PhD THESIS (Ozimo Gama, MD)

COMPARATIVE STUDY BETWEEN THE SLEEVE GASTRECTOMY AND GASTRIC PLICATION IN OBESE RATS

INTRODUCTION: Obesity results from a prolonged imbalance between energy intake and energy expenditure. Studies with experimental models of bariatric surgery provided a fundamental contribution to the understanding of morphological and functional changes in obesity and after bariatric surgery. The restrictive bariatric surgery techniques currently used are gastric banding, sleeve gastrectomy and the gastric plication. The latter is considered an experimental technique and has therefore not yet enough studies that shed light on the postoperative rates of weight loss, surgical complications, resolution of comorbidities and the mechanisms responsible for weight loss. The aim of this study was to conduct a comparative study in rats with cafeteria diet-induced, between gastric plication and sleeve gastrectomy in variation late postoperative in body weight ,plasma biochemistry and gross and microscopic alterations gastric effects obesity.

MATERIAL AND METHOD: 28 male Wistar rats were randomized into three groups after induction period of obesity by cafeteria diet and underwent sleeve gastrectomy (GV group), gastric plication (GP group) and sham operation (control group). The animals were assessed daily postoperatively and the variables were recorded: (initial seven days, 14 and 21 days) body weight and presence of complications until day 21 postoperatively, when they were euthanized and evaluated: biochemistry (glucose, insulin, HDL, total cholesterol, triglycerides, AST, ALT and serum ghrelin), degree of intra-abdominal adhesions, resistance testing will air insufflation in the stomach and microscopic evaluation of the gastric mucosa.

RESULTS: In relation to body weight variation of animals GV group (initial weight: 318 ± 7.89 g / Final weight: 213 ± 9.03g) was significantly decreased (p<0.05) at 21 post-surgery day compared to the GP group (initial weight: 314.11 ± 20.79 g / final weight: 239.16 ± 14.71 g) and control (initial weight: 315.16±17.54g / final weight: 317.91±16.06 g). The animals in the GV group had a significant decrease (p<0.001) in blood glucose, insulin, transaminases, serum HDL and ghrelin compared to animals in GP and control. Was also significantly lower the burst pressure of the stomach in the GV group, the insufflation test the atmospheric air in relation to the GP and control groups. The GP and GV groups showed even different histological grade of inflammation
(subacute inflammation) and control group (chronic inflammation).

CONCLUSIONS: The sleeve gastrectomy is more effective than gastric plication weight loss, metabolic control and reduction of serum ghrelin in obesity rats, and presents the same rates of postoperative complications (adhesions, deaths and grade inflammation).

KEYWORDS: 1. Obesity; 2. Bariatric Surgery; 3.Wistar rats.

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