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PURPOSE: To analyze the effectiveness of vertical gastrectomy in the treatment of obese patients, adherence to clinical follow-up and the influence of factors such as gender and age. METHODS: This is a retrospective, observational and descriptive study, conducted with patients undergoing vertical gastrectomy, operated at Hospital São Domingos, between January 2016 and July 2018. RESULTS: Most patients undergoing vertical gastrectomy were female (n = 193, 72.28%) and had a mean age of37.11 ± 8.96 years old. The loss of follow-up was 56.18%. Among adherent patients (n = 117; 43.82%), most patients were female (n = 89; 76.07%) and had a mean age of 37.92 ± 9.85 years old. The mean body mass index (BMI) of the adherents in the preoperative was 37.85 ± 3.72 kg/m2. Both BMI and excess weight (EW) showed a statistically significant difference between pre- and postoperative period. Percentage of excess weight loss (% EWL) was satisfactory for 96.6% of adherent patients. Older patients had a statistically significant lower % EWL compared to the other groups. CONCLUSIONS: Vertical gastrectomy was effective in the treatment of obese patients, with significant weight loss.

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Purpose To analyze the effectiveness of vertical gastrectomy in the treatment of obese patients, adherence to clinical follow-up and the influence of factors such as gender and age. Methods This is a retrospective, observational and descriptive study, conducted with patients undergoing vertical gastrectomy, operated at Hospital São Domingos, between January 2016 and July 2018. Results Most patients undergoing vertical gastrectomy were female (n = 193, 72.28%) and had a mean age of37.11 ± 8.96 years old. The loss of follow-up was 56.18%. Among adherent patients (n = 117; 43.82%), most patients were female (n = 89; 76.07%) and had a mean age of 37.92 ± 9.85 years old. The mean body mass index (BMI) of the adherents in the preoperative was 37.85 ± 3.72 kg/m2. Both BMI and excess weight (EW) showed a statistically significant difference between pre- and postoperative period. Percentage of excess weight loss (% EWL) was satisfactory for 96.6% of adherent patients. Older patients had a statistically significant lower % EWL compared to the other groups. Conclusions Vertical gastrectomy was effective in the treatment of obese patients, with significant weight loss.(AU)

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ABSTRACT Purpose To analyze the effectiveness of vertical gastrectomy in the treatment of obese patients, adherence to clinical follow-up and the influence of factors such as gender and age. Methods This is a retrospective, observational and descriptive study, conducted with patients undergoing vertical gastrectomy, operated at Hospital São Domingos, between January 2016 and July 2018. Results Most patients undergoing vertical gastrectomy were female (n = 193, 72.28%) and had a mean age of37.11 ± 8.96 years old. The loss of follow-up was 56.18%. Among adherent patients (n = 117; 43.82%), most patients were female (n = 89; 76.07%) and had a mean age of 37.92 ± 9.85 years old. The mean body mass index (BMI) of the adherents in the preoperative was 37.85 ± 3.72 kg/m2. Both BMI and excess weight (EW) showed a statistically significant difference between pre- and postoperative period. Percentage of excess weight loss (% EWL) was satisfactory for 96.6% of adherent patients. Older patients had a statistically significant lower % EWL compared to the other groups. Conclusions Vertical gastrectomy was effective in the treatment of obese patients, with significant weight loss.

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Background: Among Roux-en-Y gastric bypass complications is the occurrence of intestinal obstruction by the appearance of internal hernias, which may occur in Petersen space or the opening in mesenteric enteroenteroanastomosis.Aim: To evaluate the efficiency and safety in performing a fixing jejunal maneuver in the transverse mesocolon to prevent internal hernia formation in Petersen space.Method: Two surgical points between the jejunum and the transverse mesocolon, being 5 cm and 10 cm from duodenojejunal angle are made. In all patients was left Petersen space open and closing the opening of the mesenteric enteroenteroanastomosis.Results: Among 52 operated patients, 35 were women (67.3%). The age ranged 18-63 years, mean 39.2 years. BMI ranged from 35 to 56 kg/m2 (mean 40.5 kg/m2). Mean follow-up was 15.1 months (12-18 months). The operative time ranged from 68-138 min. There were no intraoperative complications, and there were no major postoperative complications and no reoperations. The hospital stay ranged from 2-3 days. During the follow-up, no one patient developed suspect clinical presentation of internal hernia. Follow-up in nine patients (17.3%) showed asymptomatic cholelithiasis and underwent elective laparoscopic cholecystectomy. During these procedures were verified the Petersen space and jejunal fixation. In all nine, there was no herniation of the jejunum to the right side in Petersen space.Conclusion: The fixation of the first part of the jejunum to left side of the transverse mesocolon is safe and effective to prevent internal Petersen hernia in RYGB postoperatively in the short and medium term. It may be interesting alternative to closing the Petersen space.

Racional: Entre outras complicações do bypass gástrico em Y-de-Roux está a ocorrência de obstrução intestinal pelo aparecimento de hérnias internas, que podem ocorrer no espaço de Petersen ou na abertura mesentérica da enteroenteroanastomose.Objetivo: Avaliar a eficiência e a segurança da realização de uma manobra de fixação do jejuno no mesocólon transverso para evitar formação de hérnia interna no espaço de Petersen.Método: Realizam-se dois pontos de fixação entre o jejuno e o mesocólon transverso, sendo um a 5 cm e outro a 10 cm do ângulo duodenojejunal. Em todos os pacientes foi deixado o espaço de Petersen aberto e realizado o fechamento da abertura mesentérica da enteroenteroanastomose.Resultados: Entre 52 pacientes estudados, 35 eram do sexo feminino (67,3%). A idade variou de 18 a 63 anos, com média de 39,2 anos. O IMC variou de 35 a 56 kg/m2 (média de 40,5 kg/m2). O seguimento médio foi de 15,1 meses (de 12 a 18 meses). O tempo operatório variou de 68-138 min. Não ocorreram intercorrências intra-operatórias, assim como não houve complicações pós-operatórias maiores e nem reoperações. O período de internação hospitalar variou de 2-3 dias. Durante o seguimento, nenhum paciente desenvolveu quadro suspeito de hérnia interna. Neste período, nove pacientes (17,3%) apresentaram quadro de colecistolitíase (por microcálculos) assintomática, e foram submetidos à colecistectomia videolaparoscópica eletiva. Durante estes procedimentos foram verificados o espaço de Petersen e a fixação jejunal. Em todos os nove, não havia herniação do jejuno para o lado direito do espaço de Petersen.Conclusão: A fixação da primeira parte do jejuno ao lado esquerdo do mesocólon transverso é segura e eficiente para evitar hérnia interna de Petersen em pós-operatório de BGYR no curto e médio prazo. Pode ser interessante alternativa ao fechamento do espaço de Petersen.

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