Comparación de resultados previos y posteriores a la aplicación de un protocolo de cirugía bariátrica
2011
Introduction: Bariatric surgery has been shown to be
an effective therapy for weight loss in patients with severe
obesity, and the implementation of a multidisciplinary
management protocol is recommended.
Objectives: To assess the usefulness of the implementation
of a management protocol in obesity surgery based
on the Spanish Consensus Document of the SEEDO.
Methods: Retrospective comparative study of the outcomes
in patients previously operated (51 patients) and
after the implementation of the protocol (66 patients).
The following data were gathered: anthropometry, preand
post-surgery comorbidities, post-surgical nutritional
and surgical complications, validated Quality of Life
questionnaire, and dietary habits.
Results: Withdrawals (17.6%) and alcoholism (5.8%)
were higher in patients pre- versus post-implementation
of the protocol (4.5% vs. 3%, respectively), the differences
being statistically significant. The mortality rate
was 2% in the pre-protocol group and 0% in the postprotocol
group. The dietary habits were better in the
post-protocol group, the pre-protocol group presenting a
higher percentage of feeding-behavior disorders (5.1%)
although not reaching a statistical significance. The
improvement in quality of life was higher in the post-protocol
group for all items, but only reaching statistical significance
in sexual activity (p = 0.004).
In the pre-protocol group, 70.5% of the patients had
more than one nutritional complication vs. 32.8% in the
post-protocol group (p 50% in 81.3% in the pre-protocol group vs.
74.8% in the pos-protocol group) or the comorbidities.
Conclusions: Bariatric surgery achieves excellent outcomes
in weight loss, comorbidities, and quality of life,
but presents nutritional, surgical, and psychiatric complications
that require a protocol-based and multidisciplinary
approach. Our protocol improves the outcomes regarding the
withdrawal rates, feeding-behavior disorders, dietary
habits, nutritional complications, and quality of life.
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