RESUMO
BACKGROUND: Patients who undergo Roux-en-Y gastric bypass (RYGB) have significant weight loss, and abdominoplasty is an effective corrective surgery for removing excess skin. This study aimed to evaluate the impact of the weight of removed tissue on the development of postoperative complications in patients undergoing abdominoplasty without lipoaspiration after gastric bypass at the Federal District North Wing Regional Hospital, Brasília, Brazil. METHODS: Data were analyzed from a prospective registry of patients who underwent abdominoplasty without lipoaspiration after gastric bypass from January 2011 to December 2018. The variables examined included body mass index (BMI) before RYGB and before plastic surgery, weight loss, weight of the excised abdominal flap, comorbidities, and medical complications. Analysis of the role of the weight of the removed tissue after abdominoplasty was performed to assess outcome measures. RESULTS: One hundred sixty-three patients were included. The mean age of the patients was 42 years. Their BMI at the time of abdominoplasty was 27.49 kg/m2, and the average weight loss before abdominoplasty was 47.13 kg. The preweight loss BMI was 45.27 kg/m2, and the ∆BMI was 17.78 kg/m2. The overall complication rate was 29.4%. An amount of removed tissue from the abdomen ≥ 2000 g significantly increased the rates of postoperative complications (46.7% vs. 19.4%; p = 0.002; OR = 3.13). CONCLUSIONS: Removal of ≥ 2000 g of tissue from the abdomen led to significantly more complications in patients who underwent abdominoplasty after gastric bypass. In addition, this group of patients was significantly associated with the presence of higher anthropometric variable values (BMI, weight loss, max BMI, and ∆BMI) and not associated with the presence of comorbidities.
Assuntos
Abdominoplastia , Derivação Gástrica , Laparoscopia , Obesidade Mórbida , Abdominoplastia/efeitos adversos , Adulto , Índice de Massa Corporal , Brasil , Derivação Gástrica/efeitos adversos , Humanos , Obesidade Mórbida/cirurgia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
OBJECTIVE: to evaluate the clinical characteristics of patients with colorectal cancer under the age of 50 treated at a public hospital in Brasilia over 5 years. METHODS: we conducted a longitudinal, retrospective study, with 184 patients undergoing surgical procedures at the Asa Norte Regional Hospital (HRAN), including those who underwent only biopsy, between January 2013 and January 2018. We divided the patients into two groups: under the age of 50 (n=39) and age equal to or greater than 50 years (n=145). We compared the groups as to age, sex, symptoms, time between symptom onset and diagnosis, family and personal history, tumor location, histopathological characteristics, applied surgical management, staging and mortality. RESULTS: the group of patients under the age of 50 had more individuals with stage III and IV (p=0.041), more frequent poorly differentiated tumors (10.25% versus 3.52%; p=0.153), and higher incidences of compromised surgical margins (p=0.368), angiolymphatic (p=0.07) and perineural (p=0.007) invasion, which denotes more advanced disease in this group of patients. CONCLUSIONS: the study showed the low effectiveness of population screening methods for colorectal cancer currently used in this population, given the high incidence of the disease and late diagnosis in both groups.
Assuntos
Carcinoma/patologia , Neoplasias Colorretais/patologia , Adulto , Fatores Etários , Brasil/epidemiologia , Carcinoma/epidemiologia , Carcinoma/cirurgia , Colo/patologia , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/cirurgia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Fatores de Risco , Adulto JovemRESUMO
ABSTRACT Objective : to evaluate the clinical characteristics of patients with colorectal cancer under the age of 50 treated at a public hospital in Brasilia over 5 years. Methods: we conducted a longitudinal, retrospective study, with 184 patients undergoing surgical procedures at the Asa Norte Regional Hospital (HRAN), including those who underwent only biopsy, between January 2013 and January 2018. We divided the patients into two groups: under the age of 50 (n=39) and age equal to or greater than 50 years (n=145). We compared the groups as to age, sex, symptoms, time between symptom onset and diagnosis, family and personal history, tumor location, histopathological characteristics, applied surgical management, staging and mortality. Results: the group of patients under the age of 50 had more individuals with stage III and IV (p=0.041), more frequent poorly differentiated tumors (10.25% versus 3.52%; p=0.153), and higher incidences of compromised surgical margins (p=0.368), angiolymphatic (p=0.07) and perineural (p=0.007) invasion, which denotes more advanced disease in this group of patients. Conclusions: the study showed the low effectiveness of population screening methods for colorectal cancer currently used in this population, given the high incidence of the disease and late diagnosis in both groups.
RESUMO Objetivo: avaliar o perfil clínico de pacientes portadores de câncer colorretal com idade inferior a 50 anos atendidos em um hospital público de Brasília ao longo de 5 anos. Métodos: estudo longitudinal e retrospectivo. Foram incluídos 184 pacientes submetidos a procedimento cirúrgico no Hospital Regional da Asa Norte (HRAN), incluindo aqueles que realizaram apenas biópsia, entre janeiro de 2013 e janeiro de 2018. Os pacientes foram divididos em dois grupos: com idade inferior a 50 anos (n=39) e idade igual ou superior a 50 anos (n=145). Os grupos foram comparados em relação às seguintes variáveis: idade, gênero, sintomatologia, tempo entre início dos sintomas e diagnóstico, antecedentes familiares e pessoais, localização do tumor, características anatomopatológicas, conduta cirúrgica estabelecida, estadiamento e mortalidade. Resultados: no grupo dos pacientes com idade inferior a 50 anos houve maior concentração de indivíduos com estadiamento III e IV (p=0,041), foi mais frequente a presença de tumores pouco diferenciados (10,25% contra 3,52%; p=0,153), foram descritas maiores incidências de margens cirúrgicas comprometidas (p=0,368), invasão angiolinfática (p=0,07) e perineural (p=0,007), o que denota doença mais avançada nesse grupo de pacientes. Conclusões: o estudo evidenciou a baixa efetividade dos métodos de rastreamento populacional para câncer colorretal atualmente empregados nesta população, visto a elevada incidência da doença e ao diagnóstico tardio em ambos os grupos.