Avaliação clínica e resposta orgânica em obesos mórbidos submetidos a gastroplastia vertical videolaparoscópica com ou sem cuidados perioperatórios preconizados pelo Projeto ACERTO : estudo randomizado

Abstract

To evaluate clinical results, insulin resistance and inflammatory response to trauma in morbidly obese patients undergoing laparoscopic Sleeve gastrectomy who received either traditional preoperative care or treatment following the ACERTO protocol. Method: The population of the study consisted of morbidly obese patients, who were operated on with the Sleeve procedure, from Cuiaba, MT, between April and October 2012. We studied the inflammatory response and insulin resistance by measuring levels of glucose, insulin, reactive C protein, albumin, pre-albumin, alpha 1 acid glicoprotein, interleukin 6 and glycosylated hemoglobin. We also studied hydration, nausea and vomiting, hypertension, and length of hospital stay. Results: Patients who followed the ACERTO protocol showed no post-operative hypertensive crises (p = 0.03), and 30% less vomiting (p = 0.35), and showed significant reductions in length of hospital stay (3 [2-3] days versus 2 [2-2] days) (p = 0.02). We did not find statistically significant differences between the two groups with respect to inflammatory response and insulin resistance (p> 0.05). Conclusion: The use of the ACERTO protocol with morbidly obese patients undergoing Sleeve operations was safe and did not incur risk of post-operative complications following surgery or anesthesis. There was no improvement in insulin resistance or inflammatory reactions. The use of the ACERTO protocol reduced hypertensive complications and the length of hospital stays.