Palavras-chave
Obesidade Mórbida
Gastrectomia Vertical
Bypass Gástrico
Complicações Pós-operatórias
Como Citar
Resumo
A obesidade tornou-se uma preocupação global de saúde pública devido às suas ramificações multifacetadas que afetam não apenas a saúde individual, mas também os sistemas de saúde e a economia global. As estratégias de tratamento para obesidade evoluíram significativamente nas últimas décadas, com a cirurgia bariátrica emergindo como uma abordagem terapêutica proeminente, particularmente para obesidade mórbida e para aqueles que não responderam a abordagens conservadoras. Esta revisão abordou as técnicas bariátricas mais comuns, incluindo Bypass gástrico em Y-de-Roux, Gastrectomia vertical (sleeve), Banda gástrica ajustável e Desvio biliopancreático com duodenal switch. Cada técnica foi analisada em relação à sua eficácia, perfil de segurança e possíveis complicações. Os resultados mostram que, embora todos os procedimentos sejam eficazes na indução de perda de peso significativa, eles apresentam variáveis graus de complicações e benefícios metabólicos. Notavelmente, muitos dos procedimentos não apenas facilitam a perda de peso, mas também induzem melhorias significativas ou remissão de comorbidades, como diabetes tipo 2. A discussão centrou-se nas implicações clínicas dessas técnicas, salientando a importância do acompanhamento pós-operatório e da gestão de possíveis deficiências nutricionais ou complicações. Em conclusão, a cirurgia bariátrica é um pilar essencial no tratamento da obesidade, mas o sucesso a longo prazo depende de uma abordagem holística que envolve não apenas a intervenção cirúrgica, mas também o suporte e a educação contínuos do paciente.
Referências
ADAMS, T.D. et al. (2017). Weight and metabolic outcomes 12 years after gastric bypass. NEJM.
ADAMS, T.D. et al. (2017). Weight and metabolic outcomes 12 years after gastric bypass. The New England Journal of Medicine.
AHMED S, POUWELS S, PARMAR C, KASSIR R, DE LUCA M, GRAHAM Y, MAHAWAR K; Global Bariatric Research Collaborative. Outcomes of Bariatric Surgery in Patients with Liver Cirrhosis: a Systematic Review. Obes Surg. 2021 May;31(5):2255-2267. doi: 10.1007/s11695-021-05289-x. Epub 2021 Feb 17. PMID: 33595790.
BALTAZAR, A. et al. (2002). Use of silicone band in biliopancreatic diversion. Obesity Surgery.
BENAIGES, D. et al. (2015). Laparoscopic sleeve gastrectomy: More than a restrictive bariatric surgery procedure? World Journal of Gastroenterology.
BOZA, C. et al. (2012). Laparoscopic sleeve gastrectomy as a stand-alone procedure for morbid obesity: Report of 1,000 cases and 3-year follow-up. Obesity Surgery.
BRETHAUER, S.A. et al. (2011). Standardized outcomes reporting in metabolic and bariatric surgery. Surgery for Obesity and Related Diseases.
BRETHAUER, S.A. et al. (2013). Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus. Annals of Surgery.
BUCHWALD, H. et al. (2004). Bariatric surgery: a systematic review and meta-analysis. JAMA.
BUCHWALD, H. et al. (2004). Bariatric surgery: A systematic review and meta-analysis. JAMA.
CHEVALLIER, J.M. et al. (2007). Complications after laparoscopic adjustable gastric banding for morbid obesity: Experience with 1,000 patients over 7 years. Obesity Surgery.
COURCOULAS, A. P. et al. (2014). Surgical Procedures and Clinical Outcomes for Obese Individuals. Annals of Surgery.
COURCOULAS, A.P. et al. (2013). Surgical vs medical treatments for type 2 diabetes mellitus: a randomized clinical trial. JAMA Surgery.
DIXON, J. B. et al. (2008). Adjustable gastric banding and conventional therapy for type 2 diabetes: A randomized controlled trial. JAMA.
DIXON, J.B. et al. (2015). Surgical vs conventional therapy for weight loss treatment of obstructive sleep apnea: A randomized controlled trial. JAMA.
HIMPEMS, J. et al. (2011). Long-term results of laparoscopic adjustable gastric banding for the treatment of morbid obesity. Surgery for Obesity and Related Diseases.
KARCZ, W.K. et al. (2019). Technical Aspects of Sleeve Gastrectomy—Literature Review. Obesity Surgery.
KOLOTKIN, R.L. et al. (2008). Changes in health-related quality of life following gastric bypass surgery for morbid obesity. Obesity Surgery.
MARCEAU, P. et al. (1995). Biliopancreatic diversion with a new type of gastrectomy. Obesity Surgery.
MECHANICK, J. I. et al. (2013). Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient. Obesity (Silver Spring).
MELISSAS, J. et al. (2013). Sleeve gastrectomy—a restrictive procedure? Obesity Surgery.
MINGRONE, G. et al. (2012). Bariatric–metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. The Lancet.
MINGRONE, G. et al. (2015). Bariatric–metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. The Lancet.
NG, M. et al. (2014). Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet.
O'BRIEN, P.E. et al. (2002). Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program: A randomized trial. Annals of Internal Medicine.
O'BRIEN, P.E. et al. (2019). Long-term outcomes after bariatric surgery: fifteen-year follow-up of adjustable gastric banding and a systematic review of the literature. Annals of Surgery.
PRACHAND, V.N. et al. (2010). Duodenal switch provides superior weight loss in the super-obese (BMI ≥50 kg/m²) compared with gastric bypass. Annals of Surgery.
ROSAENTHAL, R.J. et al. (2012). International Sleeve Gastrectomy Expert Panel Consensus Statement. Obesity Surgery.
RUBINO, F. et al. (2016). Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by international diabetes organizations. Diabetes Care.
SCHAUER, P. R. et al. (2017). Bariatric Surgery versus Intensive Medical Therapy for Diabetes — 5-Year Outcomes. The New England Journal of Medicine.
SHIKORA, S.A. et al. (2015). The current status of weight loss surgery, Current Opinion in Endocrinology, Diabetes and Obesity.
SJÖHOLM, K. et al. (2016). Incidence and remission of type 2 diabetes in relation to degree of obesity at baseline and 2 year weight change: the Swedish Obese Subjects (SOS) study. Diabetologia.
SJÖSTRÖM, L. et al. (2012). Bariatric surgery and long-term cardiovascular events. JAMA.
SJÖSTRÖM, L. et al. (2012). Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications. JAMA.
SUDAN, R. et al. (2015). Morbidity, mortality, and weight loss outcomes after reoperative bariatric surgery in the USA. JAMA Surgery.
SUTER, M. et al. (2011). A new questionnaire for quick assessment of food tolerance after bariatric surgery. Obesity Surgery.
TOPART, P. et al. (2013). Weight loss is more sustained after biliopancreatic diversion with duodenal switch than Roux-en-Y gastric bypass in superobese patients. Surgery for Obesity and Related Diseases.
TREMAROLI, V., & BÄCKHED, F. (2012). Functional interactions between the gut microbiota and host metabolism. Nature.
WHO (2021). Obesity and overweight. World Health Organization.
WORLD HEALTH ORGANIZATION. (2018). Obesity and overweight. WHO Factsheet.
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Copyright (c) 2023 Luana Novaes de Almeida, Raquel Castro Ribeiro, Julia Soares Oliveira, Paula Palhares de Resende, Hemily de Oliveira Celestino