Abstract
ABSTRACTBackground:In Brazil, there has been a significant increase in obesity rates in all age groups. Data from 2017 show that obesity affects 19% of the population. Due to the magnitude of the problem, public health policies have aimed to prevent complications related to obesity by increasing the offerfor bariatric surgeries. Aim:To analyze the current status of bariatric surgery performed in the Brazilian public health system, including data from macroregions and also the effect of digestive surgery training on the number of procedures. Methods:The database of the public health registry (DATASUS) was assessedbetween 2008 and 2018 for descriptive analysis of data and evaluation of the selected parameters. The main surgical techniques, comorbidities, mortality and the costs profile of the system were evaluated. Results:There was a 339% increase in the number of bariatric surgeries in the period evaluated. Gastric bypass was performed in 94% of cases whereas sleeve in 2.4%. Other techniques were used in 3.6%. There were discrepancies in the number of surgeries performed in different regions of the country. Conclusion:There was a considerable advance in the number of bariatric surgeries performed by the public health system between 2008 and 2018. However, there is a need to increase the offer of this service and alsospecialized training, as well as a correction in the distribution of these procedures in the national territory to achieve integrality among its users.
Highlights
Obesity is defined by WHO as the abnormal or excessive accumulation of body fat in the form of adipose tissue. It is considered a multifactorial disease, encompassing genetic, behavioral, metabolic and environmental factors[24]. It is directly associated with the risk of developing chronic diseases such as type II diabetes mellitus, cardiovascular disease, dyslipidemia, sleep apnea, osteoarthritis, dental changes and various types of neoplasms[18,24]
The aim of this study was to analyze the current state of bariatric surgery performed by the Brazilian public health system, including macroregion data and the effect of digestive surgery training on the number of procedures
There was a predominance of gastric bypass in the years evaluated, accounting for 94.9% of the procedures, while the other techniques were performed less frequently: vertical gastrectomy (2.4%), vertical banded gastroplasty (1.9%) and duodenal switch (0.6%)
Summary
Obesity is defined by WHO as the abnormal or excessive accumulation of body fat in the form of adipose tissue. It is considered a multifactorial disease, encompassing genetic, behavioral, metabolic and environmental factors[24]. It is directly associated with the risk of developing chronic diseases such as type II diabetes mellitus, cardiovascular disease, dyslipidemia, sleep apnea, osteoarthritis, dental changes and various types of neoplasms[18,24]. When obesity reaches grade III (BMI >40), clinical treatment results are unsatisfactory in 95% of patients, who regain initial weight within two years[21]. The main technique currently used is gastric bypass, which reduces the gastric cavity and the amount of food ingested (restrictive), while at the same time decreasing the intestinal absorption surface
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