HEADINGS -Anastomosis, Roux-en-Y. Morbid obesity, Postoperative complications.ABSTRAT -Background -The silicone ring is used as containment factor of the Rouxen-Y gastric bypass to induce greater ponderal loss. However, it may have some inconveniences from this stressed restriction. Aim -To analyze the complications related to silicone ring in patients who underwent Roux-en-Y gastric bypass surgery with silicon ring. Methods -From 1994 to 2005, 7 000 patients were submitted to Roux-in-Y gastric bypass with silicone ring in order to treat morbid obesity. Only 50% were followed from two to 11 years. The mean excess weight loss was around 85%. But ring complications were registered in 160 patients (2,28% of the total and 4,56% of the followed patients). Therefore, this series consist of 38 male patients (23.8%) and 122 female patients (76.2%) with average age of 44 years old and BMI of 54.4 kg/m 2 . Results -Five types of ring complications were found. The most frequent was displacement (61%) causing obstructive symptoms. The second most frequent complication was ring erosion to the lumen (22%) causing epigastric pain and nausea. Conclusions -The ring complications occur in low frequency. Ring removal, either surgical or endoscopically done, is the most usual treatment, but tends to cause partial regain of the weight lost.
ABCDDV/815
RESUMO
Introduction: Brazil is a world leader in bariatric surgery. However, the actual number of surgeries performed in the country is still unknown. It is necessary to implement an instrument to monitor the quality of care provided. This study evaluated the implementation of a Bariatric Surgery Data Registry in Brazil. Methodology: the registry was developed with Dendrite Clinical Systems Ltd., with data collected prospectively on an internet-based software. Seven centers were selected based on surgical volume and data entry commitment. The project covered three years after system implementation. Results: 1,363 procedures performed by 17 surgeons were included. Most patients were female (67.2%), with average age of 39 years old and average baseline BMI of 41.5kg/m2. Diabetes mellitus was present in 34.5%, and hypertension in 40.1%. Roux-en-Y gastric bypass was performed in 79.3%, 95.5% by laparoscopy. There was one in-hospital death of cardiovascular cause. The average hospital stay was 2.03 days. The surgery-related complication rate was 0.97% in the first month, with three reoperations. Short-term follow-up was recorded in 75.6% and one-year follow-up in 21.64%. Total body weight loss was 10% in 30 days, rising to 33.3% after one year, with no difference between surgical techniques. Conclusions: the population profile was in accordance with the global registry of the International Federation for the Surgery of Obesity and Metabolic Disorders. The main difficulty encountered was low postoperative data entry. The experience acquired in this project will help advance data collection and knowledge of the safety and effectiveness of bariatric surgery in Brazil.
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