scholarly journals Verificação de Anemia em Pacientes Submetidos à Gastroplastia Redutora Tipo Y de Roux

2015 ◽  
Vol 8 (1) ◽  
pp. 27 ◽  
Author(s):  
Mauro Akira Suizu ◽  
Romir Rodrigues ◽  
Juliana Isa Beraldo
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Complex Disease ◽  
Nutritional Deficiencies ◽  
Obese People ◽  
Operation Period ◽  
Post Operation ◽  
Bariatric Patients ◽  
Treatment Of Obesity

A obesidade, doença crônica e complexa, acomete cada vez mais a população. Devido ao tratamento difícil, a cirurgia bariátrica, quando indicada, é eficiente, pois apresenta baixos riscos aos pacientes e boa manutenção da perda de peso. Entretanto, deve-se ter atenção no pós-operatório, devido aos efeitos colaterais promovidos pela cirurgia, resultando em modificações metabólicas e falhas nutricionais, decorrente da má absorção de nutrientes, dentre eles, o ferro. O objetivo da pesquisa foi avaliar a prevalência de anemia ferropriva no período de junho a outubro de 2013, com 32 pacientes submetidos à cirurgia bariátrica do tipo Y de Roux, pertencentes à Associação dos Obesos Operados Bariátricos de Paranavaí e Região (AOOB). Após realizarmos um comparativo parcial com os 32 bariátricos da comunidade, verificarmos deficiências nutricionais. Nos 32 pacientes da comunidade, 50% manifestaram anemia, com IMC 23,37 kg/m2 (21,41 ± 25,33) e idade média de 43 anos. Já na AOOB, 31,25% apresentaram anemia (com maior prevalência dois anos após a cirurgia), IMC 29,02 kg/m2 (24,80 ± 33,24) e idade média de 42,96 anos. Nos associados da AOOB, 46,87% possuem intolerância a carne vermelha; 65% usam suplementos nutricionais e a participação nas reuniões mensais variou de 113 a 32 presenças. Apesar do estudo ter revelado índices relevantes de anemia é essencial o acompanhamento pós-operatório, como o realizado pela AOOB, melhorando a qualidade de vida dos pacientes. No entanto, é necessário um estudo mais abrangente, com espaço amostral e período de tempo maior para solidificação das evidências aqui estudadas. Verification of Anemia in Patients with Bariatric Surgery (Roux-En-Y Gastric Bypass) Obesity, a chronic and complex disease, is more and more common in the population. Due to difficult treatment of obesity, bariatric surgery is efficient since it provides a good weight loss with few risks to patients. The post-operation period is important due to the side effects caused by metabolic modifications and nutritional flaws from a bad absorption of nutrients, especially iron. Current research, undertaken between June and October 2013, assesses the prevalence of iron-insufficiency anemia in 32 patients who underwent Roux-en-Y gastric bypass, belonging to the Association of Operated Obese People (AOOB) from the region of Paranavaí PR Brazil. Partial comparative exam with 32 bariatric patients showed nutritional deficiencies, or rather, 50% suffered from anemia, with BMI = 23.37 kg/m2 (21.41 ± 25.33) and average age 43 years, whereas in AOOB, 31.25% were anemic (after two years of surgery), IMC = 29.02 kg/m2 (24.80 ± 33.24) and mean age 42.96 years. Further, 46.87% of AOOB associates were non-tolerant to beef; 65% used nutrition supplements and participation in monthly meetings varied between 113 and 32. In spite of high anemia percentages, the post-operational follow-up is highly important since it improves the patients ́ lifestyle. However, a more comprising analysis is required with a bigger sample and a longer time span for the establishment of evidences.

scholarly journals Third reported case of rare necrolytic migratory erythema associated with bacteraemia due to severe zinc deficiency after revisional Roux-En-Y gastric bypass: case report and literature review

2021 ◽  
Author(s):  
Yassmin Salaheldin ◽  
Walid El Ansari ◽  
Esraa Aljaloudi ◽  
Wahiba Elhag
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Risk Factor ◽  
Case Report ◽  
Zinc Deficiency ◽  
Nutritional Deficiencies ◽  
Level Of Evidence ◽  
Necrolytic Migratory Erythema ◽  
High Index Of Suspicion

Abstract Introduction Obesity is a risk factor for zinc deficiency. After bariatric surgery, non-compliance to diet/vitamin supplements, surgical complications leading to vomiting/diarrhea, poor follow-up and malabsorption can precipitate or exacerbate pre-existing zinc deficiency. Case report We report a patient with rare necrolytic migratory erythema associated with bacteraemia due to severe zinc deficiency after revisional Roux-en-Y gastric bypass (following primary laparoscopic sleeve gastrectomy). Conclusion Bariatric teams should screen patients before bariatric surgery for nutritional deficiencies and continue surveillance of their nutritional status after surgery. They should maintain a high index of suspicion for zinc deficiency in patients with skin rash after bariatric surgery. Level of evidence Level V, case report.

scholarly journals Post-bariatric surgery lab tests: are they excessive and redundant?

2019 ◽  
Vol 34 (10) ◽  
pp. 4626-4631
Author(s):  
Terri Menser ◽  
Jose Muniz Castro ◽  
Adriana Lopez ◽  
Stephen L. Jones ◽  
Bita A. Kash ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Logistic Regression ◽  
Nutritional Deficiency ◽  
Nutritional Deficiencies ◽  
Multiple Time ◽  
Time Points ◽  
Bariatric Patients ◽  
Lab Test ◽  
Over Time

Abstract Introduction Following bariatric surgery, ongoing postoperative testing is required to measure nutritional deficiencies; the purpose of this study was to quantify the prevalence of these nutritional deficiencies based on two-year follow-up tests at recommended time points. Methods and procedures A retrospective data analysis was conducted of all laboratory tests for bariatric patients who underwent surgery between May 2016 and January 2018 with available lab data (n = 397). Results for nine different nutritional labs were categorized into six recommended postoperative time periods based on time elapsed since the procedure date. Binary variables were created for each laboratory result to calculate descriptive statistics of abnormalities for each lab test over time and used in the individual GEE logistic regression models. Grouped logistic regression examined the total nutritional deficiencies of the nine combined nutrients considering total available labs. Results Multiple lab tests indicated a very low frequency of abnormalities (e.g., Vitamin A, Vitamin B12, Copper, and Folate). Many of the nine included nutritional labs had an average deficiency of less than 10% across all time points. The grouped logistic model found preoperative nutritional deficiency to be predictive of postoperative nutritional deficiency (OR 3.70, p < 0.001). Conclusions We found the vast majority of routine lab test results to be normal at multiple time points. Current practice can add up to significant lab expenses over time. The frequency of postoperative testing in this population may be redundant and of very little value. Unnecessary follow-up laboratory testing costs the patients and the health care system in both time and resources. Patients with preoperative deficiencies appear to be at higher risk for nutritional deficiencies when compared to bariatric surgery patients that did not have preoperative nutritional deficiencies. Future research should focus on defining cost effective postoperative lab testing guidelines for at risk bariatric patients.

scholarly journals NUTRITIONAL ASPECTS AND THE USE OF NUTRITIONAL SUPPLEMENTS BY WOMEN WHO UNDERWENT GASTRIC BYPASS

2017 ◽  
Vol 30 (1) ◽  
pp. 11-13 ◽  
Author(s):  
Elisangela Mara TRINDADE ◽  
Telma Souza e Silva GEBARA ◽  
Maria Paula Carlini CAMBI ◽  
Giorgio Alfredo Pedroso BARETTA
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Gastrointestinal Tract ◽  
Qualitative Analysis ◽  
Postoperative Period ◽  
Nutritional Deficiencies ◽  
Daily Consumption ◽  
Nail Changes ◽  
Treatment Of Obesity

ABSTRACT Background: Bariatric surgery is deemed one of the most effective procedures for the treatment of obesity and it aims at the reduction and maintenance of weight loss in long term, as the control of the related comorbidities. Aim: Quantify the occurrence of alterations of the gastrointestinal tract, suggestive signs of nutritional deficiencies and the use of supplements in a group of women undergoing bariatric surgery. Methods: The sample consisted of women aged 20-65 years submitted to Roux-en-Y gastric bypass with monitoring equal to or higher than 24 months. For the qualitative analysis, the Feeding Frequency Questionnaire was used. Results: In the postoperative period, alopecia was the most reported (79.3%), followed by changes in the texture of the nails, both considered predictive of nutritional deficiencies. Changes in the gastrointestinal tract were described in 86.2%, and episodes of dumping were reported in 65.5%. Qualitative analysis has shown reduced daily consumption of sources of animal and plant proteins. Conclusion: After bariatric surgery can occur flatulence, vomiting and dumping syndrome as the most frequent representative symptoms of digestive functional disorders. Alopecia and nail changes are the most important signs of nutritional deficiency. The use of dietary supplements in the postoperative period is scarce and sporadic.

scholarly journals Bariatric Surgery as the Culprit of Malnutrition

2021 ◽  
pp. 1-3
Author(s):  
Antonis Vlassopoulos
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Protein Energy Malnutrition ◽  
Nutritional Deficiencies ◽  
Micronutrient Deficiencies ◽  
Protein Energy ◽  
Life Threatening ◽  
Bariatric Patients ◽  
Similar Weight ◽  
Reduction Effect

Obesity is a chronic life-threatening disease, and bariatric surgery is the most effective treatment in those patients. The two main operations are laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB). LSG carries a smaller risk for nutritional deficiencies, while gastric bypass procedures are associated with increased nutritional deficiencies because the procedure is more complex and changes the gastrointestinal anatomy. Recent studies comparing LSG and RYGB have proven that these types of operation may lead to a similar weight reduction effect but cause different micronutrient deficiencies. Types of malnutrition after bariatric surgery include protein-energy malnutrition and deficiencies of micronutrients, such as iron, folate, vitamin A, and vitamin B<sub>12</sub>. Bariatric patients who do not adhere to the recommended diets are at a greater risk of developing relevant malnutrition. Therefore, life-long postoperative clinical and laboratory monitoring is necessary to diagnose deficiencies of vitamins, trace elements, and minerals and to correct them with supplements. Unfortunately, no standardized aftercare regimes exist for these patients, and the costs for nutritional supplements are paid by the patients themselves.

scholarly journals Is One Anastomosis Gastric Bypass with a Biliopancreatic Limb of 150 cm Effective in the Treatment of People with Severe Obesity with BMI > 50?

2021 ◽  
Author(s):  
Arnaud Liagre ◽  
Francesco Martini ◽  
Radwan Kassir ◽  
Gildas Juglard ◽  
Celine Hamid ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Severe Obesity ◽  
Postoperative Mortality ◽  
One Anastomosis Gastric Bypass ◽  
Sustained Weight Loss ◽  
Biliopancreatic Limb ◽  
Percentage Excess Weight Loss

Abstract Purpose The treatment of people with severe obesity and BMI > 50 kg/m2 is challenging. The present study aims to evaluate the short and mid-term outcomes of one anastomosis gastric bypass (OAGB) with a biliopancreatic limb of 150 cm as a primary bariatric procedure to treat those people in a referral center for bariatric surgery. Material and Methods Data of patients who underwent OAGB for severe obesity with BMI > 50 kg/m2 between 2010 and 2017 were collected prospectively and analyzed retrospectively. Follow-up comprised clinical and biochemical assessment at 1, 3, 6, 12, 18, and 24 months postoperatively, and once a year thereafter. Results Overall, 245 patients underwent OAGB. Postoperative mortality was null, and early morbidity was observed in 14 (5.7%) patients. At 24 months, the percentage total weight loss (%TWL) was 43.2 ± 9, and percentage excess weight loss (%EWL) was 80 ± 15.7 (184 patients). At 60 months, %TWL was 41.9 ± 10.2, and %EWL was 78.1 ± 18.3 (79 patients). Conversion to Roux-en-Y gastric bypass was needed in three (1.2%) patients for reflux resistant to medical treatment. Six patients (2.4%) had reoperation for an internal hernia during follow-up. Anastomotic ulcers occurred in three (1.2%) patients. Only two patients (0.8%) underwent a second bariatric surgery for insufficient weight loss. Conclusion OAGB with a biliopancreatic limb of 150 cm is feasible and associated with sustained weight loss in the treatment of severe obesity with BMI > 50 kg/m2. Further randomized studies are needed to compare OAGB with other bariatric procedures in this setting. Graphical abstract

scholarly journals A Very Rare Cause of Dilated Cardiomyopathy after Bariatric Surgery: Selenium Deficiency

2021 ◽  
pp. 1-3
Author(s):  
Gulay Kocak ◽  
Munevver Gul Avsar ◽  
Cansu Yazar ◽  
Aylia Yesilova ◽  
Gulcagri Yildiz ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Trace Elements ◽  
Sleeve Gastrectomy ◽  
Dilated Cardiomyopathy ◽  
Selenium Deficiency ◽  
Water Soluble ◽  
Nutritional Deficiencies ◽  
Reduced Ejection Fraction ◽  
Long Term Follow Up

Background: Sleeve gastrectomy for weight loss has increased significantly nowadays. Various complications may develop after this surgery that requires long-term follow-up of these patients. Nutrition is the most important aspect of the follow-up. The deficiency of trace elements, fat-soluble and water-soluble vitamins following bariatric surgeries have been well-described complications. Although nutritional supplementations are often initiated after bariatric surgery, the clinical outcomes related to the deficiency of trace elements have not been well known yet. Case Presentation: A 27-year-old woman who underwent a laparoscopic sleeve gastrectomy for surgical treatment of obesity 9 months ago presented to the emergency department with a signs of heart failure. Transthoracic echocardiography revealed dilated, poorly functioning left ventricle with reduced ejection fraction (28.9%) consistent with dilated cardiomyopathy. We assumed nutritional deficiencies secondary to sleeve gastrectomy as a cause of dilated cardiomyopathy, as the patient had inappropriate nutritional supplements after surgery. Laboratory tests revealed selenium and zinc deficiency that supported our hypothesis. Our patient completely recovered with adequate supplementation of selenium, zinc and thiamine. Conclusion: We highlighted that the early diagnosis of dilated cardiomyopathy due to selenium deficiency following bariatric surgery is of great importance since selenium deficiency is a cause of reversible cardiomyopathy.

scholarly journals Pregnancy as a cause of gastroesophageal reflux after mini-gastric bypass bariatric surgery (MGB-OAGB). A clinical case

2018 ◽  
Vol 12 (2) ◽  
pp. 76-79
Author(s):  
V. S. Samoylov ◽  
V. V. Novomlinskiy ◽  
N. А. Malkina
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Gastroesophageal Reflux ◽  
Clinical Symptoms ◽  
Late Complications ◽  
Mini Gastric Bypass ◽  
Major Type ◽  
Abdominal Pressure ◽  
Complete Relief ◽  
Bariatric Patients

The number of post-bariatric patients is increasing from year to year; any medical specialist can see consequences and sometimes complications of these interventions. The variety of different scenarios associated with such patients is not well studied. Mini-gastric bypass (MGB-OAGB) is a major type of primary or recurrent bariatric surgery in obese patients. Biliary reflux (BR) is one of the most significant late complications of this operation. An increase in the intra-abdominal pressure during pregnancy can lead to the development of BR with its typical clinical symptoms, which may sometimes puzzle an obstetrician-gynecologist. In these cases, there are limitations in using traditional diagnostic approaches and regular medications for conservative treatment of BR. This report presents a clinical observation on a patient who underwent MGB-OAGB as a recurrent bariatric intervention for her morbid obesity. With no signs of gastroesophageal reflux before surgery, soon after it or in the I trimester of pregnancy, a typical clinical picture of BR developed in the II and III trimesters. A complete relief of the BR symptoms after the childbirth (confirmed by gastro-esophago-scopy) suggested a direct connection between the BR and the increase in intra-abdominal pressure during pregnancy.

scholarly journals Prevalence of All-Cause Mortality and Suicide among Bariatric Surgery Cohorts: A Meta-Analysis

2018 ◽  
Vol 15 (7) ◽  
pp. 1519 ◽  
Author(s):  
Russell Lim ◽  
Melvyn Zhang ◽  
Roger Ho
Keyword(s):  
Bariatric Surgery ◽  
Analytical Study ◽  
Meta Analysis ◽  
Well Being ◽  
Mortality Rates ◽  
Pooled Prevalence ◽  
All Cause Mortality ◽  
Bariatric Patients ◽  
Post Bariatric Surgery

Introduction: Prior meta-analysis has reported mortality rates among post-operative bariatric patients, but they have not considered psychiatric factors like suicide contributing to mortality. Objectives: The current meta-analysis aims to determine the pooled prevalence for mortality and suicide amongst cohorts using reported suicides post bariatric surgery. It is also the aim of the current meta-analytical study to determine moderators that could account for the heterogeneity found. Results: In our study, the pooled prevalence of mortality in the studies which reported suicidal mortality was 1.8% and the prevalence of suicide was 0.3%. Mean body mass index (BMI) and the duration of follow-up appear to be significant moderators. Conclusions: Given the prevalence of suicide post bariatric surgery, it is highly important for bariatric teams to consider both the medical and psychiatric well-being of individuals pre- and post-operatively.

Nutritional Deficiencies and Bariatric Surgery

2018 ◽  
Author(s):  
Anthony B. Mozer ◽  
Konstantinos Spaniolas ◽  
Walter J. Pories
Keyword(s):  
Bariatric Surgery ◽  
Oral Intake ◽  
Emergency Department Visits ◽  
Nutritional Deficiencies ◽  
Vitamin Supplementation ◽  
Behavioral Modification ◽  
Poor Oral Intake ◽  
Preoperative Counseling ◽  
Disproportionate Number

Dietary intolerance and poor oral intake account for a disproportionate number of emergency department visits and readmissions after bariatric surgery. Micronutrient, vitamin, and protein deficiencies can occur after both malabsorptive and restrictive weight-loss operations, and they are best mitigated against by conscientious preoperative counseling and vigilance in follow-up. Routine vitamin supplementation can prevent the need for unnecessary laboratory testing, while symptoms of dumping syndrome can frequently be managed with dietary and behavioral modification alone. Alternative enteral feeding access for alimentary supplementation can be safely performed surgically or with assistance by interventional radiology, and should be considered in the management of perforation, early anastomotic leak, surgical revision, or patients with refractory malnourishment.

scholarly journals Nutritional Support for Bariatric Surgery Patients: The Skin beyond the Fat

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1565
Author(s):  
Paolo Toninello ◽  
Alvise Montanari ◽  
Franco Bassetto ◽  
Vincenzo Vindigni ◽  
Antonio Paoli
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Postoperative Period ◽  
Body Contouring ◽  
Massive Weight Loss ◽  
Water Soluble ◽  
Nutritional Deficiencies ◽  
Multivitamin Supplementation ◽  
Bariatric Patients ◽  
The Aesthetic

Body contouring surgery after the massive weight loss due to bariatric surgery deals with different kinds of complications. The aim of this review is to analyze the role that some nutrients may play in tissue healing after surgery, thus helping plastic surgeons to improve the aesthetic and health outcomes in massive weight loss patients under a multidisciplinary approach. As a matter of fact, preoperative nutritional deficiencies have been shown for vitamins and minerals in a large percentage of post-bariatric patients. Preoperative deficiencies mainly concern iron, zinc, selenium, and vitamins (both fat-soluble and water-soluble), but also total protein. During the postoperative period, these problems may increase because of the patients’ very low intake of vitamins and minerals after bariatric surgery (below 50% of the recommended dietary allowance) and the patients’ low compliance with the suggested multivitamin supplementation (approximately 60%). In the postoperative period, more attention should be given to nutritional aspects in regard to the length of absorptive area and the percentage of weight loss.

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