Lanzi P.,Clinical Dietetics and Nutrition Unit |
Noe D.,Clinical Dietetics and Nutrition Unit |
Ventura P.,San Carlo Borromeo Hospital |
Vitali T.,San Carlo Borromeo Hospital |
And 4 more authors.
Nutritional Therapy and Metabolism | Year: 2011
Objective: Bariatric surgery, increasingly popular in recent years for treating morbid obesity, is not free of complications. This study compared clinical outcomes and long/short-term complications of malabsorptive/restrictive surgery. Methods: In the last five years, 102 severely obese patients were recruited to undergo surgery, 44 to malabsorptive surgery (Doldi biliointestinal bypass) and 58 to restrictive surgery (gastric banding). Examinations at baseline and yearly for three years included anthropometry (weight, BMI); eating behavior/habits; blood tests for nutritional status; cardiovascular risk score assessment; psychiatric/ endocrinological counseling; basal metabolism and body composition (fat/fat-free mass). After surgery, any complication that occurred was recorded and treated. Results: After three years, the mean weight loss was 46 kg (31%, p<0.01) for biliointestinal bypass and 21 kg (19%, p<0.01) for gastric banding. Lipid and glycemic profiles returned to normal and eating behavior improved after both procedures. Complications of biliointestinal bypass included nutritional deficits, mainly of liposoluble vitamins (13 patients, 29%); gallstones (5 patients, 11%); kidney stones (3 patients, 7%); arthritis and arthralgia (4 patients, 9%). One reconversion was required. Complications of gastric banding included epigastralgia (12 patients, 21%); persistent vomiting (9 patients, 16%); erosion (2 patients, 3%); slippage (1 patient). Six patients (10%) required band removal. Conclusions: Obesity surgery achieves stable weight loss, comorbidity resolution and cardiovascular risk reduction. Accurate monitoring and treatment of complications will reduce the surgery-related morbidity. 2011 SINPE-GASAPE. Source