Laparoscopic Gastric Bypass: Development of Technique, Respiratory Function, and Long-Term Outcome

Olbers, Torsten; Lönroth, Hans; Fagevik-Olsén, Monika; Lundell, Lars

doi:10.1381/096089203765887679

Cited by 188 publications

(117 citation statements)

References 19 publications

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“…No entanto, este foi equivalente aos dias de internação hospitalar, período no qual a fisioterapia respiratória é rotineiramente aplicada na prática clínica. Outros autores, com o objetivo de avaliar os efeitos da fisioterapia respiratória em pacientes submetidos à cirurgia bariátrica por videolaparoscopia, também adotaram um período de intervenção de 2 a 3 dias 3,29 .…”

Section: Discussionunclassified

Comparação entre inspirometria de incentivo e pressão positiva expiratória na função pulmonar após cirurgia bariátrica

et al. 2009

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RESUMO: O objetivo deste estudo foi comparar o efeito da pressão positiva expiratória (EPAP, na sigla em inglês) e da inspirometria de incentivo a fluxo sobre a função pulmonar após o bypass gástrico em Y de Roux por videolaparoscopia. Participaram 28 mulheres, não-tabagistas e não-pneumopatas, com índice de massa corporal entre 35 e 50 kg/m 2 , submetidas à cirurgia bariátrica. Todas foram avaliadas por espirometria, cirtometria toracoabdominal e quanto à mobilidade diafragmática no pré e segundo dia de pós-operatório (o tempo de internação foi de 2 dias). Foram divididas em dois grupos, GI -grupo inspirômetro (n=13) e GE, grupo EPAP (n=15). A fisioterapia foi iniciada no dia da cirurgia, cada técnica, inspirometria ou EPAP, com duração de 15 minutos; a fisioterapia motora foi padronizada para ambos os grupos. No pós-operatório, houve redução similar nos dois grupos das variáveis: capacidade vital, volume de reserva inspiratório, capacidade vital forçada e ventilação voluntária máxima. Não houve alteração nos valores do volume corrente no GI e volume de reserva expiratório no GE. A mobilidade diafragmática e a mobilidade toracoabdominal foram menos prejudicadas no GI. No pós-operatório da cirurgia bariátrica por videolaparoscopia, a inspirometria de incentivo a fluxo exerceu melhores efeitos na manutenção do volume corente, na mobilidade diafragmática e toracoabdominal, enquanto a EPAP foi mais eficaz no restabelecimento do volume de reserva expiratório. DESCRITORES: Cirurgia bariátrica; Exercícios respiratórios; Fisioterapia (Especialidade); Obesidade ABSTRACT: The aim of this study was to compare the effect of expiratory positive airway pressure (EPAP) and flow-oriented incentive spirometry on pulmonary function after laparoscopic Roux-en-Y gastric bypass surgery. Twenty-eight non-smoking women, with no lung disease and body mass index of 35 to 50 kg/m 2 , undergoing laparoscopic gastric bypass surgery (hospitalized for two days) were assessed by spirometry, thoracoabdominal cirtometry and as to diaphragmatic motion prior to, and on the second post-operative day. Before surgery patients were divided into two groups, SG -spirometer group (n=13), and EG -EPAP group (n=15). Motor physical therapy was standardized for both groups; respiratory therapy (both modalities) started on the day of surgery, in 15-minute sessions. Post-operative results showed similar reduction, in both groups, in the values of vital capacity, forced vital capacity, maximum voluntary ventilation, and inspiratory reserve volume. No changes were found in tidal volume values in SG, neither in expiratory reserve volume in EG. Diaphragmatic and thoracoabdominal motion were less harmed in SG. After bariatric surgery thus incentive spirometry had better effect in maintaining tidal volume, as well as on diaphragmatic and thoracoabdominal motion; while EPAP proved more efficient in re-establishing expiratory reserve volume in the postoperative period.

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Section: Discussionunclassified

Comparação entre inspirometria de incentivo e pressão positiva expiratória na função pulmonar após cirurgia bariátrica

et al. 2009

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“…The operative RYGB technique, as described in detail elsewhere, 26 included an antecolicantegastric Roux-en-Y construction with a 10 to 20 ml gastric pouch and a 100 -150 cm Roux limb and no aim at restricting the gastro-jejunal anastomosis.…”

Section: Operation Techniquementioning

confidence: 99%

Changes in eating behaviour and meal pattern following Roux-en-Y gastric bypass

et al. 2011

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Background: Little is known about eating behaviour and meal pattern subsequent to Roux-en-Y gastric bypass (RYGB), knowledge important for the nutritional care process. The objective of the study was to obtain basic information of how meal size, eating rate, meal frequency and eating behaviour change upon the RYGB surgery. Materials and methods: Voluntary chosen meal size and eating rate were measured in a longitudinal, within subject, cohort study of 43 patients, 31 women and 12 men, age 42.6 (s.d. 9.7) years, body mass index (BMI) 44.5 (4.9) kg m À2 . Thirty-one non-obese subjects, 37.8 (13.6) years, BMI 23.7 (2.7) kg m À2 served as a reference group. All subjects completed a meal pattern questionnaire and the Three-Factor Eating Questionnaire (TFEQ-R21). Results: Six weeks postoperatively meal size was 42% of the preoperative meal size, (Po0.001). After 1 and 2 years, meal size increased but was still lower than preoperative size 57% (Po0.001) and 66% (Po0.001), respectively. Mean meal duration was constant before and after surgery. Mean eating rate measured as amount consumed food per minute was 45% of preoperative eating rate 6 weeks postoperatively (Po0.001). After 1 and 2 years, eating rate increased to 65% (Po0.001) and 72% (Po0.001), respectively, of preoperative rate. Number of meals per day increased from 4.9 (95% confidence interval, 4.4,5.4) preoperatively to 6 weeks: 5.2 (4.9,5.6), (not significant), 1 year 5.8 (5.5,6.1), (P ¼ 0.003), and 2 years 5.4 (5.1,5.7), (not significant). Emotional and uncontrolled eating were significantly decreased postoperatively, (both Po0.001 at all-time points), while cognitive restraint was only transiently increased 6 weeks postoperatively (P ¼ 0.011). Conclusions: Subsequent to RYGB, patients display markedly changed eating behaviour and meal patterns, which may lead to sustained weight loss.

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“…Methodological constraints which prevented documentation of the full cohort of subjects are also a weak point in this model. Still it was rather striking to register that neither esophagogastric nor hepatobiliary abnormalities were appreciably corrected by operation, differently from what is known for diabetes, arterial hypertension and other comorbidities of advanced obesity (3,6,7,19,21,28) . Although publications regarding digestive derangements are indeed scarce, there are reasons to believe that they belong to a different category concerning comorbidities, one of the few that are not defi nitely improved by weight loss and normalization of body composition.…”

Section: Discussionmentioning

confidence: 85%

“…It is possible, for didactic reasons, to divide as early and late the complications of anti-obesity procedures. The former should mention intra-operative accidents and mortality, and peri-operative morbidity (19,32) and mortality (9,33) . The latter would focus inappropriate long-term weight loss, malnutrition (8) and many other derangements, including psychiatric illness on a few susceptible subjects -mainly those with prior psychiatric history (7,24) .…”

Section: Introductionmentioning

confidence: 99%

Endoscopic and ultrasonographic evaluation before and after Roux-en-Y gastric bypass for morbid obesity

Teivelis

Faintuch

Ishida

et al. 2007

Arq. Gastroenterol.

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Laparoscopic Gastric Bypass: Development of Technique, Respiratory Function, and Long-Term Outcome

Cited by 188 publications

References 19 publications

Comparação entre inspirometria de incentivo e pressão positiva expiratória na função pulmonar após cirurgia bariátrica

Comparação entre inspirometria de incentivo e pressão positiva expiratória na função pulmonar após cirurgia bariátrica

Changes in eating behaviour and meal pattern following Roux-en-Y gastric bypass

Endoscopic and ultrasonographic evaluation before and after Roux-en-Y gastric bypass for morbid obesity

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