Efeitos da cirurgia bariátrica em Y-de-Roux sobre parâmetros metabólicos em obesos adultos
Arquivos
Data
2012-03-22
Autores
Silva, Stephan Garcia Andrade 
Orientadores
Dâmaso, Ana Raimunda
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A obesidade severa afeta todo o organismo favorecendo o
desenvolvimento de sérias doenças, incluindo hipertensão, diabetes mellitus,
aterosclerose, assim como aumenta a prevalência de cânceres. Os tratamentos
convencionais (dietas, atividade física, terapia comportamental, intervenção
medicamentosa) têm sido pouco eficazes na manutenção da perda de peso em
longo prazo para indivíduos obesos mórbidos em comparação a outros níveis como
sobrepeso e obesidade. O número de cirurgias bariátricas sofreu um aumento de
500% no Brasil na última década. Esse crescimento coloca o Brasil na segunda
posição do ranking mundial de cirurgias bariátricas, ficando atrás apenas dos
Estados Unidos. Objetivo: Avaliar os efeitos da cirurgia bariátrica em Y-de-Roux
sobre os parâmetros metabólicos e bioquímicos de obesos adultos. Amostra e
Métodos: O estudo aconteceu por meio de uma coorte retrospectiva envolvendo
prontuários médicos de pacientes adultos, submetidos à cirurgia bariátrica em Y-deRoux, de uma clínica da cidade de Santos-SP. Foram observados 519 prontuários
médicos para aplicação dos critérios de inclusão e não inclusão. Este procedimento
resultou em 205 prontuários, os quais constituíram a amostra do estudo. A amostra
foi composta por 29 pacientes do sexo masculino (37,78±12,67 anos) e 176 do sexo
feminino (38,75±11,35 anos), submetidos à cirurgia entre os anos de 2004 a 2009. A
amostra foi estratificada em gêneros e faixas etárias. Resultados: Os resultados
mostraram a diminuição significativa do peso corporal, IMC, glicemia e insulina de
jejum em todas as idades e em ambos os gêneros. Com isso houve melhoras nos
índices que correspondem à sensibilidade e resistência à insulina (QUICKI e HOMAIR, respectivamente). Concomitantemente a redução de medidas antropométricas, o
perfil lipídico apresentou melhoras nas frações de colesterol total, LDL-C e
triglicérides. Não houve mudança significativa nos níveis de HDL-C. A prevalência
de pacientes hipertensos diminuiu após seis meses de acompanhamento. Houve um
aumento significativo da prevalência de anemia tanto em curto quanto em longo
prazo. Houve uma diminuição significativa nos níveis de proteínas totais e vitamina
B12 Conclusão: A derivação gástrica em Y-de-Roux mostrou-se uma importante
ferramenta na remissão e controle da epidemia da obesidade. A melhora nos
parâmetros da síndrome metabólica são fatores determinantes na remissão das
comorbidades associadas à obesidade, tais como diabetes, dislipidemias e
aterosclerose. Intercorrências advindas do processo restritivo e desabsortivo do
procedimento podem surgir. O sucesso do tratamento cirúrgico é dependente de
acompanhamento por uma equipe multidisciplinar antes e após o procedimento.
Introduction: Severe obesity affects the entire body favoring the development of serious diseases, including hypertension, diabetes mellitus, atherosclerosis, and increases the prevalence of cancers. Conventional treatments (diet, physical activity, behavioral therapy, medication) have not been effective in maintaining weight loss in the long term for people with morbid obesity compared to other levels such as overweight and obesity. The number of bariatric surgeries increased by 500% in Brazil in the last decade. This growth placed Brazil in the second position in the world ranking of bariatric surgery, back only from United States. Objective: To evaluate the effects of bariatric surgery in Roux-en-Y on the metabolic and biochemical parameters of obese adults. Sample and Methods: The study took place through a retrospective cohort involving medical records of adult patients undergoing bariatric surgery-Y-Roux, of a clinical from the city of Santos-SP. The study sample consisted of 519 medical records. After applying the criteria for inclusion and inclusion, 205 charts were selected to be part of this study. The sample consisted of 29 male patients (37.78 ± 12.67 years) and 176 females (38.75 ± 11.35 years) that underwent surgery between the years 2004 to 2009. The sample was stratified by gender and age range. Results: Results showed a significant decrease in body weight, BMI, fasting glucose and insulin at all ages and both genders. This has seen improvements in the indices that correspond to the sensitivity and insulin resistance (QUICKI and HOMA-IR, respectively). Concomitant reduction of anthropometric measurements, lipid profile showed improvements in the fractions of total cholesterol, LDL-C and triglycerides. There was no significant change in HDL-C. The prevalence of hypertensive patients decreased after six months of monitoring. There was a significant increase in the prevalence of anemia in both short and long term. There was a significant decrease in total protein and vitamin B12 Conclusion: Roux-en-Y gastric bypass proved to be an important tool in remission and control the epidemic of obesity. The improvements in parameters of the metabolic syndrome are key factors in the remission of comorbidities associated with obesity such as diabetes, dyslipidemia and atherosclerosis. Complications resulting from the restrictive process disabsorptive and the procedure may arise. The success of surgical treatment is dependent on monitoring by a multidisciplinary team before and after the procedure
Introduction: Severe obesity affects the entire body favoring the development of serious diseases, including hypertension, diabetes mellitus, atherosclerosis, and increases the prevalence of cancers. Conventional treatments (diet, physical activity, behavioral therapy, medication) have not been effective in maintaining weight loss in the long term for people with morbid obesity compared to other levels such as overweight and obesity. The number of bariatric surgeries increased by 500% in Brazil in the last decade. This growth placed Brazil in the second position in the world ranking of bariatric surgery, back only from United States. Objective: To evaluate the effects of bariatric surgery in Roux-en-Y on the metabolic and biochemical parameters of obese adults. Sample and Methods: The study took place through a retrospective cohort involving medical records of adult patients undergoing bariatric surgery-Y-Roux, of a clinical from the city of Santos-SP. The study sample consisted of 519 medical records. After applying the criteria for inclusion and inclusion, 205 charts were selected to be part of this study. The sample consisted of 29 male patients (37.78 ± 12.67 years) and 176 females (38.75 ± 11.35 years) that underwent surgery between the years 2004 to 2009. The sample was stratified by gender and age range. Results: Results showed a significant decrease in body weight, BMI, fasting glucose and insulin at all ages and both genders. This has seen improvements in the indices that correspond to the sensitivity and insulin resistance (QUICKI and HOMA-IR, respectively). Concomitant reduction of anthropometric measurements, lipid profile showed improvements in the fractions of total cholesterol, LDL-C and triglycerides. There was no significant change in HDL-C. The prevalence of hypertensive patients decreased after six months of monitoring. There was a significant increase in the prevalence of anemia in both short and long term. There was a significant decrease in total protein and vitamin B12 Conclusion: Roux-en-Y gastric bypass proved to be an important tool in remission and control the epidemic of obesity. The improvements in parameters of the metabolic syndrome are key factors in the remission of comorbidities associated with obesity such as diabetes, dyslipidemia and atherosclerosis. Complications resulting from the restrictive process disabsorptive and the procedure may arise. The success of surgical treatment is dependent on monitoring by a multidisciplinary team before and after the procedure
Descrição
Citação
SILVA, Stephan Garcia Andrade. Efeitos da cirurgia bariátrica em Y-de-Roux sobre parâmetros metabólicos em obesos adultos. 2012. 108f. Dissertação (Mestrado) - Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos, 2012.