Gastric histopathology in laparoscopic sleeve gastrectomy: pre- and post-operative comparison.

BACKGROUND: Sleeve gastrectomy (SG) produces excellent results in weight reduction and resolution of comorbidities. The histology of the gastric mucosa can be affected by the surgical procedure, with alterations of inflammatory patterns. The objective of this study is to evaluate alterations of the inflammatory patterns of the gastric mucosa in SG and the results in weight loss and resolution of comorbidities. METHODS: Morbidly obese patients were selected to undergo SG. Endoscopies were performed pre-operatively and post-operatively after 6 months, with an incisura and 3 cm before the pylorus biopsies. Data on weight, height, and associated diseases were collected. The data were compared, and the biopsies evaluate the inflammatory patterns. RESULTS: There was a reduction of body weight with a pre-operative weight of 132.5 ± 15.7 kg and a post-operative weight of 95.8 ±10.6 kg with a p < 0.001. Also, the body mass index (BMI) was reduced significantly with a mean pre-operative of 42.6 ± 10.6 kg/m(2) and a post-operative of 30.9 ± 3.2 kg/m(2) with a p < 0.001. The comorbidities were all resolved or improved. The pattern of gastric histology showed chronic gastritis with inflammatory activity associated with Helicobacter pylori in 33.3 % of the patients, along with foveolar hyperplasia at 58.3 %. The chronic gastritis with discrete inflammatory activity was reduced by 16.7 %, and the foveolar hyperplasia was reduced by 33.3 %. CONCLUSION: The inflammatory alterations in the pre-operative period were mainly foveolar hyperplasia and chronic gastritis associated with H. pylori, and they were reduced in the post-operative period. A significant reduction of weight and BMI occurred, and a resolution of comorbidities was observed.

Evaluation of immunohistochemical expression of ghrelin-producing rectal cells in Wistar rats underwent to the cafeteria diet

PURPOSE:To investigate the impact of cafeteria diet on ghrelin expression in rectal tissue and identify the morphologic cell type. METHODS:Twenty-four male Wistar rats were divided into four subgroups of six animals each: RC1 (rat chow 1) and CAF1 (cafeteria diet 1) for a period of 30 days; RC2 (rat chow 2) and CAF2 (cafeteria diet 2) for a period of 60 days. The animal and rectal weight, the number and the type of immunoreactive ghrelin cells were recorded and compared between the subgroups. The statistical study was established by ANOVA and Student's t test. RESULTS:There was no difference in the total of immunoreactive cells (p=0.685) between the subgroups nor between weight and presence or absence of ghrelin expression (p=0.993). All the immunoreactive cells identified were closed-type. CONCLUSION:The cafeteria diet did not have influence on the amount of immunoreactive rectal cells of ghrelin and only one type (closed-type) of immunoreactive cells was expressed in the rectum.

Evaluation of immunohistochemical expression of ghrelin-producing rectal cells in Wistar rats receiving the cafeteria diet.

PURPOSE: To investigate the impact of cafeteria diet on ghrelin expression in rectal tissue and identify the morphologic cell type. METHODS: Twenty-four male Wistar rats were divided into four subgroups of six animals each: RC1 (rat chow 1) and CAF1 (cafeteria diet 1) for a period of 30 days; RC2 (rat chow 2) and CAF2 (cafeteria diet 2) for a period of 60 days. The animal and rectal weight, the number and the type of immunoreactive ghrelin cells were recorded and compared between the subgroups. The statistical study was established by ANOVA and Student's t test. RESULTS: There was no difference in the total of immunoreactive cells (p=0.685) between the subgroups nor between weight and presence or absence of ghrelin expression (p=0.993). All the immunoreactive cells identified were closed-type. CONCLUSION: The cafeteria diet did not have influence on the amount of immunoreactive rectal cells of ghrelin and only one type (closed-type) of immunoreactive cells was expressed in the rectum.

resultados iniciais da perda do excesso de peso e redução de comorbidades em obesos mórbidos submetidos à gastrectomia vertical laparoscópica / Initial results of excess weight loss and reduction comorbidities in morbidly obese patients undergoing laparoscopic sleeve gastrectomy

Racional: Nos últimos anos, a Gastrectomia Vertical(GV) vem ganhando espaço e se destacando progressivamentecomo tratamento cirúrgico da obesidademórbida. Percebeu-se que em muitos pacientes, a GVisolada apresentava excelentes resultados na reduçãode peso e na melhora das comorbidades, dispensandouma segunda operação. Objetivo: Avaliar as alteraçõesantropométricas e diminuição de comorbidades empacientes com obesidade mórbida submetidos à GVno período de um ano. Métodos: Trata-se de um estudodo tipo transversal retrospectivo formulado atravésdos dados de prontuários e da entrevista com pacientessubmetidos à GV. Avaliou-se, no período de 3, 6 e 12meses de pós-operatório, a redução de peso, do IMC ea porcentagem de perda do excesso de peso (%PEP).Esses dados foram comparados com a presença de comorbidadese sua resolução após a cirurgia. Resultados:O excesso de peso apresentado no pré-operatório foiem média de 58,54 ± 21,82 kg, sendo significativamentemaior no sexo masculino do que no sexo feminino (p< 0,05). Após a realização da cirurgia, o IMC e a %PEPao fim de 12 meses foram respectivamente de 30,31± 4,26 kg/m² e de 63,47 ± 15,46%. Percebeu-se queindivíduos mais jovens respondiam melhor a perda depeso que indivíduos mais velhos. Em relação ao sexo,a redução do IMC foi significativamente maior no sexomasculino (p < 0,05), informação esta que não ocorreuao avaliar a %PEP (p= 0,228). Foi observado que80,64% dos pacientes apresentavam alguma comorbidadeassociada à obesidade sendo descrito 12,9% comDM tipo II, 51,6% com HAS, 25,8% com dislipidemiae 51,6% com osteoartropatia. Conclusão: a GV isoladaé uma cirurgia que vem apresentando excelentesresultados no tratamento da obesidade, mostrando-sealtamente eficaz na perda de peso e na resolução decomorbidades.

Background: In recent years, Sleeve Gastrectomy(SG) has been increasing steadily and excelling as asurgical treatment of morbid obesity. It was noticedthat in many patients, the SG alone had excellentresults in weight reduction and comorbiditiesimprovement, avoiding a second operation. Aim: Toevaluate anthropometric and comorbidities reductionin patients with morbid obesity submitted to SG in theperiod of one year. Methods: This is a retrospectivecross-sectional study using data drawn from medicalrecords and SG patients interviews. It has beenevaluated within 3, 6 and 12 months postoperatively,the reduction in weight, BMI and percentage of excessweight loss (% PEP). These data were compared with thepresence of comorbidities and their resolution aftersurgery. Results: The average weight excess in the preoperativeis 58,54 ± 21,82 kg, was significantly higherin males than in females (p < 0,001). After surgery, BMIand %PEP at 12 months were respectively 43,11 ± 6,52kg/m² and 63,47 ± 15,46%. It was noticed that youngerpeople respond better to weight loss than olderindividuals. When comparing sex, ther eduction in BMIw assignificantly higher in males (p < 0,05), this data did notoccur to evaluate the %PEP (p= 0,228). It was observedthat 80,64% of the patients had a comorbidity associatedwith obesity being described 12,9% with type II DM(como é primeira citação precisa do nome completo),48,4% had hypertension, 25,8% had dyslipidemia and51,6% to osteoarthropathy. Conclusion: The isolatedSG is a surgery that has shows excellent results intreating obesity, being highly effective in weight loss andcomorbidities resolution.