RESUMO
BACKGROUND: Many surgeons prefer a narrow gastrojejunostomy in gastric bypass believing that this provides greater weight loss. The question is whether the anastomosis remains at its initial diameter, whether it narrows or widens over time. This study tests the hypothesis that the initial diameter of the anastomosis varies over time. MATERIALS AND METHODS: One hundred obese had undergone surgery. Group A with anastomosis 1.5 cm wide and group B with anastomosis 3 cm wide. One-year follow-up was done for 83 patients. The size of the anastomosis diameter was evaluated using a balloon for cardia dilation. RESULTS: Comparing the results of surgery with the values presented 1 year after the procedure, (i) BMI decreased from 43.3 ± 6.6 to 28.7 ± 7.0 kg/m2 for group A and 44.6 ± 5.9 to 29.1 ± 6.3 kg/m2 for group B, (ii) the total weight loss was 30.6 ± 4.7% for group A and 31.9 ± 5.2% for group B, and (iii) the initial 1.5-cm anastomosis in group A measured 2.3 ± 1.0 cm while the initial 3-cm anastomosis in group B measured 2.7 ± 1.0 cm 1 year after surgery. No statistically significant difference was found for any of the variables evaluated before and after the surgical procedure. CONCLUSION: Calibrated anastomosis has no utility in increasing weight loss in gastric bypass.
Assuntos
Derivação Gástrica/métodos , Jejuno/cirurgia , Obesidade Mórbida/cirurgia , Estômago/cirurgia , Adulto , Anastomose Cirúrgica , Feminino , Humanos , Masculino , Estudos Prospectivos , Resultado do Tratamento , Redução de PesoRESUMO
Two techniques of Doppler ultrasound examination, continuous-wave and range-gated, applied to the anterior cerebral artery and to the internal carotid artery, were compared with 133xenon clearance after intravenous injection. Thirty-two sets of measurements were obtained in 16 newborn infants. The pulsatility index, the mean flow velocity, and the end-diastolic flow velocity were read from the Doppler recordings. Mean cerebral blood flow was estimated from the 133Xe clearance curves. The correlation coefficients between the Doppler and the 133Xe measurements ranged from 0.41 to 0.82. In the subset of 16 first measurements in each infant, there were no statistically significant differences between the correlation coefficients of the various Doppler ultrasound variables, but the correlation coefficients were consistently lower for the pulsatility index than for mean flow velocity or end-diastolic flow velocity, and they were consistently higher for the range-gated than for the continuous-wave Doppler technique.