Anthropometric and clinical profiles of post-bariatric patients submitted to procedures in plastic surgery
Perfil antropométrico e clínico de pacientes pós-bariátricos submetidos a procedimentos em cirurgia plástica
Simone Corrêa Rosa1,2; Jefferson Lessa Soares de Macedo, TCBC-DF1,3; Luiz Augusto Casulari2 ; Lucas Ribeiro Canedo3 ; João Vitor Almeida Marques3
INTRODUCTION
Obesity is a disease of epidemic proportions, often associated with increased morbidity and mortality, as well as increased health spending, and reduced life quality and expectancy1 . Safety in the performance of bariatric surgery, represented by low rates of early and late complications (venous thromboembolism, surgical reintervention, prolonged hospitalization) and a mortality rate of 0.3%, together with a significant improvement in comorbidities, justify its inclusion as an important strategy in the treatment of severe obesity2,3. However, many patients are not prepared to deal with excess skin due to massive weight loss, which can lead to a decline in quality of life and an increased risk of weight regain4,5. These patients show stabilization or even decline in quality of life after the second year of gastric bypass surgery6 , which can be attributed to changes in physical appearance and the decline associated with dissatisfaction with one’s own body image. Repairing plastic surgery plays an important role in stabilizing the quality of life of patients with massive weight loss after bariatric surgery, maintaining the improvement of the quality of life sustained in the long term7 . This study aims to present the anthropometric profile, the presence of comorbidities and the quality of life of post-bariatric patients submitted to procedures in plastic surgery. METHODS We carried out a prospective study in a public reference hospital for bariatric surgery, with individuals who underwent Roux-en-Y gastric bypass and were 1 - Asa Norte Regional Hospital, Plastic Surgery Service, Brasília, DF, Brazil. 2 - University of Brasília/FEPECS, Post-Graduation Course in Health Sciences, Brasília, DF, Brazil. 3 - Superior School of Health Sciences, Medical School, Brasília, DF, Brazil. Original Article ABSTRACT Objective: to evaluate the profile of patients submitted to post-bariatric plastic surgery at the North Wing Regional Hospital, Brasília, DF. Methods: we conducted a prospective, descriptive and analytical study of patients submitted to Roux-en-Y gastroplasty, and subsequently to plastic surgery, from January 2011 to December 2016. We assessed body mass index before gastroplasty and after surgery plastic surgery, postoperative complications and comorbidities. Results: we studied 139 patients (130 women and nine men), with a mean age of 41 years, who underwent 233 operations. The mean BMI at the time of plastic surgery was 27.44kg/m2 . The mean weight loss was 47.02kg and the mean maximum BMI was 45.17kg/m2 . The mean time between bariatric surgery and plastic surgery was 42 months. The most important co-morbidities before plastic surgery were arterial hypertension (11.5%), arthropathy (5.4%), diabetes mellitus (5%) and metabolic syndrome (4.3%) (p<0.01). Of the 139 patients operated on, 76.97% underwent abdominoplasty followed by mammoplasty (42.46%), rhytidoplasty (17.27%) and brachioplasty (13.67%). Fourteen (13.08%) patients underwent herniorrhaphy combined with abdominoplasty. We performed anchor abdominoplasty in 19.42%. The rate of postoperative complications was 26.65%. Conclusion: the epidemiological profile of post-bariatric patients who underwent plastic surgery was similar to that reported in the literature, except for the low rate of associated surgeries and postoperative complications. Plastic surgery in post-bariatric patients has led to an improvement in the quality of life in most of these patients.