Abstract:OBJETIVO: O objetivo deste estudo foi descrever os principais aspectos radiológicos encontrados nas obstruções intestinais pós-operatórias em pacientes submetidos a derivação gastrintestinal em Y de Roux pela técnica de Higa. MATERIAIS E MÉTODOS: Foram estudados 10 pacientes com obstrução intestinal no pós-operatório de gastroplastia redutora, examinados entre novembro de 2001 e abril de 2006. Os casos foram obtidos em sete instituições hospitalares distintas. RESULTADOS: Nos 10 pacientes, a obstrução ocorreu … Show more
“…In this prospective study, we investigated the value of contrast-enhanced MDCT in identifying postoperative complications of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy in symptomatic patients. According to multiple previous studies contrastenhanced CT imaging is considered the method of choice for investigation of abdominal symptoms, especially of patients undergoing gastric bypass [36][37][38]. Merckle et al [39] reported that CT can provide a detailed view of the anatomy after Roux-en-Y gastric bypass.…”
Background: To assess the role of contrast-enhanced multidetector computed tomography (MDCT) in the assessment of symptomatic patients following laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy. Results: We reviewed the studies of 129 cases and found complications in 113 patients: 55 early complications and 48 late complications. All of these complications were diagnosed with intravenous contrast-enhanced MDCT. Statistically significant difference was found between UGIS and MDCT in the diagnosis of many cases. Conclusion: The rate of complications in bariatric surgery is high and the associated mortality is not negligible. The interpreting radiologists should know the normal postoperative findings and be aware of possible complications.
“…In this prospective study, we investigated the value of contrast-enhanced MDCT in identifying postoperative complications of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy in symptomatic patients. According to multiple previous studies contrastenhanced CT imaging is considered the method of choice for investigation of abdominal symptoms, especially of patients undergoing gastric bypass [36][37][38]. Merckle et al [39] reported that CT can provide a detailed view of the anatomy after Roux-en-Y gastric bypass.…”
Background: To assess the role of contrast-enhanced multidetector computed tomography (MDCT) in the assessment of symptomatic patients following laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy. Results: We reviewed the studies of 129 cases and found complications in 113 patients: 55 early complications and 48 late complications. All of these complications were diagnosed with intravenous contrast-enhanced MDCT. Statistically significant difference was found between UGIS and MDCT in the diagnosis of many cases. Conclusion: The rate of complications in bariatric surgery is high and the associated mortality is not negligible. The interpreting radiologists should know the normal postoperative findings and be aware of possible complications.
“…18 Pacientes com sintomas abdominais inespecíficos e vagos devem ser prontamente submetidos à tomografia com contraste que, além de diagnosticar a obstrução, permite avançar na etiologia diagnóstica, sendo indicativa de hérnias. 19 Embora esse estudo não trate especificamente de pacientes de cirurgia bariátrica, existe coincidência entre as causas aqui encontradas e aquelas presentes em pacientes que se submetem à cirurgia, segundo a literatura. 18 Entre os homens, nota-se um aumento da gama de causas de morte, o que é esperado em um contexto de transição epidemiológica.…”
Objetivo: Avaliar as taxas de mortalidade e o perfil de óbitos com menção, na declaração de óbito, de “obesidade” e “reação anormal ou complicação tardia, por procedimentos médicos, sem menção de acidente ao tempo do procedimento”, causas consideradas evitáveis. Método: Estudo transversal de óbitos de 2004 a 2014, de residentes de Minas Gerais, obtidos no DATASUS com as causas mencionadas. Realizaram-se estudos descritivos e os testes t de Student, χ2 ou Fisher e Wilcoxon Mann-Whitney. Resultados: Em 2004, o número de óbitos por ambas as causas foi 25 para mulheres e 13 para homens; em 2014 foram 43 (aumento de 72%) e 25 (aumento de 92%), respectivamente. Em 2014 houve predomínio de doenças dos aparelhos circulatório (homens) e digestório (mulheres; aumento de 3 para 10 óbitos). A taxa de mortalidade passou, no período, de 0,19 para 0,32/100 mil para homens (15 a 84 anos); de 0,39 para 0,68/100 mil para mulheres (15 a 79 anos). Para mulheres, houve aumento na proporção de óbitos em ambiente hospitalar (p=0,031). A média de idade desses óbitos variou de 48,4 (DP=15,5) para mulheres em 2014 a 51,4 (DP=14,7) para homens no mesmo ano. Conclusão: A obesidade associou-se ao aumento na taxa de mortalidade. As doenças dos aparelhos circulatório e digestório acompanharam esse aumento. Destacam-se a ocorrência em mulheres antes dos 40 anos e serem causas evitáveis. Mulheres obesas que necessitam de cirurgia requerem atenção especial. É possível que haja associação com cirurgias bariátricas, o que requer novas investigações.
“…Adhesions were found in 0.42% of the patients in this research. In a study performed with a sample of 10 acute abdomen patients, three of them had adhesions as the cause, showing that it is an important cause of bowel obstruction 13 .…”
Background: The actual gold standard technique for obesity treatment is the Roux-en-Y gastric
bypass. However, complications may occur and the surgeon must be prepared for
them. Aim: To evaluate retrospectively the complications occurrence and associated factors in
patients who underwent bariatric surgery. Methods: In this study, 469 medical charts were considered, from patients and from data
collected during outpatient consultations. The variables considered were gender,
age, height, pre-operatory BMI, pre-operatory weight, pre-operatory comorbidities,
time of hospital stay, postoperative complications that demanded re-admission to
the hospital and the time elapsed between the procedure and the complication. The
patients' follow up was, at least, one year. Results: The incidence of postoperative complications that demanded a hospital care was
24,09%. The main comorbidity presented in this sample was hepatic steatosis. The
comorbidity that was associated with the postoperative period was type 2 diabetes.
There was a tendency for the female gender be related to the complications. The
cholecystectomy was the most frequent complication. Complications occurred during
the first year in 57,35%. Conclusion: The most frequent complication was the need to perform a cholecystectomy, where
the most frequent comorbidity was hepatic steatosis. Over half the complications
occurred during the first year postoperatively. Type 2 diabetes was associated
with the occurrence of postoperative complications; women had the highest
incidence; body mass index was not associated with the occurrence of
complications.
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