RESUMO
BACKGROUND: Since 1991 we performed vertical banded gastroplasty (VBG) as our surgical treatment of choice for morbid obesity in 680 patients, and since 1996 we also performed Roux-en-Y gastric bypass (RYGB) in 36 patients. For revisional surgery, the surgeons chose procedures based on their experience. METHODS: We recorded early complications (0.6%) and late complications (8.5%) after the primary operations. When staple-line disruption or stenosis of the banded stoma occurred after VBG, revisional surgery was performed with re-VBG or conversion to RYGBP. Some early complications needed emergency operation for bleeding or gastric perforation. RESULTS: Mortality was zero. Reoperation with re-VBG and RYGBP was effective in all patients, but for many, a long stay in hospital was necessary because reoperation had a high rate of early and late complications, 33.8% and 21.8% respectively. CONCLUSION: The treatment of complications after VBG with re-VBG and RYGBP had danger. We believe that when VBG failure occurs, to avoid dangerous complications again, we should perform a biliopancreatic diversion, which does not involve a gastric restriction.
Assuntos
Anastomose em-Y de Roux/efeitos adversos , Derivação Gástrica/efeitos adversos , Gastroplastia/efeitos adversos , Reoperação/efeitos adversos , Anastomose em-Y de Roux/métodos , Anastomose em-Y de Roux/estatística & dados numéricos , Constrição Patológica/etiologia , Constrição Patológica/cirurgia , Emergências , Derivação Gástrica/métodos , Derivação Gástrica/estatística & dados numéricos , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/cirurgia , Gastroplastia/métodos , Gastroplastia/estatística & dados numéricos , Humanos , Tempo de Internação/estatística & dados numéricos , Seleção de Pacientes , Reoperação/métodos , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Estômago/lesões , Estômago/patologia , Estômago/cirurgia , Fatores de Tempo , Resultado do TratamentoRESUMO
The study is based on 848 patients that had surgery for inguinal hernia from January 1990 to May 1996. It compares the results obtained using the traditional plastic, called "direct suture", with the results of plastics with prosthesis. A special attention is given to tension-free techniques carried in local anesthesia, undoubtedly considered advantageous because of the technical simplicity in association with the total absence of postoperative complications and relapses, when correctly executed.