PREOPERATIVE HOSPITALIZATION AS A BRIDGING STRATEGY FOR WEIGHT LOSS IN PATIENTS WITH BODY MASS INDEX = 50 KG/M2 WHO ARE CANDIDATES FOR BARIATRIC SURGERY.

Renata Ramos Severo, Fernando Santa-Cruz, Flávio Kreimer, André Bezerra de Sena, Álvaro Antônio Bandeira Ferraz
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Abstract

Background: Preoperative hospitalization with the purpose to obtain more effective weight loss provides intensive care for patients who have a higher body mass index (BMI) and associated diseases that involve a greater risk of peri- and postoperative complications. It is a therapeutic strategy that can make it possible to overcome obstacles related to the difficulty of adhering to obesity treatment.

Aims: To analyze the implementation of a preoperative hospitalization strategy for weight loss in patients eligible for bariatric surgery.

Methods: Retrospective study that included 194 patients with a BMI=50 kg/m2. They were grouped according to preoperative preparation strategies: inpatient (n=32) and outpatient (n=162), who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) between 2010 and 2020. The groups were compared regarding preoperative weight loss before and after the strategies and postoperative up to two years after surgery.

Results: Most patients were female and there were significant differences in age group (an average of 42.94 years in the preoperative hospitalization strategy group and 37.73 in the outpatient strategy group). The mean BMI in the hospitalized group was 63.01±8.72 kg/m2, and in the outpatient group it was 54.95±4.31 kg/m2. There was a significant difference only between initial and preoperative weight in the hospitalized group. Furthermore, the difference between initial weight and last recorded weight up to two years after surgery was significant in each group. The occurrence of associated diseases was higher in the outpatient group.

Conclusions: Patients following the preoperative hospitalization strategy experienced significant weight loss before surgery.

术前住院作为体重指数为50 kg / m2的减肥手术候选者减肥的桥接策略
背景:术前住院以获得更有效的减肥为目的,为具有较高体重指数(BMI)和相关疾病的患者提供重症监护,这些患者涉及更大的围手术期和术后并发症风险。这是一种治疗策略,可以使克服与坚持肥胖治疗困难有关的障碍成为可能。目的:分析符合减肥手术条件的患者术前住院策略的实施情况。方法:回顾性研究194例BMI=50 kg/m2的患者。他们根据术前准备策略分组:住院(n=32)和门诊(n=162),在2010年至2020年期间接受了Roux-en-Y胃旁路术(RYGB)或袖式胃切除术(SG)。比较两组术前和术后两年内的体重减轻情况。结果:患者以女性居多,年龄差异有统计学意义(术前住院策略组平均42.94岁,门诊策略组平均37.73岁)。住院组BMI平均值为63.01±8.72 kg/m2,门诊组BMI平均值为54.95±4.31 kg/m2。住院组只有初始体重和术前体重有显著差异。此外,两组患者术后两年的初始体重和最后记录的体重之间的差异也很显著。门诊组相关疾病发生率较高。结论:术前住院治疗的患者在手术前体重明显减轻。
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