[Neuroendocrine bases in the surgical treatment of the morbid obesity: two cases operated with the technique of Santoro, in the HERM].
OBJECTIVE
To report on a new surgical technique to treat morbid obesity ideated by Sergio Santoro , based in neuroendocrine physiological concepts.


METHODS
The operation included sleeve gastrectomy, omentectomy and enterectomy, maintaining the initial 50-100 cm. of jejunum and final 250-200 cm. of ileum, with termino terminate anastomosis . To report two cases operated at the Rebagliati Hospital.


RESULTS
Three months of the follow up both patients have early saciety, asintomatic, low odor of the feces ,weigth reduction was 17-20 Kg. with improvement of the surgical comorbidities especially diabetes and knee pain .


CONCLUSIONS
This procedures creates a proportionally reduced gastrointestinal tract, leaving its basic functions unharmed. After Santoro II operation an adaptation of the gastric chamber size to hypercaloric diet and it removes the sources of ghrelin and aims at moderate restriction with early saciety by distention , omentectomy removes the sources of plasminogen activator inhibitor -1 (PAI-1) and resistin production, enterectomy leads more nutrients to the distal bowel and raising the levels of glucagon-like peptide -1 (GLP-1) , Peptide YY (PYY) and oxintomodulina (OXM) with desirable metabolic consequences. It does no use prosthesis and does not cause exclusion of gastrointestinal segments, suboclusion, malabsorption , blind endoscopic areas and the patients do not need nutritional support or to take vitamins.
Ríos Canturín
Pedro J
PJ
Departamento de Cirugia, Hospital Rebagliati. prioscanturin@yahoo.com
Fernandez
Elmer Pérez
EP
Ríos Torres
Pedro O
PO
D000328:Adult; D000714:Anastomosis, Surgical; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007583:Jejunum / Q000601:surgery*; D009490:Neurosecretory Systems / Q000503:physiopathology; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D009852:Omentum / Q000601:surgery*