APLICAÇÃO DE PLASMA DE ARGÔNIO ENDOSCÓPICO PARA TRATAMENTO DO REGANHO DE PESO APÓS CIRURGIA BARIÁTRICA EM UMA CLÍNICA PRIVADA DE FLORIANÓPOLIS
Palavras-chave:
Plasma de argônio. Cirurgia bariátrica. Reganho de peso. Obesidade.Resumo
Introdução: Atualmente o bypass gástrico em Y de Roux (BGYR) é o método cirúrgico de escolha no tratamento da obesidade. Todavia, pode ocorrer reganho de peso após a cirurgia. A aplicação do plasma de argônio por via endoscópica constitui uma opção terapêutica que visa redução do calibre da anastomose gastrojejunal, com consequente perda de peso. Objetivo: Avaliar a relação da redução do calibre da anastomose gastrojejunal com a perda de peso e sensação de saciedade nos pacientes que readquiriram peso após BGYR. Métodos: Estudo observacional transversal, que incluiu 34 pacientes submetidos à aplicação do plasma de argônio entre 2014 e 2018, na Usuy Clínica Médica em Florianopólis. As diferenças entre as médias de peso, IMC e diâmetro da anastomose gastrojejunal frente a aplicação do plasma de argônio e saciedade referida foram estabelecidas pelo teste de Wilcoxon (p?0,05). Resultados: Observou-se redução de 6,26% do peso, 6,21% do IMC e 43,04% do diâmetro anastomótico comparando as médias pré e pós seis meses do procedimento. 53,3% dos pacientes sentiram-se mais saciados. Conclusão: A aplicação do plasma de argônio mostrou-se eficaz na redução do diâmetro da anastomose gastrojejunal, perda de peso corporal e diminuição do IMC.
Referências
World Health Organization (WHO). The World Health Report: Reducing risks, promoting healthy life. Geneva: WHO, 2002. [acesso em 2017 Ago 10]. Disponível em: http://www.who.int/whr/2002/en/whr02_en.pdf?ua=1
Collaboration NCDRF. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. The Lancet. 2016;387:1377–96.
Ministério da Saúde. Vigitel Brasil 2016: vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico / Ministério da Saúde, Secretaria de Vigilância em Saúde, Secretaria de Gestão Estratégica e Participativa. Brasília: 2016. [acesso em 2017 Ago 10]. Disponível em: http://portalarquivos.saude.gov.br/images/pdf/2017/abril/17/Vigitel.pdf
World Health Organization (WHO). Obesity: preventing and managing the global epidemic - report of a WHO consultation on obesity. Geneva: WHO, 2000. [acesso em 2017 Ago 10]. Disponível em: http://www.who.int/nutrition/publications/obesity/WHO_TRS_894/en/
Academy of Nutrition and Dietetics. Position of the Academy of Nutrition and Dietetics: Interventions for the Treatment of Overweight and Obesity in Adults. J Acad Nutr Diet. 2016;116:129-47.
Annesi JJ & Mareno N. Indirect effects of exercise on emotional eating through psychological predictors of weight loss in women. Appetite. 2015;95:219-27.
Conselho Federal de Medicina (CFM). Portaria 1766/2005 e 1942/2010. Brasilia, 2010. [acesso em 2017 Ago 10]. Disponível em: http://www.portalmedico.org.br/resolucoes/cfm/2005/1766_2005.htm
Griffen Jr WO, Young VL, Stevenson CC. A prospective comparison of gastric and jejunoileal bypass procedures for morbid obesity. Ann Surg. 1977;186:500–9.
Sala C, Ortega J, López F, García S, Martinez-Valls J, Liedo S. Use of BAROS. Score System in Patients Operated on for Morbid Obesity: Results of Our Series. Obes Surg. 2001;11(4):433-4.
Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obesity subjects. N Engl J Med. 2007;357:741–52.
Fobi MA, Lee H. The surgical technique of the banded Roux–en–Y gastric bypass. J Obes Weight Regulation. 1989;8:99–102.
Capella JF, Capella RF. Vertical banded gastroplasty–gastric bypass: preliminary report. Obes Surg. 1991;1(4):389–95.
Harvey EJ, Arroyo K, Korner J, Inabnet WB. Hormone changes affecting energy homeostasis after metabolic surgery. Mt Sinai J Med. 2010;77:446–65.
Herrera MF, Lozano-Salazar RR, Gonzáles-Barranco J, Rull JA. In: Deitel M, Cowan Jr GSM. Update: surgery for the morbidly obese patient. Canadá: FD Communications; 2000;55–62.
Rubino F. Bariatric surgery: effects on glucose homeostasis. Curr Opin Clin Nutr Metab Care 2006;9:497–507.
Thompson CC, Slattery J, Bundga ME, Lautz DB. Peroral endoscopic reduction of dilated gastrojejunal anastomosis after Roux-en-Y gastric bypass: a possible new option for patients with weight regain. Surg Endosc 2006;20:1744–8.
Sjöström L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–93.
Christou NV, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244(5):734–40.
Brethauer AS, Nfonsam V, Sherman V, Udomsawaengsup S, Schauer PR, Chand B. Endoscopy and upper gastrointestinal contrast studies are complementary in evaluation of weight regain after bariatric surgery. Surg Obes Relat Dis. 2006;2(6):643–8.
Magro DO, Geloneze B, Delfini R, Pareja BC, Callejas F, Pareja JC. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18(6):648–51.
Maclean LD, Rhode BM, Nohr CW. Late outcomes of isolated gastric bypass. Ann Surg 2000;231:524–8.
Shah M, Simha V, Garg A. Review: long-term impact of bariatric surgery on body weight, comorbidities, and nutritional status. J Clin Endocrinol Metab. 2006;91:4223–31.
Aly A. Argon plasma coagulation and gastric bypass–a novel solution to stomal dilation. Obes Surg. 2009;19(6):788–90.
Storek D, Grund KE, Gronbach G, Faring G, Becker HD. Endoscopic argon gas coagulation-initial clinical experiences. Z Gastroenterol. 1993;31(11):675–9.
Malick KJ. Clinical applications of argon plasma coagulation in endoscopy. Gastroenterol Nurs. 2006;29(5):386–91.
Baretta GA, Alhinho HC, Matias JE, Marchesini JB, de Lima JH, Empinotti C, et al. Argon plasma coagulation of gastrojejunal anastomosis for weight regain after gastric bypass. Obes Surg 2015;25(1):72–9.
Marchesini SD, Baretta GA, Cambi MP, Marchesini JB. Endoscopic plasma argon coagulation in treatment of weight regain after bariatric surgery: what does the patient think about this? Arq Bras Cir Dig. 2014; 27S1:47-50.
Abidi WM, Schulman A, Thompson CC. 1137 A large case series on the use of argon plasma coagulation for the treatment of weight regain after gastric bypass. Gastroenterology 2016; 150(4):S231.
Jirapinyo P, Dayyeh BK, Thompson CC. Gastrojejunal anastomotic reduction for weight regain in Roux en Y gastric bypass patients: Physiological, behavioral, and anatomical effects of endoscopic suturing and sclerotherapy. Surg Obes Relat Dis 2016;12:1810 6.
Moon RC, Teixeira AF, Neto MG, Zundel N, Sander BQ, Ramos FM, et al. Efficacy of Utilizing Argon Plasma Coagulation for Weight Regain in Roux-en-Y Gastric Bypass Patients. A Multi-center Study. Obes Surg. 2018;28(9):2737-2744.
Sander BQ, Paiva DS, Sander MP, Galvão Neto M, Barreta G, E Grecco, et al. Weight regain after bariatric surgery – Argon Plasma Coagulation for Gastrojejunal Anastomosis Decrease. United Eur Gastroent. 2017;5(5):161–836.
Silva PT, Patias LD, Alvarez Gda C, Kirsten VR, Colpo E, Moraes CM. Profile of patients who seek the bariatric surgery. Arq Bras Cir Dig. 2015;28(4):270-3.
Kelles SMB, Diniz MFHS, Machado CJ, Barreto SM. The profile of patients undergoing bariatric surgery in the Brazilian Unified National Health System: a systematic review. Cad Saude Publica. 2015;31(8):1587-601.
Jirapinyo P, Coutinho, LMA, Skinner MJ, Thopmson CC. Argon Plasma Coagulation for the Treatment of Weight Regain Following Roux-en-Y Gastric Bypass: Optimal Approach from a 200 Patient Experience. Gastrointest Endos. 2018;87(6):603.
Brunaldi VO, Jirapinyo P, de Moura DTH, Okazaki O, Bernardo WM, Galvão Neto M, et al. Endoscopic Treatment of weight regain following Roux-en-Y gastric bypass: a systematic review and meta-analysis. Obes Surg. 2017;28(1):266-276.
Baretta GA. Tratamento endoscópico do reganho de peso pós bypass gástrico através da fulguração com argônio da anastomose gastrojejunal. 2013. 78 f. Tese (Doutorado em Clínica Cirúrgica) – Setor de Ciências da Saúde da Universidade Federal do Paraná. Universidade Federal do Paraná, Curitiba.
Ramos AC, Marchesini JC, de Souza Bastos EL, Ramos MG, de Souza MDG, Campos JM, et al. The role of gastrojejunostomy size on Gastric Bypass weight loss. Obes Surg. 2017; 27(9):2317-2323.
Cambi MP, Marchesini SD, Baretta GA. Post-bariatric surgery weight regain: evaluation of nutritional profile of candidate patients for endoscopic argon plasma coagulation. Arq Bras Cir Dig. 2015;28(1):40–3.
Barrichello S, Neto MPG, de Souza TF, de Moura EGH, Minata M, de Quadros APO, et al. Increased Gatric Retention Capacity, Assessed by Scintigraphy, after APC Treatment of Dilated Gastrojejunal Anastomosis. GE Port J Gatroenterol. 2018;25(6):327-330.
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