Estrés quirúrgico durante el bypass gástrico en obesos mórbidos
[eng] INTRODUCTION: Morbid obesity is a widely spread disease in Western society. It is associated with an important comorbidity. Amongst the strategies used for the treatment of obesity, bariatric surgery is the most effective method. GOALS: To observe the behaviour of these patients before the acu...
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| Tipo de recurso: | tesis doctoral |
| Estado: | Versión publicada |
| Fecha de publicación: | 2010 |
| País: | España |
| Institución: | Universidad de Barcelona |
| Repositorio: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/36206 |
| Acceso en línea: | https://hdl.handle.net/2445/36206 http://www.tdx.cat/TDX-0228111-154136 http://hdl.handle.net/10803/1044 |
| Access Level: | acceso abierto |
| Palabra clave: | Estrès (Fisiologia) Cirurgia de l'obesitat Obesitat mòrbida Stress (Physiology) Obesity surgery Morbid obesity |
| Sumario: | [eng] INTRODUCTION: Morbid obesity is a widely spread disease in Western society. It is associated with an important comorbidity. Amongst the strategies used for the treatment of obesity, bariatric surgery is the most effective method. GOALS: To observe the behaviour of these patients before the acute stress involved in the bariatric surgery. To observe the changes in the ACTH, cortisol, and glucose, which are already altered because of the obesity itself, and to determine whether these patients are capable of reacting to the acute stress involved in the surgery. PATIENTS AND METHODS: A group of 34 morbid obese patients were used. The group underwent bariatric surgery. Plasma samples were assessed. These samples were obtained under the following timeline: a month before surgery, the day of surgery (before intubation and after extubation, once the effects of the anaesthesia were over), 24 hours post-surgery and a month after surgery. Furthermore, anthropometric measures were taken a month before surgery and a month alter surgery. CONCLUSIONS: Bariatric surgery provokes a series of changes in the postoperative period due both to the loss of adipose tissue and the surgical stress. The significant fat loss that takes place one month after surgery is a consequence both of the reduction of the intake and the loss of absorptive surface area. The weight loss that takes place in these patients one month after surgery produces a clear improvement in insulin resistance, thrombotic risk, and the lipid profile. During the surgical stress an alteration is produced in the parameters of acute stress. Such as glucose, ACTH and cortisol, the latter being the probable responsible of the increment of the NEFA and the PCR that we observed in the perioperatory period. |
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