Page 12 - WJOLS - Laparoscopic Journal

Ricardo Lopez Osorio, Pablo Hartedt
Patients were selected as candidates based on para- 100%, with a mean value of 242.5 mg/dl (f = 239 m =
meters previously standardized, and they were contacted 248) and all the patients with preoperative HbA1 > 7.9
to perform a re-evaluation of DM diagnostic and treat- (mean 9.11 ± 1.7) (Graph 2). The mean weight was
ment. A total of 32 patients where re-evaluated by nutri- 52.79 Kg (f = 81.36 m = 82.95) with a BMI of 29.4 Kg/m²
tionist, internal medicine, phycologist, and laparoscopic (f = 28.69, m = 30.07) (Graph 3). Dyslipidemia was
surgeon. Only 10 patients where candidates for surgery present in 80% of cases with mean TGs and human
after multispecialty evaluation, surgery information and leukocyte antigen (HLA) of 200.5 mg/dl and 39.3 mg/dl
consent, and contraindication of procedure has being respectively. Diagnostic of hypertension was made
ruled out. with routine blood pressure and was present in 80%
Patients where admitted 24 hours previous to the of the patients but only four (50%) of them were under
procedure and stapled sleeve gastrectomy was per- treatment. After the procedure, patients were routinely
formed. Invagination of the stapled line was done in all evaluated and data gathered after 12 months period.
the patients with absorbable continuous intracorporeal The mean BMI achieved overall was 22.58 Kg/m² being
suture and drainage was placed in all the patients as the minimum 18.8 Kg/m² (f = 22.28, m = 22.44) (Table 3).
well. Gastrography was performed 24 hours after the The total mean weight loss overall was 64.95 ± 12.6 Kg,
procedure in all the patients. and the mean percentage of weight loss was 35% of
initial weight (Table 2). The hemoglobin A1c below 7%
Inclusion Criteria was achieved by 80% of patients and below 6.5% by
Diagnostic of MS as described above. Tree criteria of five 60% (Graph 4). Fasting glucose levels decreased overall
of the NCEP-ATP III definition for the MS. According to from 242.80 to 98.50 mg/dl. The overall HbA1 decreased
the NCEP-ATP III definition, MS is present if three or from 9.1% to 6.6%. Triglycerides levels decreased from
more of the following five criteria are met: waist circumfe-
rence over 40'' in men or 35'' in women, blood pressure
over 130/85 mm Hg, fasting TG level over 150 mg/dl,
fasting HDL cholesterol level less than 40 mg/dl in men
or 50 mg/dl in women and fasting blood sugar over
100 mg/dl or hemoglobin alpha 1 (HbA1) ≥ 7.5%. Because
this parameters are based on a different standard
physiognomy type, diet, economical status and socio-
economically environment, for this study we used the
body mass index (BMI) as parameter of inclusion, and
were included patients ranging from BMI > 25 Kg/m²
and < 35 Kg/m².

Exclusion Criteria
• Age over 55 years Graph 1: Gender of patients
• Diabetes diagnosed or treatment over 5 years
• Contraindications for surgery over evaluation by
specialists.
Postoperative Follow-up

All patients were followed-up 2 weeks, 3, 6 and
12 months after the procedure, performing blood test
and nutritional evaluation to gather the data of weight
loss and MS criteria. Preoperative and postoperative data
are presented.
DATA EVALUATION

Ten patients were operated, 60% (n = 6) male, 40% (n = 4)
female (Graph 1). The overall mean age was 36.2 ±
17 years. All of the patients met criteria for MS, being Graph 2: hemoglobin alpha 1 overall improvement after
fasting glucose plasma levels the criteria present in sleeve gastrectomy
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