT ON QUALITY OF LIFE, WEIGHT LOSS AND COMORBIDITIES: a study comparing the biliopancreatic diversion with duodenal switch and the banded Roux-en-Y gastric bypass

“…However, because it is a predominantly disabsortive technique, it can result in a higher ratio of malodorous flatulence, chronic diarrhea, and nutritional and metabolic sequelae than RYGB (12) . The most frequent complications of BRYGB are displacement causing obstructive symptoms, ring erosion causing epigastric pain and nausea, band slippage and migration, regurgitation, vomiting and meat intolerance (5) .…”

Cirurgias bariátricas realizadas no Sistema Único de Saúde brasileiro entre 2010 e 2019

“…Alguns métodos cirúrgicos para execução da bariátrica começaram a ser realizados pelo SUS depois do período de início estipulado por esta análise, demandando estatística diferenciada para correlação. Esse fato se alinha com dados da Sociedade Brasileira de Cirurgia Bariátrica e Metabólica (SBCBM, 2020b) que remontam preferência por algumas técnicas e abandono de outras, como a gastroplastia vertical com banda devido à necessidade do uso de um anel de silicone inflável, que pode trabalhar como um corpo estranho no organismo e gerar complicações no pós-operatório, mesmo depois de anos (Elias et al, 2011;SBCBM, 2020b).…”

Silastic band erosion in the bypassed stomach after Fobi-Pouch operation for obesity: Case report

“…Complications related to the presence of a foreign body for weight loss therapy include displacement, erosion, narrowing, opening and inadequacy. Erosion of a silastic band is a rare, well-known complication after a vertical banded gastroplasty, with a reported incidence ranging from 0.9 to 7% [7] . This complication can be expectantly managed or through open, laparoscopic or endoscopic removal.…”

“…Articles reporting complications associated to the silastic ring vertical gastric bypass exist in the literature [6] , [7] , however, articles reporting erosion of the silastic marker in the bypassed stomach were not found during our review of the literature. We present the first case of a patient with upper gastrointestinal bleeding due to an eroded silastic marker in the excluded stomach managed at an academic institution.…”