Evaluation of Weight Loss and Quality of Life in Morbidly Obese Patients Undergoing Y De Roux Gastric Bypass Surgery with Reduction Ring and Without Ring, After The First Year of Follow-Up

Abstract

Obesity is an epidemic disease in the modern world. The clinical therapies, when isolated, are not effective to weight loss and control in morbidly obese patients (BMI > 40 Kg/m²) in long term. Surgery is the only method proven effective to achieve these goals. The Gastric Bypass Roux-Y (RYGB) is the most commonly performed bariatric surgery in the world including Brazil and is considered the gold standard of bariatric procedures because of its effectiveness in losing and maintaining long term weight loss associated with lower complication rates. There is a discussion about the need of using the sylastic ring at the end of gastric pouch, when the RYGB surgery is done, surgery known as the Fobi-Capella, because the high incidence of complications related to the ring and the difficulty in the intake of solids. Today, many surgical teams perform Capella’s surgery without placement the ring, with the argument that weight loss is similar without the limitations and complications related to the ring. The proposal of this study is analyzing the need to use the ring in morbidly obese patients comparing the weight loss after one year and nutrition quality. Thus, we compared two groups of patients, first group submitted in 2009 to gastric bypass (RYGB with ring or Capella’s surgery) and the second group operated in 2010 (RYGB without ring), analyzing the results for weight loss and quality of life after 1 year elapsed from surgery through established questionnaires as BAROS and specific questionnaires on nutrition quality. Of the total 21 patients, 12 patients were submitted to RYGB with ring and the other 9 patients were submitted RYGB without placement of the ring. The surgery is aimed at weight loss and resolution of comorbidities associated with obesity. It is considered an effective surgical technique when weight loss is greater than 50% of the overweight in 75% of patients. The study showed that both types of surgery, with or without the ring, reach the objective. The study noted that patients submitted to RYGB with ring have an important restriction on the intake of meat, while the group submitted to RYGB surgery without the ring eat better foods rich in protein and has no postprandial vomiting, with a better-quality food. Regarding quality of life, we observe significant improvement in all variables in both groups without statistical difference.