Beneficial Effects of Applying Low-Level Laser Therapy to Surgical Wounds After Bariatric Surgery.

BACKGROUND: Bariatric surgery is a successful method for weight loss in cases of morbid obesity; however, as an invasive procedure, surgical complications may occur. Low-level laser therapy (LLLT) has been increasingly used due to its effectiveness in controlling the inflammatory response, accelerating tissue repair, and reducing pain. The objective of this study was to investigate photobiomodulation effects after bariatric surgery and determine the laser actions during the inflammatory process, wound healing (clinical observation), and analgesia. METHODS: This study was a randomized, placebo-controlled, clinical trial in which 85 patients underwent Roux en-Y gastric bypass (RYGB) by conventional techniques (i.e., open surgery). Patients were divided into two groups and were irradiated with LLLT at 10 different points through the surgical scar in three sessions of applications: the laser group (laser-on) consisted of 43 patients who received the CW diode laser (MMOptics), while the placebo group (laser-off) consisted of 42 patients who were treated by the same protocol but with a disabled laser. Temperature was measured by a digital thermometer in both groups, and pain was evaluated using the visual analogue scale for pain. Biochemical analysis and digital images were used to document and evaluate the inflammatory response as well as tissue repair process at the surgical wound site. RESULTS: Patients in the laser group demonstrated diminished wound temperature as erythrocyte sedimentation rate (ESR) compared with the placebo group, indicating better inflammatory process control as well as improved wound healing and reduced pain. CONCLUSIONS: LLLT applied with the described protocol led to a decrease by biochemical markers and wound temperature compared with the placebo, which indicated that LLLT was able to control the inflammatory process; in addition, seroma and pain were reduced and cicatrization was improved by this preventive procedure.

Comorbidities remission after Roux-en-Y Gastric Bypass for morbid obesity is sustained in a long-term follow-up and correlates with weight regain.

BACKGROUND: Obesity-related comorbidities are treated by Roux-en-Y gastric bypass (RYGB) due to weight loss and intestinal hormone changes. Few studies report the evolution of these comorbidities in a long-term follow-up, especially if weight regain is present. This study aims to analyze: (1) the resolution of obesity-related comorbidities after RYGB in a long-term follow-up and (2) its relationship to weight regain. METHODS: A retrospective study was conducted on 140 patients submitted to RYGB for morbid obesity for at least 5 years (mean follow-up 90 months). Mean body mass index (BMI) before operation was 52 kg/m(2), at nadir weight 29 kg/m(2), and at last follow-up 33 kg/m(2). The comorbidities diabetes, cardiovascular disease, arterial hypertension, dyslipidemia, sleep apnea, arthropathy, and infertility were classified as resolved, improved, unchanged, and worsened at nadir weight that happened between the first and second year and after five or more years of surgery. For each comorbidity, we compared the changes in the distribution of patients in the categories and the correlation of it with weight loss at the nadir and final weight. RESULTS: BMI was significantly different in the three periods. Comorbidities resolution was sustained in a long-term follow-up for diabetes, hypertension, cardiovascular disease, and infertility. Comorbidities status was directly related to the weight loss for all comorbidities except infertility. CONCLUSIONS: Our results show that comorbidities remission after RYGB is sustained in a long-term follow-up. Weight regain is linked to worse results for all comorbidities except infertility.

Cancer in the excluded stomach 4 years after gastric bypass.

Gastric bypass is the preferred operation for treatment of morbid obesity on many services. The evaluation of the excluded stomach is always difficult and a matter of concern for the attending physician. There are only four reported cases of gastric cancer in the distal stomach after gastric bypass. We report a 57-year-old man who had intestinal metaplasia at the time of the Roux-en-Y gastric bypass 4 years ago and now developed an aggressive carcinoma in the bypassed stomach.