ABSTRACT
BACKGROUND: Roux-en-y gastric bypass for the management of morbid obesity is currently the safest and more efficient treatment option. the laparoscopic era has shown its benefits in this type of surgery, so some authors advocate its implementation in a practical systematic way. all of which has lead in recent years to the unavoidable change in the surgical approach. OBJECTIVES: To evaluate and compare the complications of laparoscopic gastric bypass and the conventional one in patients with morbid obesity. Application site: self-administration national university hospital. DESIGN: Comparative, prospective no randomized study. POPULATION: Between 2002 and 2011, 420 morbidly obese patients received surgical treatment for the obesity either open (167) or laparoscopic (253) surgery RESULTS: Early postoperative complication rate was 4
in the lbg and 34
in the cbg (p < 05, 95
ci 22-38), mostly represented by seromas (25
) and wall abscesses (5.4
). the percentage of late postoperative complications was 2.8
in the lbg group and 9.6
in the cbg (p=0.004, 95
ci 1.4-12.2), the most frequent being incisional hernias (7.18
). CONCLUSIONS: According to our experience and consulted literature, laparoscopic gastric bypass is a safe, reproducible and with a lower rate of both early and late complications than cbg, and so we consider and offer lbg as the ideal technique for the treatment of patients with morbid obesity.
Subject(s)
Anastomosis, Roux-en-Y/adverse effects , Gastric Bypass/adverse effects , Laparoscopy/adverse effects , Obesity, Morbid/surgery , Adult , Postoperative Complications , Prospective Studies , Female , Humans , Laparoscopy/methods , Male , Length of StayABSTRACT
La diabetes mellitus es una enfermedad crónica muy prevalente, que suele alterar el sistema inmunológico y generar complicaiones tardías de tipo vascular y neurológico. Estas se localizan con mayor predilección en ciertas áreas corporales, como son las extremidades inferiores. Agentes bacterianos suelen infectar con frecuencia las lesiones iniciales, generadas o inducidas por las alteraciones vasculoneurológicas. Todo ello origina el denominado cuadro del "pié diabético". Este se considera como una emergencia médica, por sus repercusiones en la salud, economía y futuro del afectado. El presente trabajo, fruto de nuestra experiencia y de revisión bibliográfica, analiza los tipos de lesión que puede presentar el pie diabético, sus factores predisponentes y agravantes, además de su evolución y tratamiento correspondientes; concluyéndose con recomendaciones para su prevención.