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    Estudo comparativo entre derivação gástrica em Y de Roux e derivação gástrica em anastomose única em relação ao refluxo biliar e outros resultados, até 6 meses da cirurgia bariátrica
    (Universidade Federal de São Paulo (UNIFESP), 2020-12-18) Katayama, Rafael Caue [UNIFESP]; Lopes Filho, Gaspar De Jesus [UNIFESP]; Universidade Federal de São Paulo
    Objectives: This paper intends to compare One Anastomosis Gastric Bypass (OAGB) with Roux-en-Y Gastric Bypass (RYGB) in terms of biliary reflux, effectiveness and complications. Methods: Twenty patients with morbid obesity were randomized in two groups with ten members. One group was submitted to OAGB and the other to RYGB. We carry out clinical study using the Short Form Healthy Survey 36 (SF-36) questionnaire and patient satisfaction with Visick scale. Upper digestive endoscopy was performed in the preoperative and after three and six months with gastric and esophageal biopsies for posterior histophatological analysis. Results: After six months, the weight loss was equal among the groups (Group OAGB: 43,17 ± 3,74 kg/m² preoperative, 32,05 ± 4,49 kg/m² after 6 months; Group RYGB: 43,06 ± 3,88 kg/m² postoperative, 31,83 ± 3,92 kg/m² after 6 months; p=0,88), just as the satisfaction with the surgery and the improvement of life quality evaluated by the Visick scale and SF 36 questionnaire applied before six months. We did not have major complications postoperatively. The total surgical time was considerably shorter in the OAGB Group, with 78,00 ± 13,37 minutes long, comparing to DGYR Group, with 125,50 ± 10,92 minutes long, (p=0,0001). Histopathological study were performed and did not demonstrate statistical difference of the gastric and esophageal inflammation grade after three and six months from the surgery among the groups. However, Glandular cystic degeneration, which can mean biliary reflux, was more frequent in the postoperative period after both procedures (p=0,004). No histopathological changes related to severe bile reflux were observed on postoperative period of both Groups. Conclusion: The procedures are equally effective when analyzing weight loss, patient satisfaction and life quality improvement after six months from the procedures. The inflammation grade and cellular damage in the gastric pouch and in the esophagus were similar in both groups. One Anastomosis Gastric Bypass required significantly shorter operative time than Roux-en-Y Gastric Bypass with similar postoperative complication rates.