Efecto de la gastrectomía vertical laparoscópica, con o sin preservación antral, sobre la ingesta y la tolerancia alimentaria, la composición corporal, la respuesta metabólica y las alteraciones nutricionales

Identificador:  TDX:2452

Handle: https://hdl.handle.net/20.500.11797/TDX2452

Autors:  Molina López, Alicia

Resum:
INTRODUCTION: Sleeve Gastrectomy (SG) is considered today as a consolidated surgical technique for treatment of morbid obesity. The preservation or not of gastric antrum in SG is still under discussion. OBJECTIVES: To determine if there is a relationship between preservation or not of gastric antrum in SG, in terms of weight evolution and different metabolic and nutritional parameters, during the first year after surgery. METHODOLOGY: Prospective randomized controlled trial with 60 patients undergoing SG (n=30 with antrum resection and n=30 with antrum preservation), in which we analysed: weight evolution, intake, feeding tolerance, changes in quality of life, level of physical activity, nutritional deficits and evolution of metabolic comorbidities. RESULTS: Patients undergoing SG with or without preserving gastric antrum showed a good weight evolution, reducing food intake quantitatively (with little qualitative changes), and presenting a good evolution of food tolerance. At 6 months after surgery, antrum resection group presented a lower deficit of 25 (OH) vitamin D3 respect to preservation antrum group. Both increased expenditure resulting from physical activity a year of intervention and an improvement of quality of life. The evolution of dyslipidaemia and OSAS was favourable in both groups, while the group with resection of antrum presented a better DM2 evolution. The analysis of indicators of weight loss showed the variability between them. CONCLUSIONS: Patients undergoing SG with or without antral preservation produce a very good evolution in weight and body composition, an improved quality of life, an increased physical activity and an improvement of comorbidities, although the same dietary imbalance prior to surgery persists. Resection of antrum makes a better improvement in most parameters analysed.