6533b822fe1ef96bd127dde0

RESEARCH PRODUCT

Estudio retrospectivo a largo plazo de los resultados de dos técnicas de cirugía bariátrica en pacientes con obesidad mórbida: Bypass gástrico y gastrectomía vertical

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La obesidad mórbida (Índice de Masa Corporal >40) se asocia a comorbilidades que pueden poner en riesgo la vida del paciente. El bypass gástrico en “y de roux” y la gastrectomía vertical son dos de las técnicas bariátricas más realizadas, pero, aunque se postulen como tratamientos eficaces frente a esta obesidad, no están exentas de riesgo. El objetivo principal de este estudio es conocer los efectos que estas técnicas tienen sobre el paciente a medio-largo plazo (2-5 años) siendo los seguimientos a los 0, 6, 12, 24 y 60 meses. Se realiza un estudio observacional retrospectivo y comparativo de una muestra de 244 pacientes (133 intervenidos mediante by pass gástrico en “y de roux” y 111 mediante gastrectomía vertical o “sleeve”). Las dos técnicas estudiadas muestran unos resultados excelentes según el PEIMCP (mayor al 65% en ambas), con un aumento de peso a los cinco años que no llega a ser estadísticamente significativo (p 40) is associated with comorbidities that can put the patient's life at risk. Gastric bypass in “y de roux” and vertical gastrectomy are two of the most performed bariatric techniques, but, although they are postulated as effective treatments for this obesity, they are not without risk. The main objective of this study is to know the effects that these techniques have on the patient in the medium-long term (2-5 years), with follow-ups at 0, 6, 12, 24 and 60 months. A retrospective and comparative observational study was carried out on a sample of 244 patients (133 operated by gastric bypass in “y de roux” and 111 by vertical or “sleeve” gastrectomy). The two techniques studied show excellent results according to the PEIMCP (greater than 65% in both), with an increase in weight at five years that is not statistically significant (p <0.05). Decreases in glucose concentration of 28.9% were obtained in gastric bypass and 21.1% in vertical gastrectomy, with a non-significant increase at 60 months. There is an improvement in the lipid profile in patients operated on by the two techniques in the short term, at which point there is a gradual increase in the mean values of total cholesterol, LDL cholesterol and triglycerides. Higher mean values are obtained in vertical gastrectomy, being significant in the case of total cholesterol, LDL and triglycerides in the long term, and an increase in HDL cholesterol in both techniques. There is a decrease in the concentration of liver transaminases and statistically significant decreases in total protein concentrations in the medium and long term. Significant decreases are obtained in the mean uric acid value in vertical gastrectomy, with a decrease of 25% in the long-term mean concentration, and decreases in the mean calcium values (which becomes significant in bypass with a decrease of 6 , 6% at 60 months with respect to the 6-month follow-up) and long-term vitamin B12. Gastric bypass and vertical gastrectomy are effective methods in controlling the weight of morbidly obese patients and in the management of comorbidities, but longer-term monitoring of the patient should be taken into account.