RESUMO
Latin America faces a significant public health challenge due to the high prevalence of obesity and its associated diseases. Metabolic and bariatric surgery is effective and safe to treat obesity when other treatments fail; however, its implementation in Latin America remains unsatisfactory. This review explores the current status, challenges, and innovations of metabolic and bariatric surgery in Latin America. We searched peer-reviewed journals in English and Spanish for relevant articles published between 1998 and 2023. We found that more than 20% of the Latin American population is affected by obesity. Unfortunately, only a limited number of patients have access to metabolic and bariatric surgery due to high cost, limited availability, and shortage of specialists. The review found that ongoing clinical trials are being conducted in Brazil, Mexico, Chile, and Venezuela, indicating some regional progress. However, published studies remain low in number compared with other regions. Furthermore, we summarized the clinical outcomes, risks, and perioperative assessments associated with metabolic and bariatric surgery. We discussed potential strategies to enhance the availability and affordability of this intervention. This review emphasizes the significance of metabolic and bariatric surgery in addressing the obesity pandemic, specifically for Latin America, and proposes directions for future research and innovation.
Assuntos
Cirurgia Bariátrica , Obesidade , Humanos , América Latina/epidemiologia , Obesidade/cirurgia , Obesidade/epidemiologia , PandemiasRESUMO
Obesity is a worldwide epidemic, and bariatric surgery has become increasingly popular due to its effectiveness in treating it. Therefore, understanding this area is of paramount importance. This article aims to provide an understanding of the development of the topic related to procedures, content, data, and status. To achieve this objective, a literature review and a bibliometric analysis were conducted. The methods provided insight into the current state and relevant topics over time. In conclusion, the article provided the identification of the transformation of the research field, initially focused only on physical aspects, to a more complex approach, which also incorporates psychological and social aspects and the correlation between obesity, bariatric surgery, and quality of life.
Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Humanos , Cirurgia Bariátrica/métodos , Obesidade/cirurgia , Obesidade Mórbida/cirurgia , Exame Físico , Qualidade de VidaRESUMO
BACKGROUND: Through new publications on the subject, the main goal of this article is to seek a change in the pattern of alcohol use before and after bariatric surgery. METHODS: We searched the National Library of Medicine, CINAHL, and PsycINFO databases. We included original articles regarding alcohol consumption before and after bariatric surgery to conduct the systematic review. RESULTS: Our systematic review, which included 18 articles, yielded mixed results. Meta-analysis of six articles did not reveal statistically significant differences in alcohol use behaviours before and one year after bariatric surgery. However, throughout the perspective of follow-up after bariatric surgery, nine out of the twelve articles showed improvement in the pattern of alcohol consumption when evaluated up to two years after the end of the surgical period, and four out of the five articles with monitoring beyond two years showed worsening in consumption, compared to pre-surgery alcohol use behaviours. CONCLUSIONS: Conclusions about the relationship between alcohol consumption and bariatric surgery are challenging primarily because of the variety of the methods used and the alcohol consumption measures. Despite that, our research pointed to an increased risk of alcohol use disorders two years after bariatric surgery.
Assuntos
Alcoolismo , Cirurgia Bariátrica , Humanos , Redução de Peso , Cirurgia Bariátrica/efeitos adversos , Consumo de Bebidas Alcoólicas , Resultado do TratamentoRESUMO
After massive weight loss, breasts have poor shape, projection, and skin elasticity. The nipples are distorted and ptotic. Mastopexy is difficult and historically includes the use of excess nearby tissues. The senior author reviews his experience with 24 patients over the past 4 years. Body contouring is offered after the weight loss is stable. Breasts may be reshaped by mastopexy and/or augmentation; three examples are presented. More often the breasts are reshaped during an upper body lift. This lift is a reverse abdominoplasty that ends along the inframammary fold scar of the Wise-pattern mastopexy and extends laterally along the back roll. When the breasts need enlargement, nearby discard tissue is used for augmentation. The spiral flap has been devised for that purpose. When more tissue is needed, silicone implants are used. The long inframammary scar of the McKissock vertical bipedicle mastopexy forms the junction between the breast and reverse abdominoplasty. Proper inframammary fold construction is pivotal to the upper body lift. We have successfully combine breast reshaping with upper body lift for this difficult deformity after massive weight loss and present two demonstrative examples. Breast reshaping is best performed during an upper body lift.