Resultados metabólicos de la cirugía bariátricaImpacto sobre el riesgo cardiovascular

  1. I. Mateo-Gavira 1
  2. F. J. Vílchez-López 1
  3. M. Á. Mayo-Ossorio 1
  4. D. Medina-Rivero 1
  5. E. Sánchez-Toscano 1
  6. J. M. Pacheco-García 1
  7. A. Prada-Oliveira 1
  8. M. Aguilar-Diosdado 1
  1. 1 Hospital Univesitario Puerta del Mar. Cádiz.
Revista:
Cirugía Andaluza

ISSN: 2695-3811 1130-3212

Año de publicación: 2019

Volumen: 30

Número: 4

Páginas: 510-514

Tipo: Artículo

DOI: 10.37351/2019304.12 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

Otras publicaciones en: Cirugía Andaluza

Resumen

La obesidad supone un importante impacto sociosanitario por su elevada prevalencia, las comorbilidades asociadas y su elevada mortalidad. La cirugía bariátrica, aunque no exenta de riesgos, se postula como un tratamiento eficaz en la consecución de una importante pérdida ponderal y mejoría de las patologías asociadas a la obesidad. Los datos de remisión, superiores a los de cualquier abordaje terapéutico intentado hasta la actualidad, plantean la posibilidad de considerar la cirugía metabólica como alternativa terapéutica en pacientes con diabetes y un índice de masa corporal inferior al considerado hasta el momento. Así, la cirugía metabólica ha supuesto la incorporación de las técnicas de cirugía bariátrica al arsenal terapéutico de situaciones clínicas tradicionalmente consideradas de manejo dietético y farmacológico. Dicho beneficio metabólico se traduce en una reducción del riesgo cardiovascular, así como una notable mejora en la calidad de vida de los pacientes intervenidos.

Referencias bibliográficas

  • Osland E, Yunus RM, Khan S, Memon B, Memon MA. Diabetes improvement and resolution following laparoscopic vertical sleeve gastrectomy (LVSG) versus laparoscopic Roux-en-Y gastric bypass (LRYGB) procedures: a systematic review of randomized controlled trials. Surg Endosc Other Interv Tech. 2017; 31(4):1952-63.
  • Sjöström CD, Lissner L, Wedel H, Sjöström L. Reduction in incidence of diabetes, hypertension and lipid disturbances after intentional weight loss induced by bariatric surgery: the SOS Intervention Study. Obes Res. 1999; 7(5):477–84.
  • Salas-Salvadó J, Rubio MA, Barbany M, Moreno B; Grupo Colaborativo de la SEEDO. SEEDO 2007 Consensus for the evaluation of overweight and obesity and the establishment of therapeutic intervention criteria. Med Clin (Barc). 2007; 128(5):184-96
  • Cummings DE, Rubino F. Metabolic surgery for the treatment of type 2 diabetes in obese individuals. Diabetologia. 2018; 61(2):257-264.
  • Yang J, Wang C, Cao G, Yang W, Yu S, Zhai H, et al. Long-term effects of laparoscopic sleeve gastrectomy versus roux-en-Y gastric bypass for the treatment of Chinese type 2 diabetes mellitus patients with body mass index 28-35 kg/m2. BMC Surg. 2015; 15:88.
  • Rubio MA, Monereo S, Lecube A, Resa J, Masdevall C, de la Cruz Vigo F, et al. Posicionamiento de las sociedades SEEN-SECO-SEEDO-SED sobre la cirugía metabólica en la diabetes mellitus tipo 2. Endocrinol Nutr. 2013; 60 (10): 547-8.
  • Centre for Public Health Excellence at NICE (UK); National Collaborating Centre for Primary Care (UK). Obesity: The Prevention, Identification, Assessment and Management of Overweight and Obesity in Adults and Children. NICE Clinical Guidelines, 2006; No. 43.
  • Mechanick JI, Youdim A, Jones DB, Timothy Garvey W, Hurley DL, Molly McMahon M, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient - 2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. Surg Obes Relat Dis. 2013; 9(2):159-91.
  • International Diabetes Federation. IDF Clinical Practice Recommendations for managing Type 2 Diabetes in Primary Care, 2017. www.idf.org/managing-type2-diabetes.
  • American Diabetes Association. Standards of medical care in diabetes 2018 (Position Statement). Diabetes Care. 2018; 41 (Suppl 1): S65-S72.
  • Pories WJ, Swanson MS, MacDonald KG, Long SB, Morris PG, Brown BM, et al. Who would have thought it?: An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg. 1995; 222(3):339–52.
  • DePaula AL, Macedo AL, Rassi N, Vencio S, Machado CA, Mota BR, et al. Laparoscopic treatment of metabolic syndrome in patients with type 2 diabetes mellitus. Surg Endosc 2008; 22(12): 2670-8.
  • Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pries W, Fahrbach K, et al. Bariatric surgery: A systematic review and meta-analysis. JAMA. 2004; 292(14):1724-37.
  • Osland E, Yunus RM, Khan S, Memon B, Memon MA. Diabetes improvement and resolution following laparoscopic vertical sleeve gastrectomy (LVSG) versus laparoscopic Roux-en-Y gastric bypass (LRYGB) procedures: a systematic review of randomized controlled trials. Surg Endosc. 2017; 31(4):1952-1963.
  • Leonetti F, Capoccia D, Coccia F, Casella G, Baglio G, Paradiso F. Obesity, type 2 diabetes mellitus, and other comorbidities: a prospective cohort study of laparoscopic sleeve gastrectomy vs medical treatment. Arch Surg. 2012;147 (8):694-700.
  • Mateo-Gavira I, Roldán-Caballero, P, Vílchez-López FJ, Tamayo-Serrato J, Larrán-Escandón L, Ojeda-Schuldt MB, et al. Evaluation of gastric bypass effect on cardiovascular risk and quality of life in type 2 diabetes patients. 15th European Congress of Endocrinology. Endocrine abstracts 2013; 32: P764.
  • De Paula, A. L., A. R. Stival, Ribamar J, Mancini M, Halpern A, et al. Prospective randomized controlled trial comparing 2 versions of laparoscopic ileal interposition associated with sleeve gastrectomy for patients with type 2 diabetes with BMI 21-34 kg/m. Surg Obes Relat Dis 2010; 6(3): 296-304.
  • Mingrone G, Panunzi S, De Gaetano A, Guidone C, Iaconelli A, Leccesi L, et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med. 2012; 366(17):1577-85.
  • Schauer PR, Kashyap SR, Wolski K, Brethauer SA, Kirwan JP, Pothier CE, Thomas S, Abood B, Nissen SE, Bhatt DL. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med 2012; 366(17):1567-76.
  • Mateo Gavira I, Vilchez Lopez FJ, Cayón Blanco M, García Valero A, Escobar Jiménez L, Mayo Ossorio MA, et al. Effect of gastric bypass on the cardiovascular risk and quality of life in morbid obese patients. Nutr Hosp. 2014; 29(3):508-12.
  • Sánchez Toscano E, Mateo Gavira I; Medina Rivero D; Larrán Escandón L, Mayo Osorio MA; Pacheco García JM, et al. Efecto de la gastrectomía vertical sobre las comorbilidades metabólicas en pacientes intervenidos en el Hospital Puerta del Mar (2009 - 2015). 60 Congreso de la Sociedad Española de Endocrinología y Nutrición, 2019.
  • Vilarrasa N, Rubio MA, Miñambres I, Flores L, Caixàs A, Ciudin A, et al. Long-Term Outcomes in Patients with Morbid Obesity and Type 1 Diabetes Undergoing Bariatric Surgery. Obes Surg. 2017; 27(4):856-863.
  • Delarue J, Magnan C. Free fatty acids and insulin resistance. Curr Opin Clin Nutr Metab Care 2007; 10: 142-8.
  • Fetner R, McGinty J, Russel C, et al. Incretins, diabetes, and bariatric surgery: a review. Surg Obes Relat Dis 2005; 1:589-8.
  • Ley RE, Turnbaygh PJ, Klein S, Gordon J. Microbial ecology: human gut microbes associated with obesity. Nature 2006; 444: 1022-3.
  • Buchwald H, Vargo RL, Matts JP, Long JM, Fitch LL, Campbell GS, et al. Effect of partial ileal bypass surgery on mortality and morbidity from coronary heart disease in patients with hypercholesterolemia. New Engl J Med. 1990; 323(14):946-55.
  • Sjöström L, Peltonen M, Jacobson P, Ahlin S, Andersson-Assarsson J, Anveden Å, et al. Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications. JAMA. 2014; 311(22):2297-304.
  • Sjöström L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Swedish Obese Subjects Study Scientific Group. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683-93.
  • Sjöström L, Narbro K, Sjöström CD, Karason K, Larsson B, Wedel H, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007; 357(8):741-52.