Costa Roberto Coelho Netto da Cunha, Yamaguchi Nagamassa, Santo Marco Aurelio, Riccioppo Daniel, Pinto-Junior Paulo Engler
Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brasil.
Unidade de Cirurgia Bariátrica e Metabólica, Disciplina de Cirurgia do Aparelho Digestivo, Departamento de Gastroenterologia, Hospital das Clínicas da FMUSP, São Paulo, SP, Brasil.
Arq Gastroenterol. 2014 Jul-Sep;51(3):165-70. doi: 10.1590/s0004-28032014000300002.
CONTEXT: Bariatric surgery has become the most effective method for producing weight loss in obese patients. The evaluation of improvement of comorbidities and changes in the quality of life are important outcome factors; however, it is necessary to investigate whether they persist over the long term. METHODS: A cross-sectional study was conducted on 143 obese patients from our institution from February 2007 to February 2008. These patients were divided into five independent groups, one being a control group, plus four other groups with 1, 2, 3, 4 or more years following surgical Roux-en-Y gastric bypass with a silicon ring banded. quality of life forms and anthropometric measurements were performed and its scores correlated with social factors, weight loss success, and status of obesity-related conditions. RESULTS: For the group that was 1 year postoperative, a significant percentage of excess body weight loss (EBWL%) of 81.7% was observed. The groups with 2, 3, 4 or more years of post-surgical follow-up showed a EBWL decline, but without significant difference. The main comorbidity percentages in all patients who had the surgery was as follows: 69.7% for hypertension; 88.2% for diabetes mellitus; and 27.5% for arthropathy. There was a significant decrease in the rate for diabetes resolution (P = 0.035) observed by evolutionary assessment of the comorbidity resolution. The results obtained by BAROS were good, very good, or excellent in more than 96% of patients in all evaluations that were performed. The use of the Moorehead-Ardelt Questionnaire (M/A) demonstrated improvement in the quality of life. Moreover, the quality of life, when evaluated through SF-36, also showed improvement in all related areas after 1 year; however, after 4 years, improvement remained elevated only in the areas of general state of health and functional capacity. CONCLUSIONS: The Roux-en-Y gastric bypass procedure was able to achieve EBWL of 81.7% after 1 year following surgery, remaining steady with little decline after this period. Important resolution of comorbidities, such as hypertension and diabetes, was also seen. Immediate surgical outcomes assessed by SF-36 and M/A in the area of quality of life were satisfactory, but the general state of health and functional capacity areas were sustained satisfactory at a later time only.
背景：减重手术已成为肥胖患者实现体重减轻的最有效方法。评估合并症的改善情况以及生活质量的变化是重要的结局因素；然而，有必要调查这些因素在长期内是否持续存在。 方法：于2007年2月至2008年2月对我院143例肥胖患者进行了一项横断面研究。这些患者被分为五个独立组，一组为对照组，另外四组分别为接受带硅环的Roux-en-Y胃旁路手术后1、2、3、4年及以上的患者。进行了生活质量测评和人体测量，并将其得分与社会因素、体重减轻成功情况以及肥胖相关疾病状况相关联。 结果：术后1年的组观察到显著的多余体重减轻百分比（EBWL%）为81.7%。术后随访2、3、4年及以上的组EBWL有所下降，但无显著差异。所有接受手术患者的主要合并症百分比如下：高血压为69.7%；糖尿病为88.2%；关节病为27.5%。通过对合并症缓解情况的动态评估观察到糖尿病缓解率有显著下降（P = 0.035）。在所有进行的评估中，超过96%的患者通过BAROS获得的结果为良好、非常好或优秀。使用穆尔黑德 - 阿德尔特问卷（M/A）显示生活质量有所改善。此外，通过SF - 36评估生活质量时，术后1年所有相关领域也显示出改善；然而，4年后，仅在总体健康状况和功能能力领域仍保持较高的改善水平。 结论：Roux - Y胃旁路手术在术后一年能够实现81.7%的多余体重减轻，在此之后保持稳定且下降幅度很小。还观察到高血压和糖尿病等合并症有重要缓解。通过SF - 36和M/A在生活质量方面评估的即时手术结果令人满意，但总体健康状况和功能能力领域仅在后期持续保持令人满意。
Arq Gastroenterol. 2014
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