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Gutiérrez-Rey M, Castellar-Visbal L, Acevedo-Vergara K, Vargas-Manotas J, Rivera-Porras D, Londoño-Juliao G, Castillo-Guerrero B, Perdomo-Jiménez MC, Bermúdez V. The Weight of Bariatric Surgery: Wernicke-Korsakoff Syndrome after Vertical Sleeve Gastrectomy-A Case Series. J Pers Med 2024; 14:638. [PMID: 38929859 PMCID: PMC11204981 DOI: 10.3390/jpm14060638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 06/05/2024] [Accepted: 06/08/2024] [Indexed: 06/28/2024] Open
Abstract
In this case series, the simultaneous occurrence of Wernicke's encephalopathy (WE) and dry beriberi was reported in three patients who underwent vertical sleeve gastrectomy (VSG) between May 2021 and May 2023. All patients were obese women who underwent vertical sleeve gastrectomy (VSG) without immediate postoperative complications, but two weeks later, hyperemesis and subsequent encephalopathy with ocular movement abnormalities and weakness were observed over the following thirty days. Patients were referred to neurology, where due to the high suspicion of WE, thiamine replacement therapy was initiated; meanwhile, diagnostic neuroimaging and blood tests were conducted. Neurological and psychiatric evaluations and neuroconduction studies were performed to assess the clinical evolution and present sequelae. One year after diagnosis, all patients exhibited affective and behavioral sequelae, anterograde memory impairment, and executive functioning deficits. Two patients met the criteria for Korsakoff syndrome. Additionally, peripheral nervous system sequelae were observed, with all patients presenting with sensorimotor polyneuropathy. In conclusion, Wernicke's encephalopathy requires a high diagnostic suspicion for timely intervention and prevention of irreversible sequelae, which can be devastating. Therefore, raising awareness among medical professionals regarding the significance of this disease is essential.
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Affiliation(s)
- Melissa Gutiérrez-Rey
- Universidad Simón Bolívar, Facultad de Ciencias de la Salud, Barranquilla 080001, Colombia; (M.G.-R.); (L.C.-V.); (J.V.-M.); (G.L.-J.); (B.C.-G.); (M.-C.P.-J.)
| | - Lily Castellar-Visbal
- Universidad Simón Bolívar, Facultad de Ciencias de la Salud, Barranquilla 080001, Colombia; (M.G.-R.); (L.C.-V.); (J.V.-M.); (G.L.-J.); (B.C.-G.); (M.-C.P.-J.)
| | | | - José Vargas-Manotas
- Universidad Simón Bolívar, Facultad de Ciencias de la Salud, Barranquilla 080001, Colombia; (M.G.-R.); (L.C.-V.); (J.V.-M.); (G.L.-J.); (B.C.-G.); (M.-C.P.-J.)
| | - Diego Rivera-Porras
- Universidad Simón Bolívar, Facultad de Ciencias Jurídicas y Sociales, Centro de Investigación en Estudios Fronterizos, Cúcuta 540001, Colombia;
| | - Gloria Londoño-Juliao
- Universidad Simón Bolívar, Facultad de Ciencias de la Salud, Barranquilla 080001, Colombia; (M.G.-R.); (L.C.-V.); (J.V.-M.); (G.L.-J.); (B.C.-G.); (M.-C.P.-J.)
| | - Brenda Castillo-Guerrero
- Universidad Simón Bolívar, Facultad de Ciencias de la Salud, Barranquilla 080001, Colombia; (M.G.-R.); (L.C.-V.); (J.V.-M.); (G.L.-J.); (B.C.-G.); (M.-C.P.-J.)
| | - María-Camila Perdomo-Jiménez
- Universidad Simón Bolívar, Facultad de Ciencias de la Salud, Barranquilla 080001, Colombia; (M.G.-R.); (L.C.-V.); (J.V.-M.); (G.L.-J.); (B.C.-G.); (M.-C.P.-J.)
| | - Valmore Bermúdez
- Universidad Simón Bolívar, Facultad de Ciencias de la Salud, Barranquilla 080001, Colombia; (M.G.-R.); (L.C.-V.); (J.V.-M.); (G.L.-J.); (B.C.-G.); (M.-C.P.-J.)
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Sari C, Santana C, Seip RL, Bond D, Benbrahim A, Hannoush E, McLaughlin T, Li YH, Staff I, Wu Y, Papasavas P, Tishler D, Umashanker D. Multimodal approach utilising a weight management programme prior to bariatric surgery in patients with BMI ≥50 kg/m 2: A propensity score matching retrospective cohort study. Clin Obes 2024:e12669. [PMID: 38660956 DOI: 10.1111/cob.12669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 02/10/2024] [Accepted: 02/16/2024] [Indexed: 04/26/2024]
Abstract
We evaluated preoperative weight loss and days from initial consult to surgery in patients with BMI ≥50 kg/m2 who were and were not enrolled in medical weight management (MWM) prior to laparoscopic sleeve gastrectomy. We retrospectively identified patients with BMI ≥50 kg/m2 who had primary sleeve gastrectomy between 2014 and 2019 at two bariatric surgery centres in our healthcare system. Patients presenting after 2017 that received preoperative MWM (n = 28) were compared to a historical cohort of non-MWM patients (n = 118) presenting prior to programme initiation in 2017 on preoperative percent total body weight loss (%TBWL) and days from initial consult to surgery. A total of 151 patients (MWM, 33; non-MWM, 118) met inclusion criteria. BMI was significantly greater in MWM versus non-MWM (p = .018). After propensity score matching, median BMI at initial consult in non-MWM versus MWM no longer differed (p = .922) neither were differences observed on the basis of weight, age, sex, race or ethnicity. After PSM, MWM had significantly lower BMI at surgery (p = .018), lost significantly more weight from consult to surgery (p < .001) and achieved significantly greater median %TBWL from consult to surgery (p < .001). We noted no difference between groups on 6-month weight loss (p = .533). Days from initial consult to surgery did not differ between groups (p < .863). A preoperative MWM programme integrated into multimodal treatment for obesity in patients with a BMI ≥50 kg/m2 resulted in clinically significant weight loss without prolonging time to surgery.
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Affiliation(s)
- Cetin Sari
- Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, Connecticut, USA
- Medical and Surgical Weight Loss Group, Hartford HealthCare, Hartford, Connecticut, USA
| | - Connie Santana
- Medical and Surgical Weight Loss Group, Hartford HealthCare, Hartford, Connecticut, USA
| | - Richard L Seip
- Medical and Surgical Weight Loss Group, Hartford HealthCare, Hartford, Connecticut, USA
| | - Dale Bond
- Medical and Surgical Weight Loss Group, Hartford HealthCare, Hartford, Connecticut, USA
- Research Administration, Hartford HealthCare, Hartford, Connecticut, USA
| | - Aziz Benbrahim
- Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, Connecticut, USA
- Medical and Surgical Weight Loss Group, Hartford HealthCare, Hartford, Connecticut, USA
| | - Edward Hannoush
- Medical and Surgical Weight Loss Group, Hartford HealthCare, Hartford, Connecticut, USA
| | - Tara McLaughlin
- Medical and Surgical Weight Loss Group, Hartford HealthCare, Hartford, Connecticut, USA
| | - Ya-Huei Li
- Research Administration, Hartford HealthCare, Hartford, Connecticut, USA
| | - Ilene Staff
- Research Administration, Hartford HealthCare, Hartford, Connecticut, USA
| | - Yin Wu
- Research Administration, Hartford HealthCare, Hartford, Connecticut, USA
| | - Pavlos Papasavas
- Medical and Surgical Weight Loss Group, Hartford HealthCare, Hartford, Connecticut, USA
| | - Darren Tishler
- Medical and Surgical Weight Loss Group, Hartford HealthCare, Hartford, Connecticut, USA
| | - Devika Umashanker
- Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, Connecticut, USA
- Medical and Surgical Weight Loss Group, Hartford HealthCare, Hartford, Connecticut, USA
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Effect of Laparoscopic Sleeve Gastrectomy on the Pharmacokinetics of Oral Omeprazole Using a Population Approach. Pharmaceutics 2022; 14:pharmaceutics14101986. [PMID: 36297422 PMCID: PMC9608908 DOI: 10.3390/pharmaceutics14101986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 12/04/2022] Open
Abstract
Omeprazole is commonly prescribed to obese patients and patients after laparoscopic sleeve gastrectomy (LSG). The pharmacokinetics of oral omeprazole after LSG are still unknown. Therefore, the aim of this study was to investigate the pharmacokinetics of oral omeprazole in obese patients before and after LSG. A total of 331 blood samples were collected from 62 obese patients preoperatively (visit 1) followed by 41 patients 7 days post-LSG (visit 2) and 20 patients 1 month post-LSG (visit 3). Population pharmacokinetic analysis was performed using NONMEM to characterize the effect of LSG on omeprazole absorption and disposition. A one-compartment model with 12 transit absorption compartments and linear elimination successfully described the data. Compared with pre-surgery, the oral omeprazole time to maximum plasma concentration (Tmax) was reduced and maximum plasma concentration (Cmax) was higher, but the apparent clearance (CL/F) and area under the plasma concentration–time curve (AUC) were unchanged 7 days and 1 month after surgery. In addition, the CYP2C19 genotype and liver function exhibited a significant influence on omeprazole CL/F. LSG increased the rate of omeprazole absorption but did not affect omeprazole exposure. A dose of 20 mg omeprazole once daily may be adequate for relieving gastrointestinal tract discomfort at short-term follow-up post-LSG.
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Pereira-Cunill JL, Piñar-Gutiérrez A, Martínez-Ortega AJ, Serrano-Aguayo P, García-Luna PP. Medium-term complications in patients undergoing gastric bypass. ENDOCRINOL DIAB NUTR 2022; 69:240-246. [PMID: 35353678 DOI: 10.1016/j.endien.2022.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/21/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To present our experience in the clinical follow-up of patients undergoing a gastric bypass. METHOD Description of six cases under follow-up by our unit after undergoing a gastric bypass at another private centre. RESULTS The 6 patients presented complications, the most notable being the death of one patient due to severe malnutrition and the need for revision surgery in another for the same reason, destabilisation of type 1 diabetes mellitus in another patient and fat-soluble vitamin deficiency in all of them. CONCLUSIONS There are few publications that support the safety of gastric bypass as a treatment for obesity. In our experience, it is a technique associated with a high rate of serious complications. As it is a technique that is not yet standardised, we consider that these cases should be operated on in centres where there is a multidisciplinary team with expertise in the management of possible complications, with close follow-up by surgeons and endocrinologists.
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Affiliation(s)
- José Luis Pereira-Cunill
- Unidad de Nutrición, Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Ana Piñar-Gutiérrez
- Unidad de Nutrición, Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
| | - Antonio Jesús Martínez-Ortega
- Unidad de Nutrición, Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Pilar Serrano-Aguayo
- Unidad de Nutrición, Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Pedro Pablo García-Luna
- Unidad de Nutrición, Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Kermansaravi M, Lainas P, Shahmiri SS, Yang W, Jazi AD, Vilallonga R, Antozzi L, Parmar C, Kassir R, Chiappetta S, Zubiaga L, Vitiello A, Mahawar K, Carbajo M, Musella M, Shikora S. The first survey addressing patients with BMI over 50: a survey of 789 bariatric surgeons. Surg Endosc 2022; 36:6170-6180. [PMID: 35064321 PMCID: PMC9283149 DOI: 10.1007/s00464-021-08979-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 12/31/2021] [Indexed: 11/27/2022]
Abstract
Background Bariatric surgery in patients with BMI over 50 kg/m2 is a challenging task. The aim of this study was to address main issues regarding perioperative management of these patients by using a worldwide survey. Methods An online 48-item questionnaire-based survey on perioperative management of patients with a BMI superior to 50 kg/m2 was ideated by 15 bariatric surgeons from 9 different countries. The questionnaire was emailed to all members of the International Federation of Surgery for Obesity (IFSO). Responses were collected and analyzed by the authors. Results 789 bariatric surgeons from 73 countries participated in the survey. Most surgeons (89.9%) believed that metabolic/bariatric surgery (MBS) on patients with BMI over 50 kg/m2 should only be performed by expert bariatric surgeons. Half of the participants (55.3%) believed that weight loss must be encouraged before surgery and 42.6% of surgeons recommended an excess weight loss of at least 10%. However, only 3.6% of surgeons recommended the insertion of an Intragastric Balloon as bridge therapy before surgery. Sleeve Gastrectomy (SG) was considered the best choice for patients younger than 18 or older than 65 years old. SG and One Anastomosis Gastric Bypass were the most common procedures for individuals between 18 and 65 years. Half of the surgeons believed that a 2-stage approach should be offered to patients with BMI > 50 kg/m2, with SG being the first step. Postoperative thromboprophylaxis was recommended for 2 and 4 weeks by 37.8% and 37.7% of participants, respectively. Conclusion This survey demonstrated worldwide variations in bariatric surgery practice regarding patients with a BMI superior to 50 kg/m2. Careful analysis of these results is useful for identifying several areas for future research and consensus building. Supplementary Information The online version contains supplementary material available at 10.1007/s00464-021-08979-w.
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Affiliation(s)
- Mohammad Kermansaravi
- Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
- Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat_e Rasool Hospital, Tehran, Iran
| | - Panagiotis Lainas
- Department of Minimally Invasive Digestive Surgery, Antoine-Béclère Hospital, Paris-Saclay University, Clamart, France
- Metropolitan Hospital of Athens, HEAL Academy, Athens, Greece
| | - Shahab Shahabi Shahmiri
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | | | - Ramon Vilallonga
- Endocrine, Metabolic and Bariatric Unit, Department of General and Digestive Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Passeig de la Vall d'Hebron 119-129, 08035, Barcelona, Spain
- ELSAN, Clinique Saint Michel, Centre Chirurgical de L'Obésité, Toulon, France
| | | | - Chetan Parmar
- Department of Surgery, The Whittington Health NHS Trust, London, UK
- University College London Medical School, London, UK
| | - Radwan Kassir
- Department of Digestive Surgery, Centre Hospitalier Universitaire Félix Guyon, St Denis de la Réunion, France
| | - Sonja Chiappetta
- Obesity and Metabolic Surgery Unit, Ospedale Evangelico Betania, Naples, Italy
| | - Lorea Zubiaga
- Miguel Hernandez of Elche University, Alicante, Spain
| | - Antonio Vitiello
- Advanced Biomedical Sciences Department, Naples "Federico II" University, AOU "Federico II", Via S. Pansini 5, 80131, Naples, Italy
| | - Kamal Mahawar
- South Tyneside and Sunderland Foundation NHS Trust, Sunderland, UK
| | - Miguel Carbajo
- Centre of Excellence for the Study and Treatment of Obesity and Diabetes, Valladolid, Spain
| | - Mario Musella
- Advanced Biomedical Sciences Department, Naples "Federico II" University, AOU "Federico II", Via S. Pansini 5, 80131, Naples, Italy.
| | - Scott Shikora
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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[Physical exercise and loss of weight and body mass index in bariatric surgery: a systematic review]. NUTR HOSP 2021; 39:202-210. [PMID: 34779214 DOI: 10.20960/nh.03746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION bariatric surgery is considered successful when the percentage of weight loss is equal to or higher than 25 %, or when the percentage loss of body mass index occurs above 50 % long-term. OBJECTIVE to analyze the effect of physical exercise on body weight and body mass index before and/or after bariatric surgery. METHODOLOGY articles registered in the PudMed, Scopus and Web of Science databases were searched for original papers with open access in English and Spanish that compared one or more physical exercise programs as treatment before and/or after bariatric surgery, with results on initial and final weight and body mass index, muscle mass, and fat mass from January to April 2021. RESULTS a total of 730 articles were obtained in the different databases and only 7 were selected for the analysis. Aerobic exercise combined with resistance training showed a greater decrease in the percentage of weight loss (% PP) and the percentage of loss of body mass index (% PBMI). CONCLUSIONS aerobic physical exercise in combination with endurance training is the most applied program in subjects with bariatric surgery, and the most important effects are an increase in percentage of weight loss and a decrease in body mass index.
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Galyean S, Syn D, Subih HS, Boylan M. Improving vitamin D status in bariatric surgery subjects with monthly high-dose ergocalciferol. INT J VITAM NUTR RES 2021; 92:109-117. [PMID: 34521264 DOI: 10.1024/0300-9831/a000728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Vitamin D insufficiency is common before and after bariatric surgery. Optimal supplementation to treat vitamin D insufficiency is not clearly defined. Objective: Determine if serum 25 (OH) D levels improve by the consumption of an additional monthly ergocalciferol supplement by subjects after bariatric surgery. Study design: Thirty-two subjects were randomly divided to receive an additional 100,000 IUs of ergocalciferol monthly after bariatric surgery (n=10) or standard level vitamin D supplement after bariatric surgery (n=22). Serum 25 (OH) D, calcium, and hemoglobin A1c levels were measured preoperatively and one year after bariatric surgery. Results: Mean changes in BMI at 1-year post-operation was -18.12±6.46 kg/m2 in the control group versus -18.84±4.7 kg/m2; p=0.638 in the vitamin D group. One year after bariatric surgery, the mean changes from baseline in vitamin D levels were 2.69±9.4 and 12.4±17.0 ng/mL in control and intervention groups, respectively. The treated group showed a marginally higher mean increase in Vitamin D than the control group, p=0.059. Other mean changes at 1-year post-surgery that were not significantly different include calcium -0.264±0.45 and -0.21±0.509 mg/dl in control and intervention groups, respectively and Hgb A1c -1.0±1.21 and -0.95±0.071% in control and intervention groups, respectively. Conclusion: This study showed 100,000 IUs ergocalciferol once a month is a safe and effective treatment for vitamin D insufficiency in most patients having bariatric surgery.
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Affiliation(s)
- Shannon Galyean
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, USA
| | - David Syn
- Department of Surgery Advanced Bariatric Surgery Center, Lubbock, TX, USA
| | - Hadil S Subih
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid, Jordan
| | - Mallory Boylan
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, USA
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Pereira-Cunill JL, Piñar-Gutiérrez A, Martínez-Ortega AJ, Serrano-Aguayo P, García-Luna PP. Medium-term complications in patients undergoing gastric bypass. ENDOCRINOL DIAB NUTR 2021; 69:S2530-0164(21)00189-0. [PMID: 34456162 DOI: 10.1016/j.endinu.2021.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To present our experience in the clinical follow-up of patients undergoing a gastric bypass. METHOD Description of six cases under follow-up by our unit after undergoing a gastric bypass at another private centre. RESULTS The 6 patients presented complications, the most notable being the death of one patient due to severe malnutrition and the need for revision surgery in another for the same reason, destabilisation of type 1 diabetes mellitus in another patient and fat-soluble vitamin deficiency in all of them. CONCLUSIONS There are few publications that support the safety of gastric bypass as a treatment for obesity. In our experience, it is a technique associated with a high rate of serious complications. As it is a technique that is not yet standardised, we consider that these cases should be operated on in centres where there is a multidisciplinary team with expertise in the management of possible complications, with close follow-up by surgeons and endocrinologists.
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Affiliation(s)
- José Luis Pereira-Cunill
- Unidad de Nutrición, Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - Ana Piñar-Gutiérrez
- Unidad de Nutrición, Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, España.
| | - Antonio Jesús Martínez-Ortega
- Unidad de Nutrición, Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - Pilar Serrano-Aguayo
- Unidad de Nutrición, Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - Pedro Pablo García-Luna
- Unidad de Nutrición, Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, España
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Aljaaly EA. Perioperative nutrition care and dietetic practices in the scope of bariatric surgery in Saudi Arabia using adapted protocols for evaluation. SAGE Open Med 2021; 9:20503121211036136. [PMID: 34377474 PMCID: PMC8326630 DOI: 10.1177/20503121211036136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/11/2021] [Indexed: 12/14/2022] Open
Abstract
Objectives: This study evaluates the availability of perioperative nutritional care protocols and the practices of bariatric registered dietitians in Saudi Arabia. The primary outcomes of the study were conducted using an adapted American survey “with permission.” Methods: A cross-sectional survey of a selected 32 dietitians providing bariatric services completed a self-administered online questionnaire from 12 hospitals in Jeddah, Saudi Arabia. Results: All surveyed dietitians were females, mainly Saudi nationals (93.9%, n = 30), and accredited by the Saudi Commission for Health Specialties (93.8%, n = 30). Only 37.5% (n = 6) of the dietitians were specialized in bariatric surgery. Perioperative common practices of dietitians included a conduct of screening for nutrition risk before (44%, n = 14) and after surgery (62.5%, n = 20) and applied a nutrition management protocol that is mainly based on the application of nutrition care process (62.5%, n = 20). Dietitians (81%, n = 26) reported the importance of having standardized protocols for nutritional management of patients undoing bariatric surgery, where 69% (n = 22) confirmed the availability of pre-operative written protocols in hospitals and 75% (n = 24) confirmed the existence of post-operative protocols. Pre-operative practices included using approaches for weight loss before surgery, for example, very low and low-calorie diet. Dietitians (25%, n = 8) see two to ten patients per month. The sleeve gastrectomy procedure is the most often performed surgery. Conclusion: This is the first study to evaluate the perioperative nutrition care protocols and practices related to bariatric surgery in Saudi Arabia. Perioperative bariatric protocols are available, but some dietitians are not aware of their availability and contents. Researchers emphasize the importance of creating national protocols by the Saudi Credentials Body to standardize practices within the field.
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Affiliation(s)
- Elham Abbas Aljaaly
- An Associate Professor & Consultant in Clinical Nutrition at the Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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