Gastrectomia vertical em septuagenários: um estudo caso controle
Data
2021
Autores
Lacerda, Maurício Rodrigues 
Orientadores
Goldenberg, Alberto
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A cirurgia bariátrica é o tratamento mais efetivo para redução e manutenção do peso perdido a longo prazo. A literatura médica sobre cirurgia bariátrica em idosos é limitada. Objetivo: O objetivo deste estudo é avaliar se há benefícios em realizar a cirurgia de Gastrectomia Vertical (GV) em pacientes com mais de 70 anos de idade e comparar os resultados com um grupo controle mais jovem. Métodos: As informações foram colhidas retrospectivamente de prontuário eletrônico de Clínica Privada de pacientes submetidos a GV entre junho de 2017 e setembro de 2020. Os critérios de inclusão foram pacientes com mais de 70 anos [(grupo Septuagenários (GS)] e submetidos a GV. Os pacientes do grupo controle (GC) foram selecionados com proporção de 1:1 e com idade menor que 60 anos de idade, de acordo com índice de massa corpórea (IMC) e comorbidades. O desfecho primário do estudo foi avaliar a morbidade e mortalidade no período de 30 dias de pós-operatório e a evolução do peso, diabetes mellitus tipo 2 (DM2), hipertensão arterial sistêmica (HAS) e dislipidemia (DLP) após 1 ano de seguimento. Resultados: Cinquenta pacientes foram incluídos no estudo, 25 em cada grupo. Ambos os grupos foram semelhantes em relação ao sexo, peso, IMC e presença de DM2. A morbidade e mortalidade em 30 dias foram semelhantes entre os grupos. O GS perdeu em média 26,9% do peso total inicial (19,1 - 34,2%) semelhante ao GC, com 28,0% (20,9 - 36,9%); (p=0,32). A taxa de remissão de DM2 (50,0% vs. 85,0%) (p=0,01) e HAS (30,0% vs. 64,0%; p=0,04) foi menor para pacientes do GS. Os pacientes do GS tiveram uma redução menor do número de medicamentos para HAS (-59,1% vs. -76,0%; p= 0,05). Conclusão: A cirurgia de gastrectomia vertical em septuagenários apresenta benefícios em relação à perda ponderal e à melhora de comorbidades, comparáveis a pacientes mais jovens.
Introduction: Bariatric surgery is the most effective treatment for long-term body mass index (BMI) reduction and maintenance. Very few studies on bariatric surgery in patients older than 70 years have been published. Objective: The aim of this study is to evaluate whether there are benefits to performing SG surgery in patients over 70 years of age and to compare the results with a younger control group. Method: Data were retrospectively collected from a Private Clinic’s electronic medical records of patients undergoing SG between June 2017 and September 2020. Inclusion criteria were patients older than 70 years (Septuagenarian group) who met all institutional protocols for bariatric surgery and underwent sleeve gastrectomy. Patients in the control group were selected with a 1:1 ratio and under 60 years of age, according to body mass index and comorbidities. The primary endpoint of the study was to evaluate the morbidity and mortality during the 30-day postoperative period and total weight loss, remission, or improvement of diabetes mellitus (DM2), systemic arterial hypertension (SAH), and dyslipidemia (DLP), and reduction in the number of medications used for these diseases when the patient completed 1 year of postoperative follow-up. Results: Fifty patients were included in the study, 25 in each group. Both groups were similar regarding gender, weight, BMI and presence of DM2. The 30-day morbidity and mortality were similar between the groups. The patients in the Septuagenarian group had an average of 65.1% of excess weight loss (%EWL), a result that was similar to the 69.4% of the control group (p=0.20). Regarding the percentage of total weight loss (%TWL), the Septuagenarians group lost an average of 26.9% and the control group, 28% (p= 0.32). The remission rate of DM2 (50% vs. 85% p=0.01) and SAH (30% vs. 64% p=0.04) was lower for septuagenarian patients. In addition, patients in the Septuagenarian group had less reduction in the number of medications for SAH (-59.1% vs. -76.0% p= 0.05). Conclusion: Sleeve Gastrectomy surgery performed in patients over 70 years of age has benefits regarding ponderal loss and improvement of comorbidities, as similarly observed in patients under 60 years of age.
Introduction: Bariatric surgery is the most effective treatment for long-term body mass index (BMI) reduction and maintenance. Very few studies on bariatric surgery in patients older than 70 years have been published. Objective: The aim of this study is to evaluate whether there are benefits to performing SG surgery in patients over 70 years of age and to compare the results with a younger control group. Method: Data were retrospectively collected from a Private Clinic’s electronic medical records of patients undergoing SG between June 2017 and September 2020. Inclusion criteria were patients older than 70 years (Septuagenarian group) who met all institutional protocols for bariatric surgery and underwent sleeve gastrectomy. Patients in the control group were selected with a 1:1 ratio and under 60 years of age, according to body mass index and comorbidities. The primary endpoint of the study was to evaluate the morbidity and mortality during the 30-day postoperative period and total weight loss, remission, or improvement of diabetes mellitus (DM2), systemic arterial hypertension (SAH), and dyslipidemia (DLP), and reduction in the number of medications used for these diseases when the patient completed 1 year of postoperative follow-up. Results: Fifty patients were included in the study, 25 in each group. Both groups were similar regarding gender, weight, BMI and presence of DM2. The 30-day morbidity and mortality were similar between the groups. The patients in the Septuagenarian group had an average of 65.1% of excess weight loss (%EWL), a result that was similar to the 69.4% of the control group (p=0.20). Regarding the percentage of total weight loss (%TWL), the Septuagenarians group lost an average of 26.9% and the control group, 28% (p= 0.32). The remission rate of DM2 (50% vs. 85% p=0.01) and SAH (30% vs. 64% p=0.04) was lower for septuagenarian patients. In addition, patients in the Septuagenarian group had less reduction in the number of medications for SAH (-59.1% vs. -76.0% p= 0.05). Conclusion: Sleeve Gastrectomy surgery performed in patients over 70 years of age has benefits regarding ponderal loss and improvement of comorbidities, as similarly observed in patients under 60 years of age.