BACKGROUND: Bariatric surgery provides durable weight loss and decreases the incidence of co-morbid conditions for people with obesity. Most patients benefit from resultant weight loss, but some are at risk for postoperative refractory malnutrition, a serious but poorly understood complication. OBJECTIVE: To evaluate differences in bariatric surgery patients who received a feeding tube postoperatively for malnutrition compared with other indications. SETTING: Retrospective cohort study at an academic bariatric surgery center (1985-2015). METHODS: All bariatric surgery patients that received a feeding tube postoperatively over a 30-year period were identified. Data abstraction from the medical record was performed to assess demographic characteristics, operative details, tube indication, and resultant body mass index (BMI) changes. RESULTS: From a total of 3487 patients who underwent bariatric surgery during the study period, 139 (3.9%) required placement of a feeding tube postoperatively. Refractory malnutrition was the indication in 24 patients, all after Roux-en-Y gastric bypass. There were no significant differences between these patients and other bariatric surgery patients in terms of mean age (40.6±9.9 versus 43.1±13.4 years, P = .4) and preoperative BMI (47.5±10.5 versus 51.0±9.6 kg/m2, P = .1). The median time from surgery to tube placement for malnutrition patients was 4 years. Compared with other feeding tube indications, malnutrition patients had higher percent excess BMI lost after surgery (126.2±31.9 versus 52.5±44.3%, P<.0001). After tube placement, malnutrition patients had a significant increase in mean BMI compared with other indications (14.5±20.9 versus-13.0±14.0%, P< .001). CONCLUSION: Patients with refractory malnutrition benefit from feeding tube placement, which results in a significant increase in BMI.
BACKGROUND: Bariatric surgery provides durable weight loss and decreases the incidence of co-morbid conditions for people with obesity. Most patients benefit from resultant weight loss, but some are at risk for postoperative refractory malnutrition, a serious but poorly understood complication. OBJECTIVE: To evaluate differences in bariatric surgery patients who received a feeding tube postoperatively for malnutrition compared with other indications. SETTING: Retrospective cohort study at an academic bariatric surgery center (1985-2015). METHODS: All bariatric surgery patients that received a feeding tube postoperatively over a 30-year period were identified. Data abstraction from the medical record was performed to assess demographic characteristics, operative details, tube indication, and resultant body mass index (BMI) changes. RESULTS: From a total of 3487 patients who underwent bariatric surgery during the study period, 139 (3.9%) required placement of a feeding tube postoperatively. Refractory malnutrition was the indication in 24 patients, all after Roux-en-Y gastric bypass. There were no significant differences between these patients and other bariatric surgery patients in terms of mean age (40.6±9.9 versus 43.1±13.4 years, P = .4) and preoperative BMI (47.5±10.5 versus 51.0±9.6 kg/m2, P = .1). The median time from surgery to tube placement for malnutritionpatients was 4 years. Compared with other feeding tube indications, malnutritionpatients had higher percent excess BMI lost after surgery (126.2±31.9 versus 52.5±44.3%, P<.0001). After tube placement, malnutritionpatients had a significant increase in mean BMI compared with other indications (14.5±20.9 versus-13.0±14.0%, P< .001). CONCLUSION:Patients with refractory malnutrition benefit from feeding tube placement, which results in a significant increase in BMI.
Authors: Eric A Finkelstein; Olga A Khavjou; Hope Thompson; Justin G Trogdon; Liping Pan; Bettylou Sherry; William Dietz Journal: Am J Prev Med Date: 2012-06 Impact factor: 5.043
Authors: J Hunter Mehaffey; Damien J LaPar; Kathleen C Clement; Florence E Turrentine; Michael S Miller; Peter T Hallowell; Bruce D Schirmer Journal: Ann Surg Date: 2016-07 Impact factor: 12.969
Authors: Christopher A Guidry; Stephen W Davies; Robert G Sawyer; Bruce D Schirmer; Peter T Hallowell Journal: Am J Surg Date: 2014-12-23 Impact factor: 2.565
Authors: Joel Faintuch; Mitsunori Matsuda; Maria Emilia L F Cruz; Marlene M Silva; Marcelo P Teivelis; Arthur B Garrido; J J Gama-Rodrigues Journal: Obes Surg Date: 2004-02 Impact factor: 4.129