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Language: English Portuguese. It is estimated that there are nearly 40 million people with the human immunodeficiency virus HIV worldwide. Due to the advent of antiretroviral drugs, it has been observed increasing in obesity and metabolic rates among patients undergoing treatment. Thus, numerous surgical therapies for weight loss are proposed for continuous improvement in health of patients with HIV, being the vertical gastrectomy an option for intact intestinal transit. To evaluate the applicability of the vertical gastrectomy in patients with morbid obesity and HIV. Was conducted a systematic review of the literature, in the electronic databases Scopus, Pubmed, Cinahl, Scielo, Cochrane and Lilacs, from to

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Either your web browser doesn't support Javascript or it is currently turned off. In the latter case, please turn on Javascript support in your web browser and reload this page. Language: English Portuguese. It is estimated that there are nearly 40 million people with the human immunodeficiency virus HIV worldwide.

Due to the advent of antiretroviral drugs, it has been observed increasing in obesity and metabolic rates among patients undergoing treatment. Thus, numerous surgical therapies for weight loss are proposed for continuous improvement in health of patients with HIV, being the vertical gastrectomy an option for intact intestinal transit.

To evaluate the applicability of the vertical gastrectomy in patients with morbid obesity and HIV. Was conducted a systematic review of the literature, in the electronic databases Scopus, Pubmed, Cinahl, Scielo, Cochrane and Lilacs, from to Were found articles in Scopus, in PubMed and in Cinahl. The articles were analyzed by the Jadad Quality Scale, being reduced to 40 articles, subsequently reassessed using an elaborated form by the Critical Appraisal Skills Programme CASP , reaching 12 articles in the end.

It was found that vertical gastrectomy constitutes a safe and effective method, with low mortality and low rate of postoperative complications, being recommended as surgical technique in patients with obesity, HIV and comorbidities.

Foram encontrados 2. For decades, HIV has been intrinsically linked to death. In contrast, has contributed to obesity, abdominal fat accumulation and metabolic changes, associated to better conditions on quality of life Faced with this problem, numerous surgical therapies for weight loss are being used for the continuous improvement of health and care in these patients.

Among the bariatric surgery techniques, it is emphasized the vertical gastrectomy VG or gastric sleeve, which promotes a resection of the entire stomach fundus, allowing a reduction in gastric chamber, culminating in food restriction and hormonal decrease of ghrelin, providing acceleration of the gastrointestinal tract, allowing the continued use of HAART This procedure has proved to be a safety feature, standing out by the considerable reduction of weight in patients with HIV and obesity without causing complications or loss.

The Federal Council of Medicine CFM in Brazil states that the indication and performance of bariatric surgery in adults should occur through the obesity diagnosis set about five years before, in situations where conventional treatments diet, physical activity and pharmacotherapy did not generate results, with such specialized treatment lasting at least two years.

Thus, there is a deficit in the scientific environment, requiring studies to be conducted to assess which bariatric procedures are better for patients with morbid obesity and HIV.

Based on the foregoing and on the difficulties, it was idealized to conduct this study in order to review the scientific literature on the applicability of VG in patients with HIV and morbid obesity. In this context of doubts, the following question was emerged: is the sleeve gastrectomy an effective surgical technique for patients with morbid obesity and HIV?

In this first search moment it was found a great amount of articles, being 2, in Scopus, Medline and Cinahl. Shortly after the search, the inclusion criteria for the selection of articles were established as follows: full papers in Portuguese, English, available free of charge; theme related to the studied subject. Thus, studies that did not meet the relevant criteria were excluded, as dissertations, theses and editorials, among others.

The review process was divided into two stages. First, it was used the Jadad Quality Scale consisting of five criteria with a five points total score. Articles lower than three points were considered with poor methodological quality and little possibility of extrapolating the results to clinical practice.

Only 40 articles were included. Studies that achieved a score of seven out of ten points were included in the sample, reaching the amount of 12 articles, as shown in Figure1. Finally, the articles included in the systematic review were categorized according to the following variables: methodological design level of evidence , comparison groups, dependent variables and main results. Figure 2 shows all its variables. After analyzing all 12 articles, by not probabilistic calculation based on the frequency of surgical techniques, it was noticed that the most placed procedures were: Accordingly, it was observed that the vertical gastroplasty was among the most prevalent against other surgical techniques.

Another point of relevance were the postoperative results, where it was noticed that most obese and HIV patients had a decrease in viral load, better control of type 2 diabetes and hypertension, and better immune response, as shown in Table 1. The aforementioned practice leads to a reduction of possible comorbidities associated with patients who have obesity and seropositivity for HIV, such as type 2 diabetes mellitus, hypertension, hypertrophic cardiomyopathy, hyperlipidemia, cholelithiasis, obstructive sleep apnea, hypoventilation, degenerative arthritis, psychosocial misfits, various types of neoplasms, chronic back pain, among others.

Thus, it can be seen in studies IA, IIB and XN patients who went through surgical procedure with lower levels of viral load, thereby modifying the drug regimen with better physiological condition for therapeutical support 1 , 3. Among the advantages of this procedure there is the lack of duodenum exclusion from intestinal transit, therefore not interfering with iron, calcium, zinc and B vitamins absorption sites, relevant for clinical compensation in AIDS patients.

It can be converted to a procedure with malabsorptive component, such as gastric bypass Roux-en-Y and biliopancreatic diversion with duodenal switch in case of failure, also allowing access to bile and pancreatic ducts by usual endoscopic methods 8. Thus, the VG is one of those safe and effective methods, with low morbidity and mortality, good postoperative results and low complication rate. Furthermore, it can be used as the initial isolated or secondary treatment - for example, after gastric band fails.

Thereby, this technique is being accepted and proposed by many as an isolated bariatric surgery, especially in patients with AIDS, for allowing the continued antiretroviral therapy 10 , However, despite the possibility of maintaining the continuity of the intestinal transit, some studies have demonstrated the potential risk of postoperative long-term nutritional deficiencies such as decrease in the absorption of vitamin B12 and iron It also gives chance to gastroesophageal reflux "de novo" 9 , difficulty in gastric emptying and suture line fistula 2.

Its necessary, however, to have in the future follow-up studies of complications in the late postoperative period to fully clarify the applicability of the surgical procedure in question.

Nowadays, the experience in these patients with this procedure has proven quite effective, minimizing comorbidities that compromise biological and psychological development. Vertical gastrectomy proved to be a safe procedure, favoring weight loss and control of morbid conditions associated with obesity and AIDS.

Read article at publisher's site DOI : To arrive at the top five similar articles we use a word-weighted algorithm to compare words from the Title and Abstract of each citation. Cited by articles PMID: Chirurg , 82 8 , 01 Aug Cited by 5 articles PMID: Obes Surg , 28 2 , 01 Feb Cited by 3 articles PMID: Tunis Med , 93 10 , 01 Oct Cited by 2 articles PMID: Cited by 4 articles PMID: Coronavirus: Find the latest articles and preprints.

Europe PMC requires Javascript to function effectively. Recent Activity. Recent history Saved searches. Pinto JM 1 ,. Lima MG 1 ,. Almeida AL 1 ,.

Sousa MG 1. Affiliations 4 authors 1. Share this article Share with email Share with twitter Share with linkedin Share with facebook. Objective:To evaluate the applicability of the vertical gastrectomy in patients with morbid obesity and HIV.

Methods:Was conducted a systematic review of the literature, in the electronic databases Scopus, Pubmed, Cinahl, Scielo, Cochrane and Lilacs, from to Conclusion:It was found that vertical gastrectomy constitutes a safe and effective method, with low mortality and low rate of postoperative complications, being recommended as surgical technique in patients with obesity, HIV and comorbidities.

Free full text. Arq Bras Cir Dig. PMID: Author information Article notes Copyright and License information Disclaimer. Received Jan 7; Accepted May Copyright notice. This is an open-access article distributed under the terms of the Creative Commons Attribution License. Go to:. Introduction: It is estimated that there are nearly 40 million people with the human immunodeficiency virus HIV worldwide.

Objective: To evaluate the applicability of the vertical gastrectomy in patients with morbid obesity and HIV. Methods: Was conducted a systematic review of the literature, in the electronic databases Scopus, Pubmed, Cinahl, Scielo, Cochrane and Lilacs, from to Conclusion: It was found that vertical gastrectomy constitutes a safe and effective method, with low mortality and low rate of postoperative complications, being recommended as surgical technique in patients with obesity, HIV and comorbidities.

Defining the question In this context of doubts, the following question was emerged: is the sleeve gastrectomy an effective surgical technique for patients with morbid obesity and HIV? Revising and selecting the studies Shortly after the search, the inclusion criteria for the selection of articles were established as follows: full papers in Portuguese, English, available free of charge; theme related to the studied subject. Assessment to articles quality The review process was divided into two stages.

Open in a separate window. Route of systematic review showing the steps for articles selection. Presenting the results Finally, the articles included in the systematic review were categorized according to the following variables: methodological design level of evidence , comparison groups, dependent variables and main results.

List of items that belong to the axis of the studied subject, according to the criteria. Financial source: none. Assessment of obesity - related comorbidities: a novel scheme for evaluating bariatric surgical patients.

J Am Coll Surg. A gastroplastia em manga Sleeve gastrectomy e o Diabetes Mellitus. Bariatric Surgery. Surgery for weight control in patients with morbid obesity. Med Clin North Am. Benaiges D, et al. Laparoscopic sleeve gastrectomy review. World J Gastroenterol. Arch Surg.

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