Charles EJ, Mehaffey JH, Hawkins RB, Safavian D, Schirmer BD, Hallowell PT. Benefit of feeding tube placement for refractory malnutrition after bariatric surgery.
Surg Obes Relat Dis 2018;
14:162-167. [PMID:
28169202 PMCID:
PMC5484748 DOI:
10.1016/j.soard.2016.12.017]
[Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 11/18/2016] [Accepted: 12/19/2016] [Indexed: 12/20/2022]
Abstract
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.
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