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尿石症和袖状胃切除术:尿生化变量的前瞻性评估。

Urolithiasis and sleeve gastrectomy: a prospective assessment of urinary biochemical variables.

机构信息

- Hospital das Clínicas da Universidade Federal de Pernambuco (HC/UFPE), Urology Department - Recife - PE - Brasil.

- Universidade Federal de Pernambuco (UFPE), Medical course - Recife - PE - Brasil.

出版信息

Rev Col Bras Cir. 2021 Feb 24;48:e20202804. doi: 10.1590/0100-6991e-20202804. eCollection 2021.

Abstract

INTRODUCTION

to evaluate urinary biochemical alterations related to urolithogenesis processes after sleeve gastrectomy (SG).

MATERIALS AND METHODS

: prospective study with 32 individuals without previous diagnosis of urolithiasis who underwent SG. A 24-h urine test was collected seven days prior to surgery and at 6-month follow-up. The studied variables were urine volume, urinary pH, oxalate, calcium, citrate, and magnesium and calcium oxalate super saturation (CaOx SS).

RESULTS

patients were mainly women (81.2%), with mean age of 40.6 years. Mean pre- and postoperative BMI were 47.1 ± 8.3 Kg/m2 and 35.5 ± 6.1 Kg/m2, respectively (p<0.001). Urine volume was significantly lower at the postoperative evaluation in absolute values (2,242.50 ± 798.26 mL x 1,240.94 ± 352.39 mL, p<0.001) and adjusted to body weight (18.58 ± 6.92 mL/kg x 13.92 ± 4.65 mL/kg, p<0.001). CaOx SS increased significantly after SG (0.11 ± 0.10 x 0.24 ± 0.18, p<0.001). Moreover, uric acid levels were significantly lower at the postoperative evaluation (482.34 ± 195.80 mg x 434.75 ± 158.38 mg, p=0.027). Urinary pH, oxalate, calcium, citrate, and magnesium did not present significant variations between the pre- and postoperative periods.

CONCLUSION

SG may lead to important alterations in the urinary profile. However, it occurs in a much milder way than that of RYGB.

摘要

引言

评估袖状胃切除术(SG)后与尿石形成过程相关的尿生化变化。

材料和方法

前瞻性研究,纳入 32 名既往无尿路结石诊断的个体,行 SG 术。术前 7 天和术后 6 个月收集 24 小时尿液检测。研究变量为尿容量、尿 pH 值、草酸盐、钙、柠檬酸盐和镁以及草酸钙过饱和度(CaOx SS)。

结果

患者主要为女性(81.2%),平均年龄为 40.6 岁。术前和术后 BMI 分别为 47.1 ± 8.3 Kg/m2 和 35.5 ± 6.1 Kg/m2(p<0.001)。术后评估时尿容量绝对值明显降低(2,242.50 ± 798.26 mL x 1,240.94 ± 352.39 mL,p<0.001)和调整至体重(18.58 ± 6.92 mL/kg x 13.92 ± 4.65 mL/kg,p<0.001)。SG 后 CaOx SS 显著增加(0.11 ± 0.10 x 0.24 ± 0.18,p<0.001)。此外,术后尿酸水平明显降低(482.34 ± 195.80 mg x 434.75 ± 158.38 mg,p=0.027)。术前和术后尿 pH 值、草酸盐、钙、柠檬酸盐和镁均无显著变化。

结论

SG 可能导致尿谱的重要变化。然而,它的发生方式比 RYGB 要温和得多。

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