Criterios clínicos y quirúrgicos para realizar gastrectomía vertical en pacientes con obesidad, estudio realizado en el Hospital Universitario de Guayaquil desde enero a diciembre del 2016
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2017
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Medicina
Resumen
La gastrectomía de manga vertical, es un procedimiento quirúrgico que depende de las necesidades del paciente y la discreción del cirujano. Las condiciones comórbidas pueden convertirse en el principal factor que permitirá a un paciente con un IMC inferior calificar para un procedimiento bariátrico. La gravedad de las enfermedades comórbidas se equilibra con la edad y el IMC del paciente individual para determinar la conveniencia de la intervención quirúrgica bariátrica. El objetivo del estudio fue establecer los criterios clínicos y quirúrgicos para realizar gastrectomía vertical en los pacientes con obesidad del Hospital Universitario de Guayaquil en el año 2016.El presente estudio es de tipo descriptivo, de diseño no experimental, transversal y retrospectivo. Se analizó 135 registros médicos de pacientes que fueron seleccionados para realizarse gastrectomía vertical en el Hospital Universitario en el periodo del 1 de enero hasta el 31 de diciembre del 2016. Se utilizó el programa SPSS versión 21 para el análisis estadístico.Del total de la muestra estudiada (135 pacientes), se observó una leve tendencia hacia el género masculino (59%), con una mayor predisposición de obesidad en adultos jóvenes, siendo el grupo predominante el de 20-40 años de edad con el 65%. Todos los pacientes tenían obesidad en diferentes tipos de afectación y obesidad grado 3 con IMC mayor o igual a 40 kg/m2 representó la mayoría en la presente investigación. El 100% de los pacientes presentó complicaciones por la obesidad, siendo el síndrome metabólico y las dislipidemias las más importantes. El 81% de los pacientes presentó comorbilidades asociadas y los factores de riesgo estuvieron presentes en el 100% de los pacientes. Los principales criterios para seleccionar candidatos a cirugía de gastrectomía vertical fueron la presencia de patología degenerativa de las articulaciones de rodilla y cadera asociado a IMC mayor o igual a 30 kg/m2. El IMC > 40 y el IMC > 30-35 asociado a una comorbilidad también fueron importantes criterios de selección para cirugía bariátrica.Se concluye que el IMC, edad, comorbilidades y complicaciones presentes en el paciente con obesidad son los principales determinantes para elegir el momento de la cirugía.
Vertical sleeve gastrectomy is a surgical procedure that depends on the patient's needs and the discretion of the surgeon. Comorbid conditions may become the main factor that will allow a patient with a lower BMI to qualify for a bariatric procedure. The severity of comorbid disease is balanced with age and BMI of the individual patient to determine the suitability of bariatric surgical intervention. The objective of the study was to establish the clinical and surgical criteria for performing vertical gastrectomy in patients with obesity at the University Hospital of Guayaquil in 2016. The present study is descriptive, non-experimental, transverse and retrospective design. We analyzed 135 medical records of patients who were selected to undergo vertical gastrectomy at the University Hospital in the period from January 1 to December 31, 2016. The SPSS version 21 program was used for statistical analysis. Of the total sample studied (135 patients), there was a slight tendency towards the male gender (59%), with a greater predisposition for obesity in young adults, the predominant group being 20-40 years of age with 65 %. All patients had obesity in different types of affectation and obesity grade 3 with BMI greater or equal to 40 kg / m2 represented the majority in the present investigation. 100% of the patients presented complications due to obesity, being the metabolic syndrome and dyslipidemias the most important. 81% of the patients presented associated comorbidities and the risk factors were present in 100% of the patients. The main criteria for selecting candidates for vertical gastrectomy surgery were the presence of degenerative pathology of the knee and hip joints associated with BMI greater than or equal to 30 kg / m2. BMI> 40 and BMI> 30-35 associated with comorbidity were also important selection criteria for bariatric surgery. We conclude that BMI, age, comorbidities and complications present in the patient with obesity are the main determinants for choosing the time of surgery.
Vertical sleeve gastrectomy is a surgical procedure that depends on the patient's needs and the discretion of the surgeon. Comorbid conditions may become the main factor that will allow a patient with a lower BMI to qualify for a bariatric procedure. The severity of comorbid disease is balanced with age and BMI of the individual patient to determine the suitability of bariatric surgical intervention. The objective of the study was to establish the clinical and surgical criteria for performing vertical gastrectomy in patients with obesity at the University Hospital of Guayaquil in 2016. The present study is descriptive, non-experimental, transverse and retrospective design. We analyzed 135 medical records of patients who were selected to undergo vertical gastrectomy at the University Hospital in the period from January 1 to December 31, 2016. The SPSS version 21 program was used for statistical analysis. Of the total sample studied (135 patients), there was a slight tendency towards the male gender (59%), with a greater predisposition for obesity in young adults, the predominant group being 20-40 years of age with 65 %. All patients had obesity in different types of affectation and obesity grade 3 with BMI greater or equal to 40 kg / m2 represented the majority in the present investigation. 100% of the patients presented complications due to obesity, being the metabolic syndrome and dyslipidemias the most important. 81% of the patients presented associated comorbidities and the risk factors were present in 100% of the patients. The main criteria for selecting candidates for vertical gastrectomy surgery were the presence of degenerative pathology of the knee and hip joints associated with BMI greater than or equal to 30 kg / m2. BMI> 40 and BMI> 30-35 associated with comorbidity were also important selection criteria for bariatric surgery. We conclude that BMI, age, comorbidities and complications present in the patient with obesity are the main determinants for choosing the time of surgery.
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GASTRECTOMIA, COMORBILIDAD, OBESIDAD, COMPLICACIONES, EPIDEMIOLOGIA DESCRIPTIVA, HOSPITAL UNIVERSITARIO DE GUAYAQUIL, CANTON GUAYAQUIL, ECUADOR