1
|
Sheikhbahaei E, Tavassoli Naini P, Agharazi M, Pouramini A, Rostami S, Bakhshaei S, Valizadeh R, Heshmat Ghahdarijani K, Shiravi A, Shahabi S. Cardiac fat pat change after laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis. Surg Obes Relat Dis 2022; 19:653-664. [PMID: 36681624 DOI: 10.1016/j.soard.2022.12.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/08/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022]
Abstract
Cardiac fat pad is a metabolically active organ that plays a role in energy homeostasis and cardiovascular diseases and generates inflammatory cytokines. Many studies have shown remarkable associations between cardiac fat thickness and cardiovascular diseases, making it a valuable target for interventions. Our meta-analysis aimed to investigate the effects of the 2 most popular bariatric surgeries (sleeve gastrectomy [SG] and Roux-en-Y gastric bypass [RYGB]) in cardiac fat pad reduction. A systematic review of the literature was done by searching in Scopus, Web of Science, Cochrane, and PubMed for articles published by September 16, 2022. This review followed the meta-analysis rules based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Nineteen studies met the inclusion criteria out of 128 potentially useful studies, including a total number of 822 patients. The results of subgroup analysis on the type of surgery showed that bariatric surgeries decreased the mean fat pad diameter, but the reduction was greater in SG than in RYGB. Epicardial and pericardial fat type showed a significant decrease of fat pad diameter. The results of subgroup analysis indicated RYGB had a significant reduction in mean fat pad volume. Computed tomography scan and cardiac magnetic resonance imaging showed a significant reduction of the mean cardiac fat pad volume. Epicardial and paracardial fat type showed a significant decrease in volume. The cardiac fat pad diameter and volume were significantly reduced after bariatric surgeries. SG showed greater reduction in fat pad diameter in comparison with RYGB, and RYGB had a significant reduction in mean fat pad volume.
Collapse
Affiliation(s)
- Erfan Sheikhbahaei
- Isfahan Minimally Invasive Surgery and Obesity Research Center, Alzahra University Hospital, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Mohammad Agharazi
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Pouramini
- Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepehr Rostami
- Student Research Committee, Dnipro Medical Institute of Conventional and Traditional Medicine, Dnipro, Ukraine
| | | | - Rohollah Valizadeh
- Department of Epidemiology and Biostatistics, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran
| | - Kiyan Heshmat Ghahdarijani
- Isfahan Cardiovascular Research Center, Chamran University Hospital, Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amirabbas Shiravi
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahab Shahabi
- Department of Surgery, Minimally Invasive Surgery Research Center, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
2
|
Shetye B, Hamilton FR, Bays HE. Bariatric surgery, gastrointestinal hormones, and the microbiome: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022. OBESITY PILLARS (ONLINE) 2022; 2:100015. [PMID: 37990718 PMCID: PMC10661999 DOI: 10.1016/j.obpill.2022.100015] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 03/26/2022] [Indexed: 11/23/2023]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) is intended to provide clinicians an overview of bariatric surgery (i.e., bariatric procedures that improve metabolic disease are often termed "metabolic and bariatric surgery"), gastrointestinal hormones, and the microbiome as they relate to patients with obesity. Methods The scientific information for this CPS is based upon published scientific citations, clinical perspectives of OMA authors, and peer review by the Obesity Medicine Association leadership. Results This CPS includes the pros and cons of the most common types of bariatric procedures; the roles of gastrointestinal (GI) hormones in regulating hunger, digestion, and postabsorptive nutrient metabolism; and the microbiome's function and relationship with body weight. This CPS also describes patient screening for bariatric surgery, patient care after bariatric surgery, and treatment of potential nutrient deficiencies before and after bariatric surgery. Finally, this CPS explores the interactions between bariatric surgery, GI hormones, and the microbiome. Conclusions This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) regarding bariatric surgery, gastrointestinal hormones, and the microbiome is one of a series of OMA CPSs designed to assist clinicians in the care of patients with the disease of obesity. Implementation of appropriate care before and after bariatric surgery, as well as an awareness of GI hormones and the microbiome, may improve the health of patients with obesity, especially patients with adverse fat mass and adiposopathic metabolic consequences.
Collapse
Affiliation(s)
- Bharti Shetye
- Diplomate American Board of Obesity Medicine, Medical Director, Dr. Abby's Weight Management Clinic, 6101 Webb Road, Suite 207, Tampa, FL, 33615, USA
| | - Franchell Richard Hamilton
- Diplomate American Board of Obesity Medicine, A Better Weigh Center, 8865 Davis Blvd Ste 100, Keller, TX, 76248, USA
| | - Harold Edward Bays
- Diplomate American Board of Obesity Medicine, Louisville Metabolic and Atherosclerosis Research Center, University of Louisville School of Medicine, 3288 Illinois Avenue, Louisville, KY, 40213, USA
| |
Collapse
|
3
|
DE-Cleva R, Cardia L, Vieira-Gadducci A, Greve JM, Santo MA. LACTATE CAN BE A MARKER OF METABOLIC SYNDROME IN SEVERE OBESITY? ACTA ACUST UNITED AC 2021; 34:e1579. [PMID: 34133526 PMCID: PMC8195466 DOI: 10.1590/0102-672020210001e1579] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/16/2020] [Indexed: 02/06/2023]
Abstract
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.
Collapse
Affiliation(s)
- Roberto DE-Cleva
- Department of Gastroenterology, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Lilian Cardia
- Department of Gastroenterology, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | | | - Julia Maria Greve
- Department of Orthopedics and Traumatology, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Marco Aurelio Santo
- Department of Gastroenterology, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
4
|
Guimarães M, Osório C, Silva D, Almeida RF, Reis A, Cardoso S, Pereira SS, Monteiro MP, Nora M. How Sustained is Roux-en-Y Gastric Bypass Long-term Efficacy? : Roux-en-Y Gastric Bypass efficacy. Obes Surg 2021; 31:3623-3629. [PMID: 34021884 PMCID: PMC8270797 DOI: 10.1007/s11695-021-05458-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/21/2021] [Accepted: 04/27/2021] [Indexed: 11/28/2022]
Abstract
Purpose The rate of weight regain after Roux-en-Y Gastric Bypass (RYGB) can hamper the procedure long-term efficacy for obesity treatment and related comorbidities. To evaluate the rate of weight loss and comorbidity remission failure 10 years or more after RYGB surgery. Materials and methods Retrospective observational cohort study. Patients submitted to RYGB for obesity treatment at a single centre with 10 years or more after surgery underwent a clinical reassessment. Results Among the subjects invited for clinical revaluation (n = 585), only those who performed RYGB and attended the hospital visit were included in the study (n = 281). The pre-operative mean body mass index (BMI) was 44.4 ± 6.1 kg/m2. Mean post-operative time was 12.2 ± 1.1 years. After surgery, mean BMI was significantly lower 33.4 ± 5.8 kg/m2 (p < 0.0001), 29.5% with a BMI < 30 kg/m2. Mean Total Weight Lost (%TWL) was 24.3 ± 11.4%, reaching a %TWL ≥ 20% in 70.1% with a mean %TWL of 30.0 ± 7.0%. Co-morbidities remission rate was 54.2% for type 2 diabetes, 34.1% for hypertension, 52.4% for hyperlipidemia and 50% for obstructive sleep apnea. Early complications rate was 13.2% and revision surgery occurred in 2.8% of patients. Four patients died of RYGB complications within the first 90 days after surgery. Conclusion RYGB has a high rate of long-term successful weight loss and obesity-associated comorbidity improvement. Weight loss failure requiring revision surgery occurs in a small proportion of patients. Our data confirms the long-term effectiveness of RYGB as primary bariatric intervention. Graphical abstract ![]()
Collapse
Affiliation(s)
- Marta Guimarães
- Endocrine, Cardiovascular & Metabolic Research, Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal. .,Department of Anatomy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Jorge Viterbo Ferreira 228, Building 1.3, 4050-313, Porto, Portugal. .,Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Cândido Pinho, Santa Maria da Feira, Portugal.
| | - Catarina Osório
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Cândido Pinho, Santa Maria da Feira, Portugal
| | - Diogo Silva
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Cândido Pinho, Santa Maria da Feira, Portugal
| | - Rui F Almeida
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Cândido Pinho, Santa Maria da Feira, Portugal
| | - António Reis
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Cândido Pinho, Santa Maria da Feira, Portugal
| | - Samuel Cardoso
- Department of Anatomy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Jorge Viterbo Ferreira 228, Building 1.3, 4050-313, Porto, Portugal
| | - Sofia S Pereira
- Endocrine, Cardiovascular & Metabolic Research, Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal.,Department of Anatomy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Jorge Viterbo Ferreira 228, Building 1.3, 4050-313, Porto, Portugal
| | - Mariana P Monteiro
- Endocrine, Cardiovascular & Metabolic Research, Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal.,Department of Anatomy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Jorge Viterbo Ferreira 228, Building 1.3, 4050-313, Porto, Portugal
| | - Mário Nora
- Endocrine, Cardiovascular & Metabolic Research, Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal.,Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Cândido Pinho, Santa Maria da Feira, Portugal
| |
Collapse
|
5
|
Lima RCD, Rodrigues TMDS, Scheibe CL, Campelo GP, Pinto LEV, Valadão GJC, Carvalho GPCD, Machado Junior MRD, Valadão JA, Lima PCRD, Leal PDC, Oliveira CMBD, Moura ECR. Weight loss and adherence to postoperative follow-up after vertical gastrectomy for obesity treatment. Acta Cir Bras 2021; 36:e360203. [PMID: 33624720 PMCID: PMC7902054 DOI: 10.1590/acb360203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 01/11/2021] [Indexed: 11/22/2022] Open
Abstract
Purpose To analyze the effectiveness of vertical gastrectomy in the treatment of
obese patients, adherence to clinical follow-up and the influence of factors
such as gender and age. Methods This is a retrospective, observational and descriptive study, conducted with
patients undergoing vertical gastrectomy, operated at Hospital São Domingos,
between January 2016 and July 2018. Results Most patients undergoing vertical gastrectomy were female (n = 193, 72.28%)
and had a mean age of37.11 ± 8.96 years old. The loss of follow-up was
56.18%. Among adherent patients (n = 117; 43.82%), most patients were female
(n = 89; 76.07%) and had a mean age of 37.92 ± 9.85 years old. The mean body
mass index (BMI) of the adherents in the preoperative was 37.85 ± 3.72
kg/m2. Both BMI and excess weight (EW) showed a statistically
significant difference between pre- and postoperative period. Percentage of
excess weight loss (% EWL) was satisfactory for 96.6% of adherent patients.
Older patients had a statistically significant lower % EWL compared to the
other groups. Conclusions Vertical gastrectomy was effective in the treatment of obese patients, with
significant weight loss.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Plinio da Cunha Leal
- Universidade Federal de São Paulo, Brazil; Universidade Federal do Maranhão, Brazil
| | | | - Ed Carlos Rey Moura
- Universidade Federal de São Paulo, Brazil; Universidade Federal do Maranhão, Brazil
| |
Collapse
|
6
|
Goldoni MB, Fontes PRO, GuimarÃes MM, Diedrich-Neto JA, Nogueira T, Teixeira UF, Giacomazzi CB, Kiss G, Pioner SR, Rodrigues PD. BYPASS VS. SLEEVE AND ITS EFFECTS IN NON-ALCOHOLIC FATTY LIVER DISEASE: WHAT IS THE BEST TECHNIQUE? ACTA ACUST UNITED AC 2021; 33:e1549. [PMID: 33470379 PMCID: PMC7812689 DOI: 10.1590/0102-672020200003e1549] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/16/2020] [Indexed: 02/06/2023]
Abstract
Background:
Strongly associated with obesity, non-alcoholic fatty liver disease is
considered the hepatic manifestation of the metabolic syndrome. It presents
as simple steatosis and steatohepatitis, which can progress to cirrhosis and
its complications. Among the therapeutic alternatives is bariatric surgery.
Aim:
To compare the effect of the two most frequent bariatric procedures (sleeve
and bypass) on liver disease regarding to epidemiological, demographic,
clinical and laboratory parameters.
Methods:
The results of intraoperative and 12 months after surgery liver biopsies were
used. The NAFLD activity score (NAS) was used to assess and compare the
stages of liver disease.
Results:
Sixteen (66.7%) patients underwent Bypass procedure and eight (33.3%) Sleeve.
It was observed that the variation in the NAFLD activity score was
significantly greater in the Bypass group than in Sleeve (p=0.028) and there
was a trend regarding the variation in fibrosis (p=0.054).
Conclusion:
Both surgical techniques were effective in improving the hepatic histology of
most operated patients. When comparing sleeve and bypass groups, bypass
showed better results, according to the NAS score.
Collapse
Affiliation(s)
| | | | | | | | - Tiele Nogueira
- Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil
| | | | | | - Guillermo Kiss
- Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
| | | | | |
Collapse
|
7
|
Gastric Fistula After Sleeve Gastrectomy: Clinical Features and Treatment Options. Obes Surg 2020; 31:1196-1203. [PMID: 33222105 DOI: 10.1007/s11695-020-05115-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/04/2020] [Accepted: 11/10/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To trace the clinical profile of fistula cases after sleeve gastrectomy (SG) and evaluate the efficacy and safety of endoscopic treatments and the admission costs of these patients. METHODS This is a retrospective study of patients who developed gastric fistulas after SG. All patients were submitted to surgical and/or endoscopic interventions (self-expandable stent, septotomy, and balloon dilation). The main studied variables were need for reoperation, number of endoscopic procedures, endoscopic complications, time until fistula diagnosis, fistula location, time until resolution, length of hospital stay, and health costs. RESULTS The sample was mainly female (76.2%) with a mean age of 39.5 years and a BMI of 39.6 kg/m2. In 90.5% of cases, the fistula occurred in the topography of the His angle. Thirteen patients required surgical intervention. Of the patients who underwent endoscopic interventions, it was necessary to place more than one self-expandable stent of a maximum duration of 4 weeks. Six patients underwent more than two sessions of septotomy. There was one case of bleeding after septotomy. Dilatation was required in 71.4% of patients and an average of two sessions (1-5) per patient. The diagnosis of fistula occurred 14.4 days after surgery. The average time to resolve fistulas was 50.6 days. The average hospital stay was 75.8 days. The total cost of hospitalization was on average US$ 75,180.00. CONCLUSION The surgical and endoscopic treatment of gastric fistulas after SG was safe and effective. There was a very low rate of complications. The time of onset of fistulas was not decisive for patient improvement.
Collapse
|
8
|
Lucas RWDC, Nassif PAN, Tabushi FI, Nassif DSB, Ariede BL, Brites-Neto J, Malafaia O. CAN STATURE, ABDOMINAL PERIMETER AND BMI INDEX PREDICT POSSIBLE CARDIOMETABOLIC RISKS IN FUTURE OBESITY? ACTA ACUST UNITED AC 2020; 33:e1529. [PMID: 33237167 PMCID: PMC7682149 DOI: 10.1590/0102-672020200002e1529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 05/29/2020] [Indexed: 01/26/2023]
Abstract
Background:
Obesity changes the anatomy of the patient. In addition to the aesthetic
change, the high percentage of fat determines evident functional changes.
Anthropometric normality in measuring abdominal circumference and height can
serve as a basis for measuring cardiometabolic risks of obesity.
Aim:
To verify if it is possible to determine parameters of normality between
waist and height in people with normal BMI and fat percentages, to serve as
a basis for assessing risks for obesity comorbidities.
Methods:
A sample of 454 individuals with BMI and percentages of fat considered within
the normal range was extracted. It was divided into age groups for both men
and women between 18 and 25; 26 to 35; 36 to 45; 46 to 55; 56 to 65. A total
of 249 men and 205 women were included.
Results:
Regarding the percentage of height as a measure of the abdominal perimeter,
the total female sample had an average of 44.2±1.1% and the male 45.3%+1.5.
For women, this percentage determined the equation of the waist-height ratio
represented by X=(age+217) / 5.875, and for men X=(age+190.89) / 5.2222. “X”
represents the percentage of the height measurement so that the individual
falls into the category of adequate percentage of fat and BMI.
Conclusion:
Between the stature of adult men and women with normal fat percentage and
BMI, there is a common numerical relationship, with is on average 44% for
women and 45% for men.
Collapse
Affiliation(s)
- Ricardo Wallace das Chagas Lucas
- Postgraduate Program in Principles of Surgery, Mackenzie Evangelical Faculty of Paraná/Medical Research Institute, Curitiba, PR, Brazil
| | - Paulo Afonso Nunes Nassif
- Postgraduate Program in Principles of Surgery, Mackenzie Evangelical Faculty of Paraná/Medical Research Institute, Curitiba, PR, Brazil.,Paulo Nassif Institute, Curitiba, PR, Brazil.,Bariatric and Metabolic Surgery Service, University Evangelical Mackenzie Hospital, Curitiba, PR, Brazil
| | | | - Denise Serpa Bopp Nassif
- Postgraduate Program in Principles of Surgery, Mackenzie Evangelical Faculty of Paraná/Medical Research Institute, Curitiba, PR, Brazil.,Paulo Nassif Institute, Curitiba, PR, Brazil
| | | | | | - Osvaldo Malafaia
- Postgraduate Program in Principles of Surgery, Mackenzie Evangelical Faculty of Paraná/Medical Research Institute, Curitiba, PR, Brazil.,Bariatric and Metabolic Surgery Service, University Evangelical Mackenzie Hospital, Curitiba, PR, Brazil
| |
Collapse
|
9
|
ValadÃo JA, Leal PDC, Oliveira EJSGD, Torres OJM, Pinto LEV, Marchi DDD, Gama-Filho OP, Santo MA, Nassif PAN. VERTICAL GASTRECTOMY VS. EXTENDED VERTICAL GASTRECTOMY: WHAT IS THE IMPACT ON GASTROESOPHAGEAL REFLUX DISEASE IN OBESE RATS? ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2020; 33:e1513. [PMID: 32844876 PMCID: PMC7448852 DOI: 10.1590/0102-672020190001e1513] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 03/26/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Extended vertical gastrectomy is a variation of the vertical gastrectomy technique requiring studies to elucidate safety in relation to gastroesophageal reflux. AIM To analyze comparatively vertical gastrectomy (VG) and extended vertical gastrectomy (EVG) in rats with obesity induced by cafeteria diet in relation to the presence of reflux esophagitis, weight loss and macroscopic changes related to the procedures. METHODS Thirty Wistar rats were randomized into three groups, and after the obesity induction period by means of a 28-day cafeteria diet, underwent a simulated surgery (CG), VG and VGA. The animals were followed up for 28 days in the post-operative period, and after euthanasia, the reflux esophagitis evaluation was histopathologically performed. Weight and macroscopy were the other variables; weight was measured weekly and the macroscopic evaluation was performed during euthanasia. RESULTS All animals presented some degree of inflammation and the presence of at least one inflammation criterion; however, there was no statistically significant difference in the analysis among the groups. In relation to weight loss, the animals in CG showed a gradual increase during the whole experiment, evolving to super-obesity at the end of the study, while the ones with VG and EVG had weight regain after the first post-operative period; however, a less marked regain compared to CG, both for VG and EVG. CONCLUSION There is no difference in relation to reflux esophagitis VG and EVG, as well as macroscopic alterations, and both techniques have the ability to control the evolution of weight during postoperative period in relation to CG.
Collapse
Affiliation(s)
- José Aparecido ValadÃo
- Postgraduate Program in Principles of Surgery, Medical Research Institute, Evangelic Mackenzie Faculty of Paraná, Curitiba, PR, Brazil
| | | | | | | | | | | | | | - Marco Aurelio Santo
- Department of Gastroenterology, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Paulo Afonso Nunes Nassif
- Postgraduate Program in Principles of Surgery, Medical Research Institute, Evangelic Mackenzie Faculty of Paraná, Curitiba, PR, Brazil
| |
Collapse
|