Lidia Santarpia1, Ilenia Grandone2, Lucia Alfonsi2, Maurizio Sodo3, Franco Contaldo2, Fabrizio Pasanisi2. 1. Interuniversity Research Center for Obesity and Eating Disorder CISRO, Department of Clinical Medicine and Surgery, Naples, Italy. Electronic address: Lidia.santarpia@unina.it. 2. Interuniversity Research Center for Obesity and Eating Disorder CISRO, Department of Clinical Medicine and Surgery, Naples, Italy. 3. Department of Public Health, Pre and Post Transplant Surgery, Federico II University Hospital, Naples, Italy.
Abstract
OBJECTIVE: The growing prevalence of severe obesity, combined with the failure of conservative treatments, has led to a significant spread of bariatric surgical procedures. The aim of this study was to emphasize the need of adequate presurgery patient selection and close follow-up after malabsorptive procedures for bariatric surgery. METHODS: The study retrospectively evaluated 25 (20 F, 5 M; mean age 43 ± 13 y) obese patients (mean weight before intervention 134 ± 30.7 kg, body mass index 50.7 ± 10.1 kg/m(2)) attending our outpatient clinical nutrition unit for severe malabsorption and secondary malnutrition after surgical intervention that had been performed outside the regional area. RESULTS: All patients received personalized dietetic indications; in 12 of 25 (48%) cases integrated by oral protein supplements and in 5 of 25 (20%) by medium chain triglycerides. According to screening exams, patients were prescribed oral/parenteral iron, vitamins A, B group, D, and folate supplementation. In 14 of 25 (56%) patients, parenteral hydration and in 4 of 25 (16%), long-term parenteral nutrition was required. Five patients required hospitalization for severely complicated protein-energy malnutrition. CONCLUSION: Nutritional deficiencies are common after malabsorptive procedures for bariatric surgery; these can be present or latent before surgery, frequently going unrecognized and/or inadequately treated particularly when patients are not strictly followed up by the operating center. Despite the adequate-even intensive-intervention, clinical nutritional status moderately improved in all patients.
OBJECTIVE: The growing prevalence of severe obesity, combined with the failure of conservative treatments, has led to a significant spread of bariatric surgical procedures. The aim of this study was to emphasize the need of adequate presurgery patient selection and close follow-up after malabsorptive procedures for bariatric surgery. METHODS: The study retrospectively evaluated 25 (20 F, 5 M; mean age 43 ± 13 y) obesepatients (mean weight before intervention 134 ± 30.7 kg, body mass index 50.7 ± 10.1 kg/m(2)) attending our outpatient clinical nutrition unit for severe malabsorption and secondary malnutrition after surgical intervention that had been performed outside the regional area. RESULTS: All patients received personalized dietetic indications; in 12 of 25 (48%) cases integrated by oral protein supplements and in 5 of 25 (20%) by medium chain triglycerides. According to screening exams, patients were prescribed oral/parenteral iron, vitamins A, B group, D, and folate supplementation. In 14 of 25 (56%) patients, parenteral hydration and in 4 of 25 (16%), long-term parenteral nutrition was required. Five patients required hospitalization for severely complicated protein-energy malnutrition. CONCLUSION:Nutritional deficiencies are common after malabsorptive procedures for bariatric surgery; these can be present or latent before surgery, frequently going unrecognized and/or inadequately treated particularly when patients are not strictly followed up by the operating center. Despite the adequate-even intensive-intervention, clinical nutritional status moderately improved in all patients.
Authors: Antonio J Martínez-Ortega; Gabriel Olveira; José L Pereira-Cunill; Carmen Arraiza-Irigoyen; José M García-Almeida; José A Irles Rocamora; María J Molina-Puerta; Juan B Molina Soria; Juana M Rabat-Restrepo; María I Rebollo-Pérez; María P Serrano-Aguayo; Carmen Tenorio-Jiménez; Francisco J Vílches-López; Pedro P García-Luna Journal: Nutrients Date: 2020-07-06 Impact factor: 5.717
Authors: Lidia Santarpia; Enza Speranza; Maria Laura Santopaolo; Maurizio Marra; Fabrizio Pasanisi Journal: J Int Med Res Date: 2020-11 Impact factor: 1.671