Arizmendi GA, Quero SF, Rubio OMS, López GMMC, Garza TC

Language: Spanish
References: 17
Page: 10-17
PDF size: 213.43 Kb.

ABSTRACT

Background: Overweight and obesity is major worldwide problem in public health, reaching epidemic proportions in many countries. In Mexico, more than 70% of the adult population between thirty and sixty years old are considered to be overweight or obese. It is estimated that in Mexico, the attention of diseases caused by obesity and overweight has an approximate annual cost of 3.5 billion dollars. Objective: Describe, compare and constrast prospectively the results of three surgical procedures realized in Centro Medico ISSEMYM Ecatepec (CMIE) from 2011 to 2013. Material and methods: From February 2011 to April 2013, ninety patients who had surgical criteria for bariatric surgery underwent surgery. The patients in this study sample were selected randomly, being divided in three surgical groups. The performed procedures were LRYGB in group A, LSG in group B, and LGP in group C. Age, sex, BMI, comorbidities, clinical improvement, surgical time, hospital stay length, complications and percentage of excess weight loss were analyzed, in a year and a half of medical follow up. Results: The majority of patients in the study sample were women. Thirty patients underwent surgery for each group, A, B, and C. In group A, the BMI was 43.77, group B 44.91, and group C 47.34. All patients in the sample, had some comorbidity, DM2, HAS, SAOS, mixed dyslipidemia. The resolution for comorbidities was more significant in LRYGB, and LSG, regarding LGP. The surgical time in group A was 210 minutes, group B in 82.5 minutes, and group C 75 minutes. Hospital stay length for group A was 4 days, group B 3 days and group C 2 days. The complication rate was 26.6% in group A, 20% in group B and 60% in group C, nearly half of the patients presented dilatation of the gastric reservoir. The excess weight loss percentage in group A was 56.5%, in group B 40%, and in group C 20. Group C having a recovery of 50% of the weight lost at 6 months after the surgery was performed. No mortality in either group. Conclusion: Overall, the LRYGB and the LSG seems to be more effective in the sort term for the excess weight loss, compared and contrasted to the LGP. Also, the LRYGB and the LSG have better resolution for diseases with DM2, HAS and dyslipidemia. A consequence of the results in this study, we decided not to perform the procedure LGP anymore, as a surgery to control obesity. Finally, we consider that the LRYGB and the LSG are safe and effective procedures for the morbid obesity and metabolic syndrome management.

REFERENCES

1. González JJ, Sanz L, García C. La obesidad en la historia de la cirugía. Cir Esp. 2008; 84: 188-189.

2. Sainz B. Historia mexicana de la nutrición en cirugía bariátrica. BMI. 2012; 1: 353.

3. Norma Oficial Mexicana NOM-008-SSA3-2010, Para el tratamiento integral del sobrepeso y la obesidad.

4. Moreno M. Definición y clasificación de la obesidad. Rev Med Clin Condes. 2012; 23: 124-128.

5. Barrera A, Rodríguez A, Molina MA. Escenario actual de la obesidad en México. Rev Med Inst Mex Seguro Soc. 2013; 51: 292-299.

6. Consensus Development Conference panel. Gastrointestinal surgery for sever obesity. Ann Intern Med. 1991; 115: 956-961.

7. American Association of Clinical Endocrinologist/American College of Endocrinology (AACCE/ACE), Obesity Task Force. AACE/ACE position statements on the prevention, diagnosis and treatment of obesity (1998 revision). Endocr Pract. 1998; 4: 297-350.

8. Presutti RJ, Gorman RS, Swain JM. Primary care perspective on bariatric surgery. Mayo Clin Proc. 2004; 79: 1158-1166.

9. Picot J, Jones J, Colquitt JL et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for morbid obesity: a systematic review and economic evaluation. Health Technol Assess. 2009; 13: 41.

10. Mangol P, Chosidow D, Marmuse J. Laparoscopic sleeve gastrectomy as an initial bariatric operation for high-risk patients: initial result in 10 patients. Obes Surg. 2005; 15: 1030-1033.

11. Han MS, Kim WW, Oh JH. Results of laparoscopic sleeve gastrectomy (LGS), at 1 year in morbidly obese Korean patients. Obes Surg. 2005; 15: 1469-1475.

12. Lee CM, Cirangle PT, Jossart GH. Vertical gastrectomy for morbid obesity in 216 patients; report of two-year results. Surg Endosc. 2007; 21: 1810-1816.

13. Moy J, Pomp A, Dakin A et al. Laparoscopic sleeve gastrectomy for morbid obesity. Am J Surg. 2008; 196: e56-e59.

14. Papailiou J, Konstantinos A, Konstantinos G et al. Morbid obesity and sleeve gastrectomy: how does it work? Obes Surg. 2010; 20: 1448-1455.

15. Torres ME, Ramírez JM, Márquez MA, Rojano ME, Beristaín JL, López S et al. Gastroplicatura laparoscópica como técnica de cirugía bariátrica. Experiencia inicial y revisión de la literatura. Asociación Mexicana de Cirugía Endoscópica. 2011; 12: 58-62.

16. López JA, Guzmán F, Ortega F, Hermosillo C, Calleja C, Torres J. Manga gástrica laparoscópica como procedimiento bariátrico único. Asociación Mexicana de Cirugía Endoscópica. 2008; 9: 165-169.

17. González JR. Bypass gástrico. Tratamiento quirúrgico de la obesidad mórbida. Rev Hosp Jua Mex. 2005; 72: 153-160.