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1.
Acta cir. bras. ; 33(1): 95-101, jan. 2018. ilus, tab
Artigo em Inglês | VETINDEX | ID: vti-18142

Resumo

Purpose: To perform technically the laparoscopic sleeve gastrectomy (LSG) using a unique Intragastric Single Port (IGSG) in animal swine model, evidencing an effective and safe procedure, optimizing the conventional technique.Methods: IGSG was performed in 4 minipigs, using a percutaneous intragastric single port located in the pre-pyloric region. The gastric stapling of the greater curvature started from the pre-pyloric region towards the angle of His by Endo GIA system and the specimen was removed through the single port. In the postoperative day 30, the animals were sacrificed and submitted to autopsy.Results: All procedures were performed without conversion, and all survived 30 days. The mean operative time was 42 min. During the perioperative period no complications were observed during invagination and stapling. No postoperative complications occurred. Post-mortem examination showed no leaks or infectious complications.Conclusion: Intragastric Single Port is a feasible procedure that may be a suitable alternative technique of sleeve gastrectomy for the treatment of morbid obesity.(AU)


Assuntos
Animais , Laparoscopia/métodos , Gastrectomia/métodos , Obesidade Mórbida , Terapias Complementares , Modelos Animais , Porco Miniatura , Desenvolvimento Tecnológico
2.
Acta cir. bras. ; 28(11): 788-793, Nov. 2013. ilus, tab
Artigo em Inglês | VETINDEX | ID: vti-9103

Resumo

PURPOSE: To determine the prevalence of non alcoholic fatty liver disease (NAFLD) and non alcoholic steatohepatitis (NASH) in morbidly obese patients undergoing bariatric surgery and to identify risk factors associated with the disease spectrum. METHODS: Liver biopsy was performed in 60 patients who underwent bariatric surgery, after other causes of liver disease were excluded. Clinical, biochemical and histological features were evaluated. RESULTS: NAFLD was detected in fifty-seven patients (95%) of the sample and forty patients (66.7%) of the total sample met the criteria for NASH. Perisinusoidal fibrosis was only found in three (7.5%) patients with NASH. The γGT was an independent predictive factor associated with the degree of hepatic steatosis. The variables such as dyslipidemia and ALT were independently associated with the presence of Mallory's corpuscles with the following values, respectively, OR 0, 05, 95% CI 0.002 to 0.75, P = 0.031 and OR 10, 99, 95% CI 1.44 to 83.93, P = 0.021. CONCLUSIONS: Non alcoholic fatty liver disease seems to be an obese-related condition with approximately half of asymptomatic morbidly obese patients having histological NASH. The γGT was an independent predictor of the degree of steatosis.(AU)


Assuntos
Humanos , Animais , Obesidade/classificação , Fígado Gorduroso/patologia , Fatores de Risco , Cirurgia Bariátrica
3.
Acta cir. bras. ; 28(4): 317-322, 2013. tab
Artigo em Inglês | VETINDEX | ID: vti-8971

Resumo

PURPOSE: To evaluate the frequency of obstructive sleep apnea (OSA) in obese patients scheduled for bariatric surgery and their identification for risk of OSA by Berlin Questionnaire (BQ) and excessive daytime sleepiness by Epworth Sleepiness Scale (ESS). METHODS: Fifty nine patients were evaluated by BQ and ESS. Out of these individuals, 35 performed a full-night sleep study using a type 3 portable monitoring (PM). The questionnaire results were compared for gender and BMI. The presence and severity of OSA was correlated with gender and both questionnaires. RESULTS: 94.75% of the respondents presented high risk for OSA by BQ and 59.65% presented positivity by ESS. Taking into account the AHI> 5 per hour for OSA diagnosis, all of them presented OSA, average AHI of 45.31±26.3 per hour and 68.6% have severe OSA (AHI>30). The male patients had a higher AHI (p<0.05). There was a positive correlation between the positivity in both questionnaires as well as the severity of OSA measured by AHI (p<0.05). CONCLUSION: The frequency and severe obstructive sleep apnea in the studied group is high. The Berlin Questionnaire and Epworth Sleepiness Scale had a positive correlation with the diagnosis of OSA in the group studied.(AU)


Assuntos
Humanos , Animais , Síndromes da Apneia do Sono/metabolismo , Obesidade/complicações , Cirurgia Bariátrica
4.
Acta cir. bras. ; 25(5): 407-415, Sept.-Oct. 2010. ilus, tab
Artigo em Inglês | VETINDEX | ID: vti-7745

Resumo

PURPOSE: To investigate the body weight, pulmonary function and quality of life of twenty patients with morbid obesity six months after the Fobi-Capella operation. METHODS: Patients were evaluated before and six months after surgery. The patients were mainly female (75 percent), the average age was 40.5 ± 10.27 years; average weight 110.11 kg ± 21.77 and average body mass index (BMI) 39.93 ± 7.13 kg/m² in the postoperative evaluation. Pulmonary function was assessed by spirometry using a Pulmonet/Godart NV Bilt Vetr Hotland spirometer and quality of life was assessed by applying the Moorehead-Ardelt questionnaire. The pre- and postoperative spirometry values were compared by the paired Student t test and the correlation between weight loss and pulmonary function was determined by linear regression, with the level of significance set at p < 0.05. RESULTS: The spirometry variables Respiratory Frequency (RF), Expiratory Reserve Volume (ERV) and Functional Residual Capacity (FRC) differed significantly between the pre- and postoperative periods, whereas Residual Volume (RV), Vital Capacity (VC), Total Lung Capacity (TLC), FEF25-75 (Forced Expiratory Flow between 25 and 75 percent FVC) and FEV1/FVC percent (Forced Expiratory Volume in the 1st second/ Forced Vital Capacity ratio) did not differ between periods. Only one patient reported worsening of quality of life. There was a positive correlation between weight loss and ERV (p=0.0117, r=0.5514), but no correlations were observed for the other variables. CONCLUSIONS: There was a significant weight loss and an improvement of pulmonary function as seen by respiratory frequency, reduction and increased expiratory reserve volume and functional residual capacity. The quality of life of the patients also improved after the Fobi-Capella operation.(AU)


OBJETIVO: Investigar a evolução do peso corpóreo, da função pulmonar e da qualidade de vida de 20 pacientes obesos mórbidos seis meses após operação de Fobi-Capella. MÉTODOS: Os pacientes foram avaliados antes e seis meses após a cirurgia e o sexo feminino predominou em 75 por cento, com média de idade de 40,5 anos ± 10, 27, média de peso de 110,11 kg ± 21,77 e IMC de 39,93 kg/m² ± 7,13. Para a avaliação da função pulmonar foi realizada espirometria por meio do espirômetro Pulmonet Godart NV Bilt Vetr Holland, e para a qualidade de vida foi aplicado o questionário de Moorehead-Ardelt. As comparações entre os valores espirométricos do pré e do pós-operatório foram realizadas pelo teste t de Student para amostras pareadas, e para a correlação entre a perda de peso e função pulmonar utilizou-se análise de regressão linear simples, adotando-se p < 0,05 para todos os resultados. RESULTADOS: As variáveis espirométricas Freqüência Respiratória (FR), Volume de Reserva Expiratório (VRE) e Capacidade Residual Funcional (CRF) apresentaram, aos seis meses após a operação, diferença estatisticamente significativa com os valores pré-operatórios, porém, não houve diferença significativa de Volume Residual (VR), Capacidade Vital (CV), Capacidade Pulmonar Total (CPT), Fluxo Expiratório Médio entre 25 e 75 por cento da curva de CVF (FEF25-75 por cento) e Razão entre Volume Expiratório Forçado no 1º segundo e Capacidade Vital Forçada (VEF1/CVF por cento). Apenas uma paciente relatou piora da qualidade de vida após a operação. Houve correlação positiva entre a perda da porcentagem do excesso de peso e VRE (p=0,0117, r=0,5514); as demais variáveis não apresentaram correlação significativa. CONCLUSÕES: Houve perda significante de peso, melhora da função pulmonar evidenciada pela redução da freqüência respiratória, aumento do volume de reserva expiratório e da capacidade residual funcional. A qualidade de vida dos pacientes melhorou nos seis meses após a operação de Fobi-Capella.(AU)


Assuntos
Humanos , Masculino , Feminino , Testes de Função Respiratória , Obesidade Mórbida/complicações , Cirurgia Bariátrica/reabilitação , Qualidade de Vida/psicologia , Obesidade Mórbida/reabilitação
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