Surgical treatment of patients with morbid obesity

Abstract

Introduction. Class III obesity, formerly known as morbid obesity, is a complex chronic disease in which a person has a body mass index of 40 or higher or a BMI of 35 or higher and is experiencing obesity-related health conditions. These include Type 2 diabetes mellitus, cardiovascular diseases, metabolic syndrome, chronic kidney disease, hyperlipidemia, hypertension, nonalcoholic fatty liver disease, certain types of cancer, obstructive sleep apnea, osteoarthritis, and depression. Aim of study. Analysis of surgical treatment methods for patients with morbid obesity based on bibliographic research and clinical observations. Methods and materials. Seven patients with morbid obesity who required surgical intervention, were supervised, monitored, and performed the necessary investigations during one year. The study included 3 women (42.8%) and 4 men (57.2%) with a body mass from 105 kg to 175 kg and a BMI from 35.49 to 57.8. Obesity due to caloric excess was the most common etiological cause (7 patients), associated with genetic predisposition in 57,14% (4 patients). In addition to being overweight, the patients also accused other comorbidities: Type 2 diabetes mellitus (5 patients, 71,4%); arterial hypertensions (6 patients, 85,7%); osteoarthritis with severe pain performing physical effort (4 patients, 57,1%); obstructive sleep apnea (4 patients, 57,1%); heartburn (2 patients, 28,6%); hyperlipidemia (3 patients, 42,8%) and nonalcoholic fatty liver disease (5 patients, 71,4%). Therefore, the following laparoscopic surgeries were performed: in two patients (28,6%) the Mini Gastric Bypass was performed, and in the other five (71,4%) the Gastric sleeve was done. Results. The patients were monitored for 6 months postoperatively. After the intervention, all patients presented a good general condition, without complications and were discharged after 2-4 days. Also, all patients noted weight loss, with a result from 14 to 42 kg: patient N.1 obtained a BMI from 35.49 to 25.35; N.2 from 35.8 to 31.48; N.3 from 57.8 to 44.59; N.4 from 48.85 to 35.26; N.5 from 44.08 to 36.36; N.6 from 54.88 to 42.99; N.7 from 46.09 to 33.27. Five of patients noted the decrease and stabilization of blood sugar. According to the lipidogram, at 3 patients it was noted the stabilization of the lipid indices. Also, patients communicate about the disappearing of arthralgia. The systolic and diastolic blood pressure values reached the normal or normally high blood pressure. Conclusion. Bariatric surgery ensures long-term weight loss and body mass index related with the improvement and successful treatment of comorbidities associated with morbid obesity. Laparoscopic surgery, also known as minimally invasive surgery, is an effective method, with minor postoperative complications and quick recovery compared to traditional open surgery. Sleeve gastrectomy has become one of the most commonly used bariatric procedures worldwide. in which a person has a body mass index of 40 or higher or a BMI of 35 or higher and is experiencing obesity-related health conditions. These i nclude Type 2 diabetes mellitus, cardiovascular diseases, metabolic syndrome, chronic k idney disease, hyperlipidemia, hypertension, nonalcoholic fatty liver disease, certai n types of cancer, obstructive sleep apnea, osteoarthritis, and depression. Aim of study. Analysis of surgical treatment methods for patients w ith morbid obesity based on bibliographic research and clinical observations. Methods and materials. Seven patients with morbid obesity who required surgical i ntervention, were supervised, monitored, and performed the necessary invest igations during one year. The study included 3 women (42.8%) and 4 men (57.2%) with a body mass fr om 105 kg to 175 kg and a BMI from 35.49 to 57.8. Obesity due to caloric excess was the most common etiological cause (7 patients), associated with genetic predisposition in 57,14% (4 patients). In addition to being overweight, the patients also accused other comorbiditie s: Type 2 diabetes mellitus (5 patients, 71,4%); arterial hypertensions (6 patients, 85,7%); osteoart hritis with severe pain performing physical effort (4 patients, 57,1%); obstructive sleep apnea (4 patients, 57,1%); heartburn (2 patients, 28,6%); hyperlipidemia (3 patients, 42,8%) and nonalco holic fatty liver disease (5 patients, 71,4%). Therefore, the following laparoscopic surge ries were performed: in two patients (28,6%) the Mini Gastric Bypass was performed, and in the othe r five (71,4%) the Gastric sleeve was done. Results. The patients were monitored for 6 months postoperatively. After the intervention, all patients presented a good general condition, without complic ations and were discharged after 2-4 days. Also, all patients noted weight loss, with a resul t from 14 to 42 kg: patient N.1 obtained a BMI from 35.49 to 25.35; N.2 from 35.8 to 31.48; N.3 from 57.8 to 44.59; N.4 from 48.85 to 35.26; N.5 from 44.08 to 36.36; N.6 from 54.88 to 42.99; N.7 from 46.09 to 33.27. Five o f patients noted the decrease and stabilization of blood sugar. Accor ding to the lipidogram, at 3 patients it was noted the stabilization of the lipid indices. Also, pat ients communicate about the disappearing of arthralgia. The systolic and diastolic blood pressure values reached the normal or normally high blood pressure. Conclusion. Bariatric surgery ensures long-term weight loss and b ody mass index related with the improvement and successful treatment of comorbidities as sociated with morbid obesity. Laparoscopic surgery, also known as minimally invasive surgery, is an effective method, with minor postoperative complications and quick recovery compare d to traditional open surgery. Sleeve gastrectomy has become one of the most commonly us ed bariatric procedures worldwide.