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1.
Rev Assoc Med Bras (1992) ; 65(9): 1151-1155, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31618329

RESUMO

This report describes the post-bariatric-surgery evolution of an obese patient who had low adherence to the diet and micronutrient supplementation. Four years after two bariatric surgeries, the patient was admitted due to transient loss of consciousness, slow thinking, anasarca, severe hypoalbuminemia, in addition to vitamin and mineral deficiencies. She had subcutaneous foot abscess but did not present fever. Received antibiotics, vitamins A, D, B12, thiamine, calcium, and parenteral nutrition. After hospitalization (twenty-eight days), there was a significant body weight reduction probably due to the disappearance of clinical anasarca. Parenteral nutrition was suspended after twenty-five days, and the oral diet was kept fractional. After hospitalization (weekly outpatient care), there was a gradual laboratory data improvement, which was now close to the reference values. Such outcome shows the need for specialized care in preventing and treating nutritional complications after bariatric surgeries as well as clinical manifestations of infection in previously undernourished patients.


Assuntos
Cirurgia Bariátrica , Desnutrição Proteico-Calórica/complicações , Infecções Estreptocócicas/complicações , Adulto , Deficiência de Vitaminas/complicações , Deficiência de Vitaminas/terapia , Cirurgia Bariátrica/efeitos adversos , Feminino , Humanos , Nutrição Parenteral , Complicações Pós-Operatórias , Desnutrição Aguda Grave/complicações , Desnutrição Aguda Grave/etiologia , Desnutrição Aguda Grave/terapia , Cooperação e Adesão ao Tratamento
2.
Rev Assoc Med Bras (1992) ; 65(9): 1161-1167, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31618331

RESUMO

OBJECTIVE: To investigate the use of Bilevel Positive Airway Pressure (BiPAP) in morbidly obese individuals in two moments following bariatric surgery (Roux-en-Y gastric bypass): post-anesthetic recovery (PAR) and first postoperative day (1PO). DESIGN: Randomized and blinded clinical trial. METHODS: We studied 40 morbidly obese individuals aged between 25 and 55 years who underwent pulmonary function test and chest X-ray preoperatively, and on the day of discharge (2nd day after surgery). They were randomly allocated into two groups: PAR-G (BiPAP in PAR for one hour), and 1PO-G (BIPAP for one hour on the 1PO). RESULTS: In the PAR-G and 1PO-G, respectively there were significant reductions in slow vital capacity (SVC) (p=0.0007 vs. p<0.0001), inspiratory reserve volume (IRV) (p=0.0016 vs. p=0.0026), and forced vital capacity (FVC) (p=0.0013 vs. p<0.0001) and expiratory reserve volume (ERV) was maintained only for the PAR-G (p=0.4446 vs. p=0.0191). Comparing the groups, the SVC (p=0.0027) and FVC (p=0.0028) showed a significant difference between the treatments, while the PAR-G showed smaller declines in these capacities. The prevalence of atelectasis was 10% for the PAR-G and 30% for the 1PO-G (p=0.0027). CONCLUSION: Thus, the use of BiPAP in PAR can promote restoration of ERV and contribute to the reduction of atelectasis.


Assuntos
Cirurgia Bariátrica/reabilitação , Pressão Positiva Contínua nas Vias Aéreas , Atelectasia Pulmonar/epidemiologia , Adulto , Volume de Reserva Expiratória , Feminino , Humanos , Pulmão/fisiopatologia , Pessoa de Meia-Idade , Obesidade Mórbida/cirurgia , Período Pós-Operatório , Prevalência , Atelectasia Pulmonar/prevenção & controle , Método Simples-Cego , Espirometria , Capacidade Vital
3.
Medicine (Baltimore) ; 98(41): e17205, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593078

RESUMO

Bariatric surgery (BAS) may result in adverse outcomes that include appearance of gastrointestinal (GI) symptoms and/or failure to reach the weight reduction goal. This retrospective study tested the hypothesis that pre-operative gastric emptying (GE) abnormality is responsible for adverse post-surgical outcomes.Pre-operative GE was performed using the standard solid-meal GE scintigraphy (GES) in 111 consecutive patients (105 females and 6 males, mean age 46.2 years, range 20-70 years) who were evaluated for BAS. All underwent BAS - 93 had laparoscopic sleeve gastrectomy (LSG) and 18 had Roux-en-Y (ReY) gastric bypass. All had short-term (3-6 months) and long-term (up to 54 months) follow-up with review of symptoms, physical, and laboratory examinations. Chi-square analysis was performed. P-value < .05 was considered significant.Of the 111 patients, 83 had normal and 28 had abnormal pre-op GES. Sixty-eight were asymptomatic and 43 were symptomatic prior to surgery. Following surgery, 81 patients were asymptomatic and 30 were symptomatic at long-term follow-up. There was no significant difference between pre-op GE results and post-surgical adverse clinical outcome (p = ns). However, GES results seem to have guided the selection of surgical procedure significantly (P = .008).Pre-operative GE study was not a strong predictor of clinical outcome in BAS. Although, it influenced the type of surgery, as when the GES was abnormal, the patient was more likely to undergo ReY and when GES was normal, they favored LSG. Interestingly, many of our symptomatic patients at 6 months post-op were asymptomatic after long-term follow-up.


Assuntos
Cirurgia Bariátrica/estatística & dados numéricos , Esvaziamento Gástrico/fisiologia , Obesidade Mórbida/fisiopatologia , Seleção de Pacientes , Cintilografia/estatística & dados numéricos , Adulto , Idoso , Cirurgia Bariátrica/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/cirurgia , Período Pré-Operatório , Estudos Retrospectivos , Adulto Jovem
5.
Orv Hetil ; 160(43): 1714-1718, 2019 Oct.
Artigo em Húngaro | MEDLINE | ID: mdl-31630550

RESUMO

Bariatric surgery is more effective in the management of morbid obesity and related comorbidities than conservative therapy. There are two main groups, restrictive and malabsorptive procedures. Laparoscopic gastric plication with pylorus-preserving loop duodenoileal bypass is classified into the latter group. It should be considered as the modernized variant of the classical Scopinaro procedure. In this article, the method is presented by a case report. Orv Hetil. 2019; 160(43): 1714-1718.


Assuntos
Cirurgia Bariátrica/métodos , Derivação Gástrica/métodos , Gastroplastia/métodos , Laparoscopia/métodos , Obesidade Mórbida/cirurgia , Estômago/cirurgia , Adulto , Cirurgia Bariátrica/efeitos adversos , Feminino , Derivação Gástrica/efeitos adversos , Gastroplastia/efeitos adversos , Humanos , Laparoscopia/efeitos adversos , Obesidade Mórbida/diagnóstico , Piloro , Resultado do Tratamento
6.
Arq Bras Cir Dig ; 32(3): e1450, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31644670

RESUMO

INTRODUCTION: Obesity is a disease of high prevalence in Brazil and in the world, and bariatric surgery, with its different techniques, is an alternative treatment. OBJECTIVE: To compare techniques: adjustable gastric band (AGB), sleeve gastrectomy), Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD) analyzing leaks, bleeding, death, weight loss, resolution of type 2 diabetes, systemic arterial hypertension, dyslipidemia and obstructive sleep apnea. METHODS: Were selected studies in the PubMed database from 2003 to 2014 using the descriptors: obesity surgery; bariatric surgery; biliopancreatic diversion; sleeve gastrectomy; Roux-en-Y gastric bypass and adjustable gastric banding. Two hundred and forty-four articles were found with the search strategy of which there were selected 116 studies through the inclusion criteria. RESULTS: Excess weight loss (EWL) after five years in AGB was 48.35%; 52.7% in SG; 71.04% in RYGB and 77.90% in BPD. The postoperative mortality was 0.05% in the AGB; 0.16% on SG; 0.60% in RYGB and 2.52% in BPD. The occurrence of leak was 0.68% for GBA; 1.93% for SG; 2.18% for RYGB and 5.23% for BPD. The incidence of bleeding was 0.44% in AGB; 1.29% in SG; 0.81% in RYGB and 2.09% in BPD. The rate of DM2 resolved was 46.80% in AGB, 79.38% in SG, 79.86% in RYGB and 90.78% in BPD. The rate of dyslipidemia, apnea and hypertension resolved showed no statistical differences between the techniques. CONCLUSION: The AGB has the lowest morbidity and mortality and it is the worst in EWL and resolution of type 2 diabetes. The SG has low morbidity and mortality, good resolution of comorbidities and EWL lower than in RYGB and BPD. The RYGB has higher morbidity and mortality than AGB, good resolution of comorbidities and EWL similar to BPD. The BPD is the worst in mortality and bleeding and better in EWL and resolution of comorbidities.


Assuntos
Cirurgia Bariátrica/métodos , Obesidade Mórbida/cirurgia , Cirurgia Bariátrica/estatística & dados numéricos , Desvio Biliopancreático/métodos , Brasil , Gastroplastia/métodos , Humanos , Complicações Pós-Operatórias/mortalidade , Resultado do Tratamento , Ganho de Peso , Perda de Peso
7.
Arq Bras Cir Dig ; 32(3): e1452, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31644672

RESUMO

BACKGROUND: In high-income countries, morbid obesity is a growing health problem that has already reached epidemic proportions. When performing a laparoscopic gastric bypass several operative methods exist. AIM: To describe the institutional experience using a knotless unidirectional barbed suture (V-Loc 180/Covidien, Mansfield, MA) to create a hand-sewn gastrojejunostomy (GJ) and jejunojejunostomy (JJ) during bariatric surgery. METHODS: Evaluation of a case series of 87 morbidly obese patients who underwent laparoscopic gastric bypass with a hand-sewn gastrojejunostomy (GJA) and jejunojejunostomy (JJA) between 01/2015 and 06/2017. The patients were divided into two groups: in group I, GJA und JJA sutures were performed using the knotless unidirectional barbed suture; in group II, GJA and JJA were sutured with resorbable multifilament thread (Vicryl® 3/0 Ethicon, Livingstone, UK). The recorded data on gender, age, BMI, ASA score, operative time, postoperative morbidity, length of hospital stay, and reoperation, were analyzed and compared. RESULTS: All procedures were completed laparoscopically with no mortality. The mean operative time was 123.23 (±30.631) in group I and 127.57 (±42.772) in group II (p<0.05). The postoperative complications did not differ significantly between the two groups. Early complications were observed for two patients (0.9%) in the barbed suture group and for one patient (0.42%) in the multifilament suture group (p<0.05). In group I two patients (0.9%) required reoperation: on the basis of jejunojejunal stenosis in one patient, and local abscess near the gastrojejunostomy, without a leakage, in the other. In group II one patient (0.42%) required reoperation due to stenosis of the GJA. The duration of hospital admission was similar for both groups: 3.36 (±0.743) days in group I vs. 3.38 (±1.058) days in group II (p<0.05). CONCLUSION: The novel anastomotic technique is a safe and effective method and can be applied to gastrojejunal anastomosis and jejunojejunal anastomosis in laparoscopic gastric bypass.


Assuntos
Cirurgia Bariátrica/instrumentação , Segurança de Equipamentos/instrumentação , Obesidade Mórbida/cirurgia , Técnicas de Sutura/instrumentação , Adulto , Anastomose Cirúrgica/instrumentação , Anastomose Cirúrgica/métodos , Cirurgia Bariátrica/métodos , Feminino , Derivação Gástrica/instrumentação , Derivação Gástrica/métodos , Humanos , Jejunostomia/instrumentação , Jejunostomia/métodos , Jejuno/cirurgia , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Poliglactina 910 , Complicações Pós-Operatórias , Estudos Prospectivos , Estômago/cirurgia , Resultado do Tratamento , Técnicas de Fechamento de Ferimentos/instrumentação
9.
Rev Col Bras Cir ; 46(4): e2238, 2019 Sep 09.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31508735

RESUMO

OBJECTIVE: to compare the effects of the hydroalcoholic extract from the peel of Camu-Camu, a fruit plant belonging to the Myrtaceae family, widely distributed in the Amazon basin, with those of sleeve gastrectomy, on the weight and glycemia of Wistar rats. METHODS: twenty-four Wistar rats underwent obesity induction through a hyperlipid diet for eight weeks (fat period), and were randomized into three groups: Control Group (CG), Camu-Camu Group (CCG) and Bariatric Surgery Group (BSG). After this period, all animals returned to a normal diet and the intervention period began: CG did not undergo any intervention beyond diet change; CCG animals underwent gavage procedure for administration of Camu-Camu hydroalcoholic extract, 1g/kg/day, for four weeks; and the BSG was submitted to the surgical procedure of sleeve gastrectomy. We followed all animals for four weeks. RESULTS: there was only one loss in BSG due to a gastric fistula. We observed significant variations in the animals' mean weight: the CG evolved with weight gain even after the withdraw of the hypercaloric diet, while the other two groups presented weight reduction. BSG presented a significant reduction of weight and BMI (p<0.05); CCG achieved a significant reduction only of the BMI (p<0.05). There were no statistically significant changes in the glycemic levels. CONCLUSION: in spite of reducing weight, the crude hydroalcoholic extract of the Camu-Camu peel was not able to be as efficient as sleeve gastrectomy in the control of body weight in Wistar rats.


Assuntos
Cirurgia Bariátrica , Myrtaceae/química , Obesidade/dietoterapia , Obesidade/cirurgia , Perda de Peso , Animais , Suplementos Nutricionais , Modelos Animais de Doenças , Frutas/química , Masculino , Terapia Nutricional , Obesidade/etiologia , Ratos , Ratos Wistar
10.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 46(3): 134-141, jul.-sept. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-182721

RESUMO

La creciente prevalencia de mujeres obesas en edad fértil es una crisis de salud pública y social. La anticoncepción es un tema clave en mujeres con obesidad. Las mujeres obesas tienen una actividad sexual similar a las mujeres de peso normal y en ellas se considera que el uso de anticoncepción es menos eficaz, teniendo mayor riesgo de embarazo no deseado. Debido a una variedad de alteraciones del metabolismo, la obesidad es un factor de riesgo cardiovascular que puede aumentar, cuando se combina con la anticoncepción hormonal. Todos estos factores deben considerarse al elegir un método anticonceptivo en una mujer obesa. El objetivo de esta revisión es evaluar el riesgo-beneficio de cada tipo de anticoncepción disponible y la problemática de anticoncepción después de la cirugía bariátrica, proporcionando al médico una guía práctica sobre el uso de píldoras anticonceptivas orales en mujeres obesas


The increasing prevalence of obese women of childbearing age is a public and social health crisis. Contraception is a key issue in women with obesity. Obese women have a sexual activity no different from women of normal weight, and the use of contraception is considered less effective, as there is a higher risk of having an unwanted pregnancy. Due to a variety of metabolic disorders, obesity is a cardiovascular risk factor that can increase when combined with hormonal contraception. All these factors should be considered when choosing a contraceptive method in an obese woman. The objective of this review is to evaluate the risk-benefit of each type of available contraception, and the problem of contraception after bariatric surgery, in order to provide doctors with a practical guide on the use of oral contraceptive pills in obese women


Assuntos
Humanos , Feminino , Adulto , Obesidade/complicações , Obesidade/diagnóstico , Anticoncepção , Fatores de Risco , Progestinas/administração & dosagem , Medição de Risco , Cirurgia Bariátrica/métodos , Doenças Metabólicas/complicações , Período Fértil , Tromboembolia Venosa/complicações , Organização Pan-Americana da Saúde
11.
Ther Umsch ; 76(3): 123-127, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31498045

RESUMO

Mechanisms of bariatric and metabolic surgery Abstract. Abstract: Under the circumstances of rising numbers of patients suffering obesity and its related comorbidities, bariatric -surgery becomes a more and more important treatment option. Thereby the Roux-en-Y gastric bypass (= RYGB) and sleeve gastrectomy (= SG) are the most frequent operations performed in this field. The significant weight loss and the observed changes in food consumption cannot be explained by mechanical restriction and caloric malabsorption as initially assumed, but seem to be rather based on a complex interplay of endocrinological, neurological and behavioral mechanisms. It is thus the aim of this article to provide a short overview on the most important physiological mechanisms of bariatric and metabolic -surgery considering the available data to date.


Assuntos
Cirurgia Bariátrica , Derivação Gástrica , Obesidade Mórbida , Gastrectomia , Humanos , Obesidade Mórbida/cirurgia , Perda de Peso
12.
Ther Umsch ; 76(3): 154-160, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31498047

RESUMO

Medical Follow Up After Bariatric Surgery Abstract. The number of patients undergoing bariatric surgery to treat morbid obesity is increasing rapidly. Therefore it is an important issue to be aware of outcome and complications after bariatric surgery. This review presents a compilation of important gastrointestinal symptoms, as pain, diarrhea and dumping, and includes treatment options. It characterizes possible micronutrient deficiencies, gives instructions concerning the adaptation of drugs and illustrates possible adverse outcomes, such as excessive weight loss, insufficient weight loss and weight regain after bariatric surgery.


Assuntos
Cirurgia Bariátrica , Gastroenteropatias , Obesidade Mórbida , Complicações Pós-Operatórias/prevenção & controle , Cirurgia Bariátrica/efeitos adversos , Seguimentos , Gastroenteropatias/etiologia , Humanos , Obesidade Mórbida/cirurgia , Perda de Peso
13.
Ther Umsch ; 76(3): 133-137, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31498050

RESUMO

Metabolic surgery in patients with poorly controlled type 2 diabetes and low BMI Abstract. Bariatric surgery has been established as an efficient therapy for morbid obesity. Metabolic surgery represents the operative treatment of type 2 diabetes and other metabolic disorders. Metabolic surgery does not focus on weight loss, as many mechanisms, which are responsible for the improvement of the glycemic control are independent from weight loss. There are many studies, which show the efficient effect of metabolic surgery in diabetic patients with class II obesity. Furthermore, there is growing evidence, that metabolic surgery does also work in patients with a BMI below 35 kg / m2. Multiple surgical and endocrinological associations have endorsed these facts and adopted their guidelines. In obese type 2 diabetics with a BMI below 35 kg / m2 and a poor glycemic control metabolic surgery should be considered as a therapeutic option.


Assuntos
Cirurgia Bariátrica , Diabetes Mellitus Tipo 2 , Obesidade Mórbida , Índice de Massa Corporal , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/cirurgia , Humanos , Obesidade Mórbida/complicações , Obesidade Mórbida/cirurgia , Perda de Peso
14.
Ther Umsch ; 76(3): 129-132, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31498051

RESUMO

Bariatric Surgery in Switzerland: Legal foundations and standard procedures Abstract. This article describes the history of bariatric and metabolic surgery in Switzerland including the guidelines that define the interdisciplinary management of morbidly obese patients including quality measures. The most frequently performed surgical interventions are being described.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Humanos , Obesidade Mórbida/cirurgia , Suíça
16.
Rev Col Bras Cir ; 46(4): e2252, 2019 Sep 09.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31508737

RESUMO

OBJECTIVE: to present a descriptive analysis of the results of a care bundle applied to obese patients submitted to bariatric surgery, regarding infection control. METHODS: a care bundle was designed to control surgical site infection (SSI) rates in patients undergoing bariatric surgery. The bundle included smoking cessation, bathing with 4% chlorhexidine two hours before surgery, cefazolin (2g bolus) in anesthetic induction associated with a continuous infusion of the same drug at a dose of 1g over a two-hour period, appropriate trichotomy, glycemic control, supplemental oxygen, normothermia, intraspinal morphine for the relief of pain, and sterile dressing removal 48 hours after surgery. All patients were followed up for 30 days. RESULTS: among the 1,596 included patients, 334 (20.9%) underwent open surgery and 1,262 (79.1%) underwent videolaparoscopic surgery. SSI rates were 0.5% in the group submitted to laparoscopic surgery and 3% in the one submitted to open surgery. The overall incidence of SSI was 1%. Intra-abdominal, respiratory tract, and urinary tract infections occurred in 0.9%, 1.1%, and 1.5% of the sample, respectively. Higher body mass index was associated with higher incidence of SSI (p=0.001). Among patients with diabetes, 2.2% developed SSI, while the rate of infection among non-diabetics was only 0.6%. CONCLUSION: the established care bundle, structured by core evidence-based strategies, associated with secondary measures, was able to maintain low SSI rates after bariatric surgery.


Assuntos
Cirurgia Bariátrica/efeitos adversos , Cirurgia Bariátrica/métodos , Pacotes de Assistência ao Paciente , Infecção da Ferida Cirúrgica/prevenção & controle , Adolescente , Adulto , Idoso , Índice de Massa Corporal , Brasil/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade/cirurgia , Assistência Perioperatória/métodos , Estudos Prospectivos , Fatores de Risco , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/etiologia , Adulto Jovem
17.
Ned Tijdschr Tandheelkd ; 126(9): 437-441, 2019 Sep.
Artigo em Holandês | MEDLINE | ID: mdl-31522209

RESUMO

In a general dental practice, attention was drawn to a patient by numerous deep carious cavities following bariatric surgery. In the research literature, indications can be found for a negative influence of bariatric surgery on oral health. Risk factors for caries, such as the number of cariogenic bacteria in saliva, inadequate quantity and quality of saliva, gastrooesophageal reflux and vomiting may be become more pronounced. Additionally, dietary habits will change due to the altered anatomy of the gastro-intestinal tract. Negative effects of bariatric surgery on periodontal tissue have also been found. However, it is conceivable that patients who are overweight already have poorer oral health prior to bariatric surgery,due to lifestyle and dietary habits, than comparable people who are not overweight. Health education programmes prior to and following bariatric surgery seem to have a positive effect on oral health. Initiating more research into oral health related to bariatric surgery is recommended.


Assuntos
Cirurgia Bariátrica , Cárie Dentária , Promoção da Saúde/organização & administração , Cirurgia Bariátrica/efeitos adversos , Cárie Dentária/epidemiologia , Humanos , Saúde Bucal
18.
Praxis (Bern 1994) ; 108(10): 655-662, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-31387501

RESUMO

Alcohol and the Bariatric Patient: When One Drink Becomes Two Drinks Abstract. Moderate consumption of alcohol is a risk factor for weight gain and obesity. Alcohol affects all components of the energy balance. Alcohol consumption is - as in the general population - also a widespread phenomenon in obese and bariatric patients. As a function of the bariatric surgery technique, alcohol metabolism is altered: gastric bypass surgery and sleeve gastrectomy lead to a faster absorption of alcohol, higher peak alcohol concentration and a longer alcohol persistence in the circulation. Further reward mechanisms for alcohol are changed, so that alcohol consumption is enhanced and promoted, with an increased risk to develop alcohol dependency. It is time to address these issues in the daily practice and to fill the existing research gaps.


Assuntos
Consumo de Bebidas Alcoólicas , Cirurgia Bariátrica , Derivação Gástrica , Obesidade Mórbida , Consumo de Bebidas Alcoólicas/efeitos adversos , Etanol , Gastrectomia , Humanos , Obesidade
19.
Rev Med Suisse ; 15(659): 1458-1460, 2019 Aug 21.
Artigo em Francês | MEDLINE | ID: mdl-31436062

RESUMO

The number of bariatric surgery interventions has increased over the past 10 years. The effectiveness of bariatric surgery is currently well demonstrated. However, the need to organize a careful medical follow-up of these patients is essential to ensure a positive evolution over the long term. In fact, weight change may be highly variable : excessive weight loss, early stabilization, progressive weight recovery in the middle or long term, all events that often require a multidisciplinary approach. The risk of osteoporosis, dumping syndrome and micronutrient deficiencies requires long-term medical monitoring. In absence of adequate management, such complications may hinder the success of surgery. This article describes the most important points of long-term medical follow-up of patients who underwent bariatric surgery.


Assuntos
Cirurgia Bariátrica , Cirurgia Bariátrica/efeitos adversos , Síndrome de Esvaziamento Rápido/etiologia , Humanos , Osteoporose/etiologia , Tempo , Perda de Peso
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