Periodicidad semestral: flujo continuo.
ISSN - Electrónico: 2661-6947 / DOI: 10.36015 • LILACS BIREME (19784); LATINDEX (20666)
1. INTRODUCTION
Currently, obesity is considered a pandemic, the incidence of which has tripled in the last 30 years, and has generated increasing public health problems. Based on the guidelines of the American Association of Endocrinologists (AACE), the Obesity Society, the American Society for Metabolic and Bariatric Surgery (ASMBS), the Association for Obesity Medicine and the American Association of Anesthesiologists, this document is intended to serve as a roadmap to guide the procedure to be followed in patients suffering from this chronic disease who come to San Francisco General Hospital (HGSF)1.
Obesity is characterized by the use of several medications due to related comorbidities: cardiovascular disease, type 2 iabetes mellitus, chronic kidney disease, non-alcoholic fatty liver disease, metabolic syndrome and several types of cancers2. This protocol contains the highest level of evidence available to date, in relation to the surgical and non-surgical management of the patient with a diagnosis of obesity, including issues such as the identification of candidate patients for bariatric procedures, type of procedures that should be offered, preoperative, trans-operative management and follow-up post-operative care2-4.
Since the publication by the American Society for Metabolic and Bariatric Surgery (ASMBS) in 2013 of the guidelines for the management of patients with obesity, there has been a significant increase in publications
that support excellent results for the treatment of patients with obesity and type 2 diabetes mellitus through bariatric and metabolic surgery2,5,6. In 2016 the publication of the Diabetes Surgery Summit (DSS2)7 makes a difference in the management of patients with type 2 diabetes mellitus, it is so that the same have grown substantially and the evidence shows that bariatric metabolic management of these patients is superior to medical management and lifestyle changes when glycemic control and remission of comorbidities are evaluated. With the previous evaluation of the multidisciplinary team, we will have scientific information of the highest level that will allow us to have a patient with optimal recovery applying the criteria of Enhanced Recovery after Bariatric Surgery (ERASB)8.
In Ecuador, obesity has become a public health problem; thus, in the pediatric population it has increased since 1986 from 8,0% to 26,0% in 2012 in the 11 to 19 years age group. The prevalence of overweight and obesity in the adult population in Ecuador is 62,8%, according to sex is 5,5% higher in women (65,5%) than in men (60,0%), and the highest rate of obesity and overweight occurs between the fourth and fifth decades of life, with prevalences higher than 73,0%9,10.
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