一次吻合胃旁路术(OAGB)后营养缺乏的管理:单中心经验。

IF 2.4 3区 医学 Q2 SURGERY
J Jedamzik, L Pedarnig, C Bichler, J Eichelter, M Mairinger, L Gensthaler, L Nixdorf, P Richwien, N Vock, F B Langer, G Prager, D M Felsenreich
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引用次数: 0

摘要

背景:代谢/减肥手术(MBS)仍然是治疗肥胖及其并发症最有效和持久的方法。除了任何手术并发症外,营养缺乏通常不太明显但可能严重的副作用近年来引起了人们的兴趣。众所周知,OAGB需要彻底补充。设置:回顾性研究;大学医院的基础。目的:评估现实生活中接受OAGB患者的营养问题及其管理。方法:回顾性分析2018年1月至2019年8月期间接受OABG手术的患者。分析营养问题(甲状旁腺激素、维生素A、E、D、B12、叶酸、白蛋白、铁蛋白、铁和转铁蛋白饱和度)以及术后并发症和再手术的实验室数据(从患者电子病历中获得)。此外,还评估了体重发展、肥胖相关并发症的改善/缓解以及定期摄入多种维生素补充剂(MVS)。结果:120例患者行OAGB;其中女性89人。101例患者进行了随访。平均随访时间27.8±20.9个月。OAGB导致%TWL为36.7±9.5%,%EWL为86.8±25.5%。术前缺乏的是维生素D(53.3%),其次是叶酸(16.7%)和维生素A(6.7%)。随访期间,每位患者至少出现一种维生素缺乏症,维生素D和A缺乏症占多数(74.3%和41.0%),31例患者叶酸缺乏症(30.7%)。3例(2.9%)出现维生素B12缺乏症和缺钙。虽然建议,但只有45.5%的人选择服用专门的MVS,而10%的人根本没有服用任何MVS。超过一半的患者(53.5%)服用了额外的补充剂。19例患者接受了与初始OAGB相关的再手术。结论:可以得出两个结论:首先,对搭桥患者进行长期广泛的缺陷评估是普遍需要的。其次,MVS对做过搭桥手术的患者至关重要。此外,需要通过教育患者和其他治疗医生来促进依从性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Management of nutritional deficiencies following one anastomosis gastric bypass (OAGB): a single-center experience.

Background: Metabolic/bariatric surgery (MBS) remains the most effective and long-lasting treatment for obesity and its complications. Apart from any surgical complications, the often less obvious but possibly severe side-effects of nutritional deficiencies have become of interest in recent years. OAGB is known to come with the need for thorough supplementation.

Setting: Retrospective study; university-hospital based.

Aim: Assessing nutritional issues and their management in a real-life cohort of patients undergoing OAGB.

Methods: Patients that underwent OABG between 01/2018 and 08/2019 were retrospectively assessed. Laboratory values (gained from electronic patients charts) were analyzed for nutritional issues (parathyroid hormone, vitamin A, E, D, B12, folic acid, albumin, ferritin, iron, and transferrin saturation) as well as postoperative complications and reoperations. Furthermore, weight development, improvement/remission of obesity-related complications, and regular intake of multivitamin supplementation (MVS) were assessed.

Results: 120 patients underwent OAGB; 89 were female. A follow-up was available for 101 patients. Mean length of follow-up was 27.8 ± 20.9 months. OAGB led to a %TWL of 36.7 ± 9.5% and %EWL of 86.8 ± 25.5%. Preoperative deficiencies were vitamin D (53.3%), followed by folic acid (16.7%) and vitamin A (6.7%). During follow-up, every patient developed at least one deficiency, hypovitaminosis D and A were predominant (74.3% and 41.0%), and 31 suffered from folic acid deficiency (30.7%). Hypovitaminosis B12 and calcium deficiency was observed in three patients (2.9%). Although advised to, only 45.5% opted for the intake of specialized MVS, whereas 10% did not take any MVS at all. More than half of all patients (53.5%) took additional supplements. Nineteen patients underwent reoperations associated with the initial OAGB.

Conclusion: Two conclusions can be drawn: First, there is a general need for bypass patients to get assessed for a broad array of deficiencies over time. Second, MVS is essential for patients that had bypass surgery. Additionally, compliance needs to be promoted by educating patients as well as other treating physicians.

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来源期刊
Updates in Surgery
Updates in Surgery Medicine-Surgery
CiteScore
4.50
自引率
7.70%
发文量
208
期刊介绍: Updates in Surgery (UPIS) has been founded in 2010 as the official journal of the Italian Society of Surgery. It’s an international, English-language, peer-reviewed journal dedicated to the surgical sciences. Its main goal is to offer a valuable update on the most recent developments of those surgical techniques that are rapidly evolving, forcing the community of surgeons to a rigorous debate and a continuous refinement of standards of care. In this respect position papers on the mostly debated surgical approaches and accreditation criteria have been published and are welcome for the future. Beside its focus on general surgery, the journal draws particular attention to cutting edge topics and emerging surgical fields that are publishing in monothematic issues guest edited by well-known experts. Updates in Surgery has been considering various types of papers: editorials, comprehensive reviews, original studies and technical notes related to specific surgical procedures and techniques on liver, colorectal, gastric, pancreatic, robotic and bariatric surgery.
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