Abstract

RIOS CANTURIN, Pedro J.; PEREZ FERNANDEZ, Elmer  and  RIOS TORRES, Pedro O.. Neuroendocrinas bases in the surgical treatment of the morbid obesity: with regard to two cases operated with the Technique of Santoro, in the HERM. Rev. gastroenterol. Perú [online]. 2008, vol.28, n.4, pp.383-389. ISSN 1022-5129.

Objetive: To report on a new surgical technique to treat morbid obesity ideated by Sergio Santoro, based in neuroendocrine physiological concepts. Method: 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) andoxintomodulina (OXM)withdesirable metabolic consequences. Itdoes 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.

Keywords : Morbid obesity; bariatric surgery; based on neuroendocrine physiology and evolution.

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