ABSTRACT
BACKGROUND: Obesity is a major health problem. One anastomosis-gastric bypass (OAGB) is a restrictive and malabsorptive weight loss surgery that carries the same characteristics of Roux-en-Y gastric bypass in its status as a weight loss mechanism; but, its results remain controversial. AIM: To describe the technique and outcomes of OAGB and its effects on weight loss and remission of comorbidities. METHODS: Retrospective review of all patients who underwent OAGB procedure from January 2017 to January 2018. Patients' baseline characteristics were recorded. The routine in follow-up were at 1, 3, 6 and 12 months. RESULTS: A total of 51 patients underwent OAGB. The mean age was 43.8±9.3 years, mean weight was 125±31 and mean BMI was 55.8±12 kg/m2. With regard to comorbidities, 64.7% had type 2 diabetes mellitus (T2DM), 43.1% systemic arterial hypertension (SAH) and 51% dyslipidemia. The BMI decreased for 48.4±1.3 to 31±4.4 at 12 months (p=0.0001) and we obtained an average decreased of 65% excess weight loss (EWL) at 12 months of follow-up. There was improvement in the values of total cholesterol (CT) (p=0.348); triglycerides (TGC) (p=0.0001); LDL (p=0.06), HDL (p=0.029) and A1C (p=0.405). Remission of T2DM al 12 months follow-up after surgery was 57% (p=0.124), remission of SAH 37% (p=0.040) and remission of dyslipidemia of 43% (p=0.967). CONCLUSIONS: OAGB is a commonly performed and safe procedure. Short term results appear promising; however, long-term follow-up is necessary to evaluate complications and possible nutritional effects.
Subject(s)
Gastric Bypass/methods , Obesity, Morbid/surgery , Weight Loss , Adult , Female , Follow-Up Studies , Humans , Male , Middle Aged , Retrospective Studies , Treatment Outcome , Young AdultABSTRACT
ABSTRACT Background: Obesity is a major health problem. One anastomosis-gastric bypass (OAGB) is a restrictive and malabsorptive weight loss surgery that carries the same characteristics of Roux-en-Y gastric bypass in its status as a weight loss mechanism; but, its results remain controversial. Aim: To describe the technique and outcomes of OAGB and its effects on weight loss and remission of comorbidities. Methods: Retrospective review of all patients who underwent OAGB procedure from January 2017 to January 2018. Patients' baseline characteristics were recorded. The routine in follow-up were at 1, 3, 6 and 12 months. Results: A total of 51 patients underwent OAGB. The mean age was 43.8±9.3 years, mean weight was 125±31 and mean BMI was 55.8±12 kg/m2. With regard to comorbidities, 64.7% had type 2 diabetes mellitus (T2DM), 43.1% systemic arterial hypertension (SAH) and 51% dyslipidemia. The BMI decreased for 48.4±1.3 to 31±4.4 at 12 months (p=0.0001) and we obtained an average decreased of 65% excess weight loss (EWL) at 12 months of follow-up. There was improvement in the values of total cholesterol (CT) (p=0.348); triglycerides (TGC) (p=0.0001); LDL (p=0.06), HDL (p=0.029) and A1C (p=0.405). Remission of T2DM al 12 months follow-up after surgery was 57% (p=0.124), remission of SAH 37% (p=0.040) and remission of dyslipidemia of 43% (p=0.967). Conclusions: OAGB is a commonly performed and safe procedure. Short term results appear promising; however, long-term follow-up is necessary to evaluate complications and possible nutritional effects.
RESUMO Racional: A obesidade é um grande problema de saúde. Bypass gástrico com uma anastomose (OAGB) é operação de perda de peso restritiva e disabsortiva que carrega as mesmas características do bypass gástrico em Y-de-Roux em seu status de mecanismo de perda de peso, mas seus resultados permanecem controversos. Objetivo: Descrever a técnica e os resultados do OAGB e seus efeitos na perda de peso e na remissão de comorbidades. Método: Revisão retrospectiva de todos os pacientes que foram submetidos a OAGB de janeiro de 2017 a janeiro de 2018. As características basais dos pacientes foram registradas. O acompanhamento de rotina foi de 1, 3, 6 e 12 meses. Resultados: Um total de 51 pacientes foi submetido a OAGB-HGM. A idade média foi de 43,8±9,3 anos, o peso médio foi de 125±31 e o IMC médio de 55,8±12 kg/m2. Em relação às comorbidades, 64,7% apresentavam diabete melito tipo 2 (DM2), 43,1% hipertensão arterial sistêmica (HAS) e 51% dislipidemia. O IMC diminuiu para 48,4±1,3 a 31±4,4 em 12 meses (p=0,0001) e a redução média foi de 65% de perda de excesso de peso (EWL) em 12 meses de seguimento. Houve melhora nos valores do colesterol total (CT) (p=0,348); triglicéridos (TGC) (p=0,0001); LDL (p=0,06), HDL (p=0,029) e A1C (p=0,405). A remissão do DM2 ao seguimento de 12 meses após a operação foi de 57% (p=0,124), remissão da HAS 37% (p=0,040) e remissão da dislipidemia de 43% (p=0,967). Conclusões: OAGB-HGM é procedimento comumente realizado e seguro. Resultados de curto prazo parecem promissores; no entanto, o acompanhamento em longo prazo é necessário para avaliar as complicações e possíveis efeitos nutricionais
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Obesity, Morbid/surgery , Gastric Bypass/methods , Weight Loss , Retrospective Studies , Follow-Up Studies , Treatment OutcomeABSTRACT
BACKGROUND: Gallstone ileus is a rare cause of intestinal obstruction (1-4%). It results from the migration of a gallstone through a bilio-enteric fistula. Treatment begins with fluid therapy, followed by enterolithotomy, fistula closure, and cholecystectomy. OBJECTIVES: To determine the clinical presentation in patients with gallstone ileus and subsequent medical -surgical management outcomes. MATERIAL AND METHODS: A retrospective, observational, descriptive and transversal study was conducted on patients diagnosed with intestinal obstruction secondary to a gallstone ileus from May 2013 to October 2014. The following variables were recorded: age, sex, comorbidities, mean time of onset of symptoms, length of preoperative and postoperative stay, imaging studies, biochemical tests, type of surgical management, stone location and size, complications, mortality, and postoperative follow-up. RESULTS: The study included 10 patients (male: female ratio 1:4), with a mean age of 61.9 years. The mean time of onset symptoms 15.4 days, and preoperative stay was 2days. On admission, 80% of patients had leukocytosis and neutrophilia, and 70% with renal failure. The most common surgical management was enterolithotomy with primary closure (50%), finding 80% of the stones in the terminal ileum. Recurrence was found in 2 cases. Mean postoperative hospital stay was 6.3 days. Mortality was 20%. CONCLUSIONS: Gallstone ileus most commonly presented in women in the seventh decade of life, with intermittent bowel obstruction. On hospital admission, they presented with systemic inflammatory response, electrolyte imbalance and abnormal liver function tests. Initial treatment must include fluid-electrolyte replacement, and tomography scans must be made in all cases. In our experience, the best procedure is enterolithotomy and primary closure, which presented lower morbidity and mortality.
