Dados do Trabalho

Título

Benefits of vertical endoscopic sleeve gastroplasty in obesity treatment through a physical conditioning program before and after the endoscopic procedure

Introdução e Objetivo

Obesity is a health condition that affects a large part of the world population, becoming a public health problem, and a new treatment alternative is endoscopic vertical gastroplasty. We developed a special protocol for physical training in obese patients who underwent vertical endoscopic gastroplasty. Training criteria were according to ACSM guidelines.
To determine a physical conditioning program for post-vertical endoscopic gastroplasty patients. Define the technical parameters of special sports training in endoscopic techniques for obesity Develop the model of training and physical fitness in obese patients undergoing vertical endoscopic gastroplasty
We determine the need based on new criteria for patients with gastroplasty and their rapid incorporation into physical activity. The physical activity prescription guidelines were made based on ACSM and AHA criteria.

Casuística e Método

Descriptive, cross-sectional study. Population 546 patients, 45 with a body mass index between 30 and 49.5 kg/m2 who agreed to undergo vertical endoscopic sleeve gastroplasty from June 19, 2020 to April 20, 2021. The variables were presented in percentages and measures of central tendency, frequency and dispersion. Students' T for difference in means with the value of p>0.5.

Resultados

The age frequency from 25 to 62 years with mean: 47,1 years, with a standard deviation (SD) 9.1. Female sex was 61.3%, and male was 38.6%. Reduction of obesity according to the percentage of excess weight lost was 40.9%. The body mass index lost was 57.8%. Minimal complications and low risk during and after the procedure, there were no cases of mortality. The main ones found at 3 months of evaluation reached the following resolution: hypertension 100%, prehypertension 76%, prediabetes 52.9%, type diabetes mellitus 50%, elevated total cholesterol 36.3%. All the variables studied have a value of p < 0.00.

Discussão

Currently there are new alternatives to treat obesity, currently endoscopic techniques seek to reduce it along with associated pathologies.
The excess weight lost in the study of laparoscopic sleeve gastrectomy for morbid obesity carried out by Roa et al. (2006), was 52.8%, data very similar to López-Nava et al. (2016) in endoscopic sleeve gastroplasty (Apollo method) with 55.3%.
In the analysis of medium-term weight loss after gastrojejunal and Roux-en-Y bypass and sleeve gastrectomy, the percentage of maximum excess weight lost occurs 18 months after surgery, reaching values ​​above 50%. Espinet et al. in endoscopic sleeve gastroplasty together with diet and psychological help, showed a 55.3% reduction in the percentage of excess weight.
The global registry of IFSO (2018), after 6 months of evaluation in bariatric surgery worldwide, reached a percentage of excess weight loss greater than 50%. Weight loss in patients undergoing gastric bypass bariatric surgery (2013-2016), was greater than or equal to 50%.
Espinet et al. in endoscopic sleeve gastroplasty together with diet and psychological help, showed a 55.3% reduction in excess weight. The present study, the first to use this technique for obesity treatment in Ecuador, found a 41% excess weight loss, a value accepted by the American Society of Gastrointestinal Endoscopy (ASGE) and the American Society of Metabolic and Bariatric Surgery (ASMBS). ) consider that the percentage of fat lost should obtain at least a 25% percentage of weight loss and less than 5% of serious adverse events.
In our study, only minor adverse events occurred in the period studied.
In a pilot study by Lopez-Nava et al. (2013) with the vertical endoscopic sleeve gastroplasty technique, significant weight loss was found in obese patients with a BMI greater than 30.

Conclusão

Endoscopic vertical gastroplasty is an obesity procedure of choice in patients who have no surgical or clinical option. With a program of physical activity carried out before and after the procedure, the quality of life of the patient is improved.