Dispneia, fadiga e qualidade de vida um ano após cirurgia bariátrica: estudo observacional considerando o tipo de cirurgia

Abstract

The Obesity is a cardiometabolic disease of complex and multifactorial etiology, characterized by excess body mass and which can lead to major damage to health. This condition has repercussions on changes in mechanics and lung compliance, which can cause symptoms such as dyspnea and is associated with reports of fatigue. In addition to the associated symptoms, obesity can contribute to a worse quality of life, due to the limitations and stigmas imposed by excess body mass and its comorbidities. Obesity treatment includes everything from drug treatment and lifestyle changes to bariatric surgery. Bariatric surgery can be performed using laparotomy or laparotomy techniques, where the first consists of a minimally invasive technique and the second in an abdominal incision with a larger diameter for manipulating the stomach. Videolaparoscopic surgery was one of the most significant advances for the bariatric procedure, since laparotomy, associated with greater reports of pain in the postoperative period, prolonged hospital stays, high risk of infection and higher mortality rate. Despite all the benefits of surgical treatment such as loss of body mass and resolution of associated comorbidities, this approach can cause several post-surgical complications, including a persistence of symptoms such as dyspnea and fatigue that can have a negative impact on quality of life. Therefore, the aim of the present study was to investigate the symptoms of dyspnea and fatigue in patients after bariatric surgery by laparoscopy or laparotomy one year after the procedure and to compare these symptoms, as well as the loss of body mass between the two types of surgery. In addition, to investigate the existence of an association between dyspnea, fatigue and loss of body mass with quality of life considering both types of surgery. This is an observational, retrospective and longitudinal study, involving adults, of both sexes, with bariatric surgery by laparotomy and videolaparoscopy in hospitals that perform this procedure in the city of Juiz de Fora, Minas Gerais. All hospitals that perform this type of procedure were contacted and a source to collaborate with a research, two of which offered to provide information for the development of the study. After authorization, patients examined for bariatric surgery in the last 10 to 14 months were contacted and treated for participation in the study. They who accepted and signed the free and informed consent term were about a face-to-face anamnesis and later had the study variables evaluated by responding to the following self-applicable instruments: MRC (dyspnea), EICF (fatigue) and BAROS and SF - 36 (quality of life). Fifty-one subjects aged between 24 and 51 years (36.4 ± 1.1 years) and the majority were female (68.6%) participated in the study. The mean scores of dyspnea found one year after surgery performed by laparoscopy and laparotomy were 2 ± 1 and 1 ± 1, respectively. The average scores obtained for the fatigue experience were 18 ± 1 and 18 ± 1 one year after the surgery performed by laparoscopy and laparotomy, respectively, while one the average scores for the impacts of fatigue were 31 ± 3 and 32 ± 3, respectively. A difference was found, expressed in the loss of body mass between laparotomy and laparotomy surgery (37.9 ± 9.3 kg vs. 47.5 ± 12.3 kg; P <0.01), respectively, without significant differences for the other variables, comparisons regarding the type of surgery. In addition, there was no correlation between dyspnea and fatigue symptoms and loss of body mass with quality of life one year after surgery, for the two surgical techniques employed. The findings of the present study recover the symptoms of dyspnea and fatigue, and the QoL does not differ between patients undergoing bariatric surgery by laparoscopy or laparotomy one year after the procedure. The effectiveness of bariatric surgery in reducing body mass and resolving obesity-associated comorbidities has been confirmed.