Complications from Bariatric Surgery in Brazil and Macrorregions from 2019 to 2023: An Ecological Study

Abstract

Introduction: Obesity is a complex condition characterized by the excessive accumulation of adipose tissue, resulting in a significantly increased risk of chronic diseases. Bariatric surgery is an effective procedure for the treatment of obesity, aimed at reducing gastric volume and, consequently, the amount of food ingested. This approach aims to promote significant weight loss and improve the overall health of the patient. In addition to appetite reduction, the surgery can lead to hormonal changes that help regulate metabolism and satiety. However, despite the recognized benefits, bariatric surgery is not without risks and complications. This study aims to investigate the effects of bariatric surgery on patient health, considering both the benefits and the potential complications associated with the procedure. A critical analysis of these aspects will provide a deeper understanding of bariatric surgery as a treatment strategy for obesity, contributing to an informed debate about its implications for public health. Objective: To analyze the incidence of complication rates from bariatric surgery in Brazil and its regions from 2019 to 2023. Methods: An ecological and descriptive study on complications from bariatric surgery and approved Hospital Admission Authorizations (AIH) for vertical banded gastroplasty, intestinal bypass gastroplasty, and vertical sleeve gastrectomy in Brazil, considering the variables of region, state, and cause of death/hospitalization. Secondary public access data from the Ministry of Health's System of Information on Surgical Complications after Bariatric Surgery were used, accessed through DATASUS via Tabnet by searching by region and year/month of processing from 2019 to 2023, in addition to procedures of vertical banded gastroplasty (0407010181), intestinal bypass gastroplasty (0407010173), and vertical sleeve gastrectomy (0407010360). The complication rate was calculated based on the population undergoing bariatric surgery. Inclusion Criteria: Articles published between 2002 and 2024, in Portuguese, English, and Spanish, that include the health descriptors mentioned later. Exclusion Criteria: Articles published outside the stipulated time frame, in languages not described in the inclusion criteria. Results: In Brazil, there were 363 recorded complications from bariatric surgery from 2019 to 2023, in the context of 25,845 bariatric surgeries, which corresponds to only 1.4% of the cases. The Southern region stood out with the highest number of surgeries performed, accounting for 13,929 (53.9%) and, consequently, the highest numbers of surgical complications over the five years with 256 (70.5%) cases of postoperative complications. Conversely, in 2022, the Northern region presented a complication rate of 50% of its cases, as out of the 2 bariatric surgeries that year, 1 resulted in a complication. Finally, there was a greater predominance in Brazil of intestinal bypass gastroplasty, responsible for 25,072 surgeries. Conclusion: In Brazil, low rates of complications from bariatric surgery were recorded, ensuring the efficacy and safety of bariatric surgery for the treatment of obesity.