Comparative estimation of results of various surgical bariatric operations
Objective. To compare the results of the bariatric surgical operations for the 5 year period in patients, suffering obesity among population of Azerbaijan.
Маterials and methods. Bariatric surgical operations were performed in 104 patients, suffering obesity among population of Azerbaijan. Average age of the patients was 33.1 years old, and average body mass index (BMI) - 57.5 kg/m2. Comparative analysis of various technical modifications and postoperative complications was conducted. The patients were examined preoperatively and in 1, 3, 6 and 12 mo after the operation. BMI, the signs of diabetes, hypertension, the apnoe syndrome while sleeping and hepatic adipose dystrophy were investigated in dynamics.
Results. In 88 (84,6%) patients, in whom a standard laparoscopic sleeve gastrectomy (LSG) was performed, in 6 mo afterwards the body mass have reduced by (39.5 ± 11.5) kg at average. Of 12 (11.5%) patients after gastric shunting in 2 (1.9%) patients a gastric shunting in accordance to Roux method was performed, in 8 (7.6%) - gastric minishunting, 2 (1.9%) - LSG and Roux shunting. As a result, the body mass have reduced by (46 ± 14) kg, аnd during 6-12 mo observation its effective increase was observed by (33.5 ± 8.5) kg at average. In 1 (1%) patient in other clinic the gastric duplication operation was performed. The body mass during the following year have reduced by 20 kg and stopped, so the patient have been applied into our clinic and to him gastrorestrictive operation was performed. His body mass have reduced by 36 kg. In 3 (2.9%) patients, who have gained the body mass in 2 years after the operation, reoperation procedure was LSG. Subsequently in these patients a satisfactory reduction of the body mass was noted.
Conclusion. After LSG performance the body mass reduction in patients with severe obesity is mostly satisfactory, the vitamin balance disorders are absent, and dynamics of concurrent pathology is positive, making this procedure mostly secure. Meanwhile after shunting bariatric surgery the abovementioned indices are higher and in presence of diabetes mellitus this procedure is mostly effective. LSG is anatomically and physiologically ideal operation, because in case of ineffective body mass lowering the reoperation is possible, and this operation is feasible in patients without diabetes Type II.
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