Laparoscopic Sleeve Gastrectomy and Nutrient Deficiencies: A Prospective Study.

BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is being increasingly established as a definitive procedure for weight loss. The mechanism for weight loss in LSG is gastric restriction and neurohormonal changes, but there is deficient information on its nutritional effect. The aim of this prospective study was to assess vitamin and micronutrient deficiencies following LSG (whats and when) in organized follow-up visits. PATIENTS AND METHODS: LSG was performed in 112 consecutive patients between June 2010 and December 2013. In all patients, the vitamin and micronutrient deficiencies were corrected before the LSG procedure. Patients were investigated for vitamin and micronutrient concentrations 2, 4, 6, 9, and 12 months after surgery. RESULTS: During the study time, 112 patients (65% female) underwent LSG. The mean age was 26 years (range: 20 to 37 y), and the mean preoperative body mass index was 41 (range: 35 to 52). Complications and nutrient deficiencies were observed and analyzed throughout the follow-up period. CONCLUSIONS: The appearance of vitamin and nutritional deficiencies after LSG is a common phenomenon. Correction of the deficiencies before surgery, sufficient supplementation immediately after the procedure, and routine long follow-up are important to avoid the serious consequences of the deficiencies.

Pain after inguinal hernia repair. Possible role of bowel preparation.

OBJECTIVE: To evaluate the possible effectiveness of bowel preparation on pain after hernia repair. METHODS: This was a prospective randomized study, performed at King Fahad Hospital, Hofuf, Kingdom of Saudi Arabia between January 2000 and December 2002. The group of patient was randomly divided in 2 groups. Sixty-two patients (Group I) had bowel preparation and 65 patients (Group II) had no bowel preparation. All patients in the Group 1 received lactulose 2 days before surgery and rectal enema on the day of surgery. Patients were assessed at 8 hours interval in the hospital. They were assessed for the severity of pain during the first micturation and bowel motion. RESULTS: The pain score in the first 24 hours was significantly lower in the Group 1 (p<0.01) as well as second 24 hours (p<0.001). The pain in the first micturation (p<0.001) and during the first bowel motion (p<0.001) was less in Group I compared to Group II. CONCLUSION: Patients with bowel preparation before hernia repair had significantly less pain postoperatively even in the first micturation as well as the first bowel motion than those without bowel preparation.