Obesity surgery
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Comparative Study
Higher content of trans fatty acids in abdominal visceral fat of morbidly obese individuals undergoing bariatric surgery compared to non-obese subjects.
The purpose of this study was to determine the total content of trans fatty acids (TFA) in subcutaneous, retroperitoneal and visceral fat of morbidly obese and non-obese patients submitted to bariatric surgery or plastic and abdominal surgery. ⋯ Our values for TFA content in all adipose tissues analyzed are higher than reported in other countries (3-6%). We showed more TFA in visceral adipose tissue than in other abdominal fat (subcutaneous and retroperitoneal) stores. The visceral adipose tissue level is worrisome because the higher rate of lipolysis in this tissue appears to be an important indicator of metabolic alterations and the levels of TFA found in adipose tissue presumably reflect the higher dietary intake of TFA by Brazilians.
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A previous study reported an association between obesity and increased tenderness. However, the effect of weight reduction on tenderness is not known. The aim of the study was to assess tenderness thresholds before and after bariatric surgery. ⋯ Nonarticular tenderness in obese women remained high after weight reduction. These findings are relevant to physicians taking care of obese patients. Further studies are needed to elucidate the relationship between weight reduction and pain thresholds.
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Comparative Study
Size, volume and weight of the stomach in patients with morbid obesity compared to controls.
There is no mention in surgical literature regarding anatomic measurements of the stomach in patients with morbid obesity. We investigated by a prospective study the length of the lesser and greater curvature, the volume or total capacity and the weight of the stomach in morbidly obese patients compared to controls. ⋯ No significant differences were found in anatomic measurements of the stomach between control subjects and patients with morbid obesity.
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Wound infection risk is inversely related to subcutaneous tissue oxygenation, which is reduced in obese patients and may be reduced even more during laparoscopic procedures. ⋯ Obese patients having laparoscopic surgery require a significantly greater FIO(2) to reach an arterial oxygen tension of about 150 mmHg than non-obese patients; they also have significantly lower subcutaneous oxygen tensions. Both factors probably contribute to an increased infection risk in obese patients.