Avalia??o da efetividade do fechamento dos espa?os mesent?rico e de Petersen ap?s bypass g?strico em Y de Roux
Ano de defesa: | 2020 |
---|---|
Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | |
Tipo de documento: | Dissertação |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Pontif?cia Universidade Cat?lica do Rio Grande do Sul
|
Programa de Pós-Graduação: |
Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de
|
Departamento: |
Escola de Medicina
|
País: |
Brasil
|
Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | http://tede2.pucrs.br/tede2/handle/tede/9300 |
Resumo: | Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been shown to be an effective treatment for morbid obesity. Spite of its effectiveness and relative safety, it is associated with certain long-term complications, the most common is internal hernia (IH). Several modifications in surgical technique have been proposed in an attempt to decrease the incidence of IH, and one of which is the closure of mesenteric defects at the time of primary surgery. The aim of this study is to determine the effectivenes of the closure of mesenteric and Petersen?s spaces in patients after gastric bypass. Methods: Retrospective study from June 2012 to December 2017 in two Centers of Excellence in Bariatric Surgery from Surgery Rewiew Corporation and SBCBM. Patients that were being followed after Roux and Y gastric bypass that needed another laparoscopy due to gallstones had their closure of the mesenteric space reviewed. The presence of failure of the closure was then related with demographics data and excess weight loss information. Results: 210 patients were included, 84% women. The frequency of failure of the closure of mesenteric defects was 4,8% ( CI 95% 2,3-8,6), and only in 1 case the defect was wide open and in 2 cases the defect was larger than 2 cm out of the 10 cases founded. There was no difference between the groups with or without failure in relation to age, BMI, weight loss neither rapid excess weight loss. Conclusion: The closure of the mesenteric and Petersen spaces is an effective maneuver, since during a new laparoscopy the spaces were closed and, in the failed cases, the gaps were so small that do not appear to have a clinical effect. |
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Padoin, Alexandre Vontobelhttp://lattes.cnpq.br/0241056171343649http://lattes.cnpq.br/5379766636884309Geist, Ana Carolina Brochado2020-10-29T18:46:47Z2020-03-30http://tede2.pucrs.br/tede2/handle/tede/9300Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been shown to be an effective treatment for morbid obesity. Spite of its effectiveness and relative safety, it is associated with certain long-term complications, the most common is internal hernia (IH). Several modifications in surgical technique have been proposed in an attempt to decrease the incidence of IH, and one of which is the closure of mesenteric defects at the time of primary surgery. The aim of this study is to determine the effectivenes of the closure of mesenteric and Petersen?s spaces in patients after gastric bypass. Methods: Retrospective study from June 2012 to December 2017 in two Centers of Excellence in Bariatric Surgery from Surgery Rewiew Corporation and SBCBM. Patients that were being followed after Roux and Y gastric bypass that needed another laparoscopy due to gallstones had their closure of the mesenteric space reviewed. The presence of failure of the closure was then related with demographics data and excess weight loss information. Results: 210 patients were included, 84% women. The frequency of failure of the closure of mesenteric defects was 4,8% ( CI 95% 2,3-8,6), and only in 1 case the defect was wide open and in 2 cases the defect was larger than 2 cm out of the 10 cases founded. There was no difference between the groups with or without failure in relation to age, BMI, weight loss neither rapid excess weight loss. Conclusion: The closure of the mesenteric and Petersen spaces is an effective maneuver, since during a new laparoscopy the spaces were closed and, in the failed cases, the gaps were so small that do not appear to have a clinical effect.Introdu??o: Bypass g?strico em Y de Roux laparosc?pico (BGYRL) tem demonstrado ser um tratamento efetivo para obesidade m?rbida. Apesar de sua efic?cia e seguran?a, est? associada com algumas complica??e tardias sendo a h?rnia interna (HI) a mais comum. V?rias modifica??es na t?cnica est?o sendo propostas na tentativa de diminuir a incid?ncia da HI e o fechamento dos defeitos mesent?ricos na cirurgia prim?ria ? uma delas. O objetivo desse estudo ? avaliar a efetividade do fechamento dos espa?os de Petersen e mesent?rico realizado durante bypass g?strico em Y de Roux. Material e M?todo : estudo transversal, realizado de Junho de 2012 a Dezembro de 2017 em dois Centros de Excel?ncia em Cirurgia Bari?trica pelo Surgical Review Corporation e SBCBM. Os pacientes que estavam em acompanhamento ap?s bypass g?strico em Y de Roux laparosc?pico com fechamento de ambos espa?os mesent?ricos e que necessitaram de nova laparoscopia devido a presen?a de colelit?ase tiveram seus espa?os revisados no final do procedimento. A presen?a de falha desse fechamento foi ent?o relacionada com dados demogr?ficos, al?m de dados de perda de excesso de peso. Resultados : 210 pacientes foram avaliados, 84% do sexo feminino. A frequ?ncia de falha do fechamento foi 4,8% (IC 95% 2,3-8,6) sendo que em apenas 1 caso a abertura foi total e em 2 o defeito era maior que 2 cm dos 10 casos encontrados. N?o houve diferen?a entre os grupos com falha ou sem falha do fechamento em rela??o a idade, IMC, perda de peso nem r?pida perda de excesso de peso. Conclus?o: O fechamento dos espa?os mesent?rico e de Petersen ? uma manobra efetiva, visto que durante nova laparoscopia os espa?o estavam fechados e, nos casos com falha, a maioria eram defeitos pequenos que n?o parecem ter efeito cl?nico.Submitted by PPG Medicina e Ci?ncias da Sa?de (medicina-pg@pucrs.br) on 2020-07-23T18:50:55Z No. of bitstreams: 1 dissertacao_anacarolina.pdf: 1206057 bytes, checksum: 8fdc64c79d0d938d6b98d9628aa400f9 (MD5)Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2020-10-29T18:43:17Z (GMT) No. of bitstreams: 1 dissertacao_anacarolina.pdf: 1206057 bytes, checksum: 8fdc64c79d0d938d6b98d9628aa400f9 (MD5)Made available in DSpace on 2020-10-29T18:46:47Z (GMT). No. of bitstreams: 1 dissertacao_anacarolina.pdf: 1206057 bytes, checksum: 8fdc64c79d0d938d6b98d9628aa400f9 (MD5) Previous issue date: 2020-03-30Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPESapplication/pdfhttp://tede2.pucrs.br:80/tede2/retrieve/179209/DIS_ANA_CAROLINA_BROCHADO_GEIST_CONFIDENCIAL.pdf.jpgporPontif?cia Universidade Cat?lica do Rio Grande do SulPrograma de P?s-Gradua??o em Medicina e Ci?ncias da Sa?dePUCRSBrasilEscola de MedicinaBypass G?stricoObesidadeComplica??es P?s-operat?riasObstru??o IntestinalCirurgia Bari?tricaDor AbdominalGastric BypassObesityPostoperative ComplicationsIntestinal ObstructionBariatric SurgeryAbdominal PainCIENCIAS DA SAUDE::MEDICINAAvalia??o da efetividade do fechamento dos espa?os mesent?rico e de Petersen ap?s bypass g?strico em Y de Rouxinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisTrabalho ser? publicado como artigo ou livro60 meses29/10/2025-721401722658532398500500500600-224747486637135387-9693694523087866273590462550136975366info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_RSinstname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSTHUMBNAILDIS_ANA_CAROLINA_BROCHADO_GEIST_CONFIDENCIAL.pdf.jpgDIS_ANA_CAROLINA_BROCHADO_GEIST_CONFIDENCIAL.pdf.jpgimage/jpeg4099http://tede2.pucrs.br/tede2/bitstream/tede/9300/4/DIS_ANA_CAROLINA_BROCHADO_GEIST_CONFIDENCIAL.pdf.jpg557bc43e63d29e2d55eb6b7ac792930dMD54TEXTDIS_ANA_CAROLINA_BROCHADO_GEIST_CONFIDENCIAL.pdf.txtDIS_ANA_CAROLINA_BROCHADO_GEIST_CONFIDENCIAL.pdf.txttext/plain1989http://tede2.pucrs.br/tede2/bitstream/tede/9300/3/DIS_ANA_CAROLINA_BROCHADO_GEIST_CONFIDENCIAL.pdf.txtcdd40d39a8750bd8b216a7853ff3ed24MD53ORIGINALDIS_ANA_CAROLINA_BROCHADO_GEIST_CONFIDENCIAL.pdfDIS_ANA_CAROLINA_BROCHADO_GEIST_CONFIDENCIAL.pdfapplication/pdf461229http://tede2.pucrs.br/tede2/bitstream/tede/9300/2/DIS_ANA_CAROLINA_BROCHADO_GEIST_CONFIDENCIAL.pdf3d66badaa665da9b05b4d628dc31124cMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-8590http://tede2.pucrs.br/tede2/bitstream/tede/9300/1/license.txt220e11f2d3ba5354f917c7035aadef24MD51tede/93002020-10-29 21:00:11.192oai:tede2.pucrs.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://tede2.pucrs.br/tede2/PRIhttps://tede2.pucrs.br/oai/requestbiblioteca.central@pucrs.br||opendoar:2020-10-29T23:00:11Biblioteca Digital de Teses e Dissertações da PUC_RS - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false |
dc.title.por.fl_str_mv |
Avalia??o da efetividade do fechamento dos espa?os mesent?rico e de Petersen ap?s bypass g?strico em Y de Roux |
title |
Avalia??o da efetividade do fechamento dos espa?os mesent?rico e de Petersen ap?s bypass g?strico em Y de Roux |
spellingShingle |
Avalia??o da efetividade do fechamento dos espa?os mesent?rico e de Petersen ap?s bypass g?strico em Y de Roux Geist, Ana Carolina Brochado Bypass G?strico Obesidade Complica??es P?s-operat?rias Obstru??o Intestinal Cirurgia Bari?trica Dor Abdominal Gastric Bypass Obesity Postoperative Complications Intestinal Obstruction Bariatric Surgery Abdominal Pain CIENCIAS DA SAUDE::MEDICINA |
title_short |
Avalia??o da efetividade do fechamento dos espa?os mesent?rico e de Petersen ap?s bypass g?strico em Y de Roux |
title_full |
Avalia??o da efetividade do fechamento dos espa?os mesent?rico e de Petersen ap?s bypass g?strico em Y de Roux |
title_fullStr |
Avalia??o da efetividade do fechamento dos espa?os mesent?rico e de Petersen ap?s bypass g?strico em Y de Roux |
title_full_unstemmed |
Avalia??o da efetividade do fechamento dos espa?os mesent?rico e de Petersen ap?s bypass g?strico em Y de Roux |
title_sort |
Avalia??o da efetividade do fechamento dos espa?os mesent?rico e de Petersen ap?s bypass g?strico em Y de Roux |
author |
Geist, Ana Carolina Brochado |
author_facet |
Geist, Ana Carolina Brochado |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Padoin, Alexandre Vontobel |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/0241056171343649 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/5379766636884309 |
dc.contributor.author.fl_str_mv |
Geist, Ana Carolina Brochado |
contributor_str_mv |
Padoin, Alexandre Vontobel |
dc.subject.por.fl_str_mv |
Bypass G?strico Obesidade Complica??es P?s-operat?rias Obstru??o Intestinal Cirurgia Bari?trica Dor Abdominal |
topic |
Bypass G?strico Obesidade Complica??es P?s-operat?rias Obstru??o Intestinal Cirurgia Bari?trica Dor Abdominal Gastric Bypass Obesity Postoperative Complications Intestinal Obstruction Bariatric Surgery Abdominal Pain CIENCIAS DA SAUDE::MEDICINA |
dc.subject.eng.fl_str_mv |
Gastric Bypass Obesity Postoperative Complications Intestinal Obstruction Bariatric Surgery Abdominal Pain |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::MEDICINA |
description |
Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been shown to be an effective treatment for morbid obesity. Spite of its effectiveness and relative safety, it is associated with certain long-term complications, the most common is internal hernia (IH). Several modifications in surgical technique have been proposed in an attempt to decrease the incidence of IH, and one of which is the closure of mesenteric defects at the time of primary surgery. The aim of this study is to determine the effectivenes of the closure of mesenteric and Petersen?s spaces in patients after gastric bypass. Methods: Retrospective study from June 2012 to December 2017 in two Centers of Excellence in Bariatric Surgery from Surgery Rewiew Corporation and SBCBM. Patients that were being followed after Roux and Y gastric bypass that needed another laparoscopy due to gallstones had their closure of the mesenteric space reviewed. The presence of failure of the closure was then related with demographics data and excess weight loss information. Results: 210 patients were included, 84% women. The frequency of failure of the closure of mesenteric defects was 4,8% ( CI 95% 2,3-8,6), and only in 1 case the defect was wide open and in 2 cases the defect was larger than 2 cm out of the 10 cases founded. There was no difference between the groups with or without failure in relation to age, BMI, weight loss neither rapid excess weight loss. Conclusion: The closure of the mesenteric and Petersen spaces is an effective maneuver, since during a new laparoscopy the spaces were closed and, in the failed cases, the gaps were so small that do not appear to have a clinical effect. |
publishDate |
2020 |
dc.date.accessioned.fl_str_mv |
2020-10-29T18:46:47Z |
dc.date.issued.fl_str_mv |
2020-03-30 |
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info:eu-repo/semantics/publishedVersion |
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por |
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Pontif?cia Universidade Cat?lica do Rio Grande do Sul |
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Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de |
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PUCRS |
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Brasil |
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Pontif?cia Universidade Cat?lica do Rio Grande do Sul |
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