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Colegio de Medicos y Cirujanos República de Costa Rica

2014, Number 609

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Rev Med Cos Cen 2014; 71 (609)

Cirugía bariática como modalidad de tratamiento en el paciente con obesidad mórbida

Viloria-González T

Language: Spanish
References: 24
Page: 85-98
PDF size: 704.32 Kb.


ABSTRACT

Bariatric Surgery is an optimal treatment indicated for obese patients with Body Mass Index (BMI) greater than or equal to 40 kg/m2 or BMI ≥ 35 kg/m2 and comorbidities potentially treatable by the means of a surgical procedure. There are over 200.000 bariatric procedures performed yearly in the United States, mostly for women carrying morbid obesity (class III or BMI ≥40 kg/m2). Bariatric Surgery is classified as restrictive, malabsorptive or a third type which is a combination of the previous. Malabsorptive procedures accomplish a greater degree of weight loss, but they feature as the ones associated with a greater risk of nutritional deficiencies. Presurgical assessment of these patients requires the assembling of a multidisciplinary team. Therapeutical failure presents when less than a 40% of weight loss over the ideal weight is achieved after the surgery. Patients must be also warned about a 5-7% of weight regain expectable during the first 5 years after surgery. Mortality rates linked to Bariatric Surgery are as low as 0.78%, and the possible rewards achieved include: a decrease in the odds of developing cancer up to 85%, a decrease in adverse cardiovascular events and the remission of type 2 diabetes mellitus in 95% of diabetic patients who have undergone operation, provided that they constitute young adults with an evolution of their diabetes lesser than 5 years.


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