Bariatric surgery and its complications: analysis of long-term results

Abstract

Obesity, characterized by a body mass index (BMI) ≥ 30 kg/m², is a growing global health issue affecting approximately 650 million adults, representing 13% of the world’s population. Associated with conditions such as type 2 diabetes, hypertension, and cardiovascular diseases, obesity can also lead to mental health issues and reduced quality of life. For individuals with severe obesity, bariatric surgery, including vertical gastrectomy and Roux-en-Y gastric bypass (RYGB), is an effective treatment option when dietary and pharmacological interventions are insufficient. Criteria for surgery were established by the NIH and have evolved to include patients with a BMI between 30 and 35 with type 2 diabetes. A systematic review was conducted to assess the effectiveness of bariatric surgery management strategies. Studies from the past 10 years were analyzed, sourced from PubMed and LILACS, focusing on surgical interventions, postoperative care, and complication prevention. Older and irrelevant studies were excluded. The review involved screening 110 articles, with a final selection of 6 meeting the established criteria. The analysis revealed that bariatric surgery offers significant improvements in physical quality of life, with enduring benefits for patients' physical health. However, mental quality of life may decline over time, requiring ongoing psychological monitoring. Surgery may also lead to complications such as postprandial hypoglycemia and dumping syndrome. Hypoglycemia, affecting up to 50% of patients after gastric bypass or vertical gastrectomy, can be managed with dietary adjustments and medication. Dumping syndrome, associated with gastric bypass, causes gastrointestinal discomfort and should be managed carefully. Additionally, surgery can result in significant bone loss, increasing fracture risk and necessitating ongoing evaluations and support for bone health. While bariatric surgery is effective for weight loss and improving physical quality of life, its long-term complications, such as metabolic and psychological issues, need to be carefully managed. Continuous follow-up is crucial for addressing adverse effects and improving overall patient health. Strategies such as psychological monitoring, bone health assessment, and nutritional support are essential to maximize the benefits of surgery and minimize associated risks.