title: Silicone-ring Roux-en-Y gastric bypass in the treatment of obesity: effects of laparoscopic versus laparotomic surgery on respiration.
abstract: BACKGROUND
  The objective of this study was to compare the effects of silicone-ring Roux-en-Y gastric bypass carried out by laparoscopy versus that accomplished by laparotomy on pulmonary function.
  
  
  METHODS
  A total of 26 women (body mass index (BMI) 35-49 kg/m(2)) were studied candidates for silicone-ring Roux-en-Y gastric bypass carried out by laparoscopy (LG; n = 13) and laparotomy (or open surgery (OG); n = 13). Smokers, patients having lung disease, and those unable to carry out the tests properly were excluded. The physical therapy was standardized for both the groups. Respiratory evaluation was carried out during the preoperative period and on the second postoperative day by using spirometry and other tests that evaluated respiratory muscle strength and diaphragmatic mobility. Pain was evaluated by the visual analog scale on the second postoperative day. The statistical analysis was carried out with parametric or nonparametric tests, depending on the distribution of variables, considering p < 0.05 as statistically significant.
  
  
  RESULTS
  Patients were similar with respect to age, BMI, and waist-to-hip ratio. A decrease in all variables was observed for both the groups in the postoperative period, although this decrease was less pronounced in the LG group. Pain intensity was also lower in the LG group. The length of hospital stay was 2 days, and there were no pulmonary complications.
  
  
  CONCLUSIONS
  As there were no differences in the incidence of pulmonary complications and the length of hospital stay between the groups, the results showed that silicone-ring Roux-en-Y gastric bypass carried out by laparoscopy caused less pain and impairment of pulmonary function in the postoperative period.
authors.affiliation: Methodist University of Piracicaba (UNIMEP), Piracicaba, São Paulo, Brazil. marcelacbarbalho@hotmail.com
authors.forename: Marcela Cangussu
authors.initials: MC
authors.lastname: Barbalho-Moulim
authors.forename: Gustavo Peixoto Soares
authors.initials: GP
authors.lastname: Miguel
authors.forename: Eli Maria Pazzianotto
authors.initials: EM
authors.lastname: Forti
authors.forename: Marcelo de Castro
authors.initials: Mde C
authors.lastname: César
authors.forename: João Luiz Moreira Coutinho
authors.initials: JL
authors.lastname: Azevedo
authors.forename: Dirceu
authors.initials: D
authors.lastname: Costa
mesh_terms: D000328:Adult; D005260:Female; D015390:Gastric Bypass / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D009765:Obesity / Q000601:surgery*; D012119:Respiration; D012129:Respiratory Function Tests; D012828:Silicones
chemical_list: D012828:Silicones