Safety and Efficacy of Revisional Surgery as a Treatment for Malnutrition after Bariatric Surgery.
J Am Coll Surg
; 236(1): 156-166, 2023 01 01.
Article
em En
| MEDLINE
| ID: mdl-36102543
ABSTRACT
BACKGROUND:
Malnutrition after bariatric operation is a rare but potentially life-threatening complication. The safety and efficacy of revisional bariatric operation in malnourished patients are not well elucidated. STUDYDESIGN:
We performed a retrospective chart review of patients who underwent revisional bariatric operation for severe malnutrition at our institution between 2008 and 2020. Associations of demographic and clinical characteristics with dichotomous outcomes of interest were examined using Fisher's exact tests, Cochran-Armitage tests for trend, and two-sample t -tests when appropriate.RESULTS:
Fifty-three patients underwent revisional bariatric operation for malnutrition from 2008 and 2020. The median follow-up was 24 months. The anatomy before revision was Roux-en-Y gastric bypass (n = 40, 75%), biliopancreatic diversion with duodenal switch (n = 6, 11%), sleeve gastrectomy (n = 4, 8%), and mini gastric bypass (n = 3, 6%). The percentage of patients requiring supplemental or total nutritional support decreased from 89% preoperatively (47% on enteral feedings and 42% on total parenteral nutrition (TPN) with or without tube feeding) to 13.2% at the last encounter after revision (7.5% still requiring enteral feedings and 5.7% on TPN). There was an association between the number of prior abdominal operations and postoperative pneumonia (p 0.03) and need for blood transfusion (p 0.01). There were no associations between major complications or last encounter nutrition and any preoperative variables other than age at the time of operation. There were 2 mortalities during a median follow-up of 24 months, and both occurred more than 1 year postoperatively.CONCLUSION:
Revisional operation for severely malnourished bariatric operation patients is effective in the discontinuation of supportive nutrition. Postoperative complications are increased but not prohibitive.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Obesidade Mórbida
/
Derivação Gástrica
/
Laparoscopia
/
Desnutrição
/
Cirurgia Bariátrica
Limite:
Humans
Idioma:
En
Revista:
J Am Coll Surg
Assunto da revista:
GINECOLOGIA
/
OBSTETRICIA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Mongólia