Abstract

Abstract To assess the effect of vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB) on the esophageal and intestinal morphology of western diet (WD)-obese rats and to characterize the stomach histopathology of WD rats submitted to VSG. Male Wistar rats received WD from 2-4 months of age, to induce obesity, before randomly submitting them to pseudo (WD-SHAM), VSG (WD-VSG) or RYGB (WD-RYGB) surgeries. Gastrointestinal histomorphometry was performed at 3-months post-surgery. The upper esophagus of VSG and RYGB rats increased luminal area, while reductions in the keratin layer of the mucosa and the tunica muscularis were observed only in the RYGB animals. In the lower esophagus, both surgeries increased keratin layer thickness, but reduced the mucosal mucus content, while RYGB increased the thickness of the tunica mucosa and muscularis. The glandular region of the stomach of WD-VSG rats exhibited hypotrophy, epithelial erosion, fibrosis and moderate inflammatory infiltration. VSG and RYGB increased the villi height in the ileum, and the thickness of the tunica muscularis in the jejunum and ileum of WD rats; furthermore, RYGB augmented the ileal villi height. Thus both approaches induced histomorphological alterations in the esophagus and intestine and VSG damaged the gastric mucosa, even over the long-term.

Highlights

  • The obesity epidemic has reached alarming proportions worldwide, and is becoming the number one Public Health issue as, in addition to its direct organic impact, its multifactorial etiology predisposes individuals to several other chronic diseases (Chooi et al 2019)

  • Obesity parameters evaluated in Western diet (WD) rats submitted to bariatric or SHAM operations The body weight (BW) in the day of surgery was similar among the groups of WD rats that were randomly

  • WD-Vertical sleeve gastrectomy (VSG) rats started to display an increase in BW, resulting in a greater BW gain during the last 2 months of the experimental period (83.0 ± 6.8 g), than that observed for WD-Roux-en-Y gastric bypass (RYGB) rats (38.0 ± 3.9 g; P < 0.05)

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Summary

Introduction

The obesity epidemic has reached alarming proportions worldwide, and is becoming the number one Public Health issue as, in addition to its direct organic impact, its multifactorial etiology predisposes individuals to several other chronic diseases (Chooi et al 2019). From the age of 40 to 75 years, men and women that are mildly or severely obese exhibit reductions of 3-4 and 7-8 disease-free years, respectively, independently of socioeconomic status or favorable life-style factors (Nyberg et al 2018). Increased adiposity augments the risk of all forms of mortality, with higher degrees of obesity being associated with greater reductions in life expectancy (Aune et al 2016, Bhaskaran et al 2018). Vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB) are the most performed bariatric techniques. While VSG is a restrictive procedure that reduces the size of the stomach by 80%, RYGB combines a restrictive procedure

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