减肥手术患者的术后营养和营养并发症:最新进展

Havva Sezer, D. Yazıcı
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引用次数: 0

摘要

近几十年来,肥胖的治疗选择趋向于减肥手术。减肥手术包括不同的程序,可以是限制性的,吸收不良的,或两者的结合。吸收不良的手术通过肠段旁路导致体重减轻,从而减少食物吸收。限制性手术通过限制食物摄入导致体重减轻(1)。限制性手术包括腹腔镜袖胃切除术(LSG)、腹腔镜可调节胃束带(LAGB)和垂直胃束带成形术。减肥手术中的吸收不良手术是病态肥胖患者长期减肥最有效的治疗选择。减肥手术后的营养是一个非常专业的情况。减肥手术后最严重的并发症是营养缺乏和与之相关的疾病,如贫血和骨质疏松症。术前应进行与营养缺乏相关的筛查,以优化患者的术后结果和营养状况。减肥手术如Roux-en-Y胃旁路术(RYGB)和十二指肠开关胆胰分流术(BPD-DS)会减少营养吸收。此外,减肥手术可能会加剧先前存在的营养不足。接受减肥手术的患者应随访常见微量营养素缺乏和蛋白质-热量营养不良。这些患者的术后随访存在空白。本综述旨在关注减肥手术患者的术后营养策略和营养并发症。
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Postoperative Nutrition and Nutritional Complications in Patients with Bariatric Surgery: An Update
Introduction Therapeutic options for obesity have trended toward bariatric surgeries in recent decades. Bariatric surgery involves different procedures that can be restrictive, malabsorptive, or a combination of both. Malabsorptive procedures lead to weight loss by intestinal segment bypass that reduces food absorption. Restrictive procedures lead to weight loss by restricting food intake (1). Restrictive procedures include laparoscopic sleeve gastrectomy (LSG), laparoscopic adjustable gastric banding (LAGB), and vertical band gastroplasty. Malabsorptive procedures inBariatric surgery is the most effective therapeutic option for long-term weight loss among patients with morbid obesity. Nutrition after bariatric surgery is a very specialized condition. The most severe complications that can develop after bariatric surgery are nutritional deficiencies and the diseases related to them, such as anemia and osteoporosis. Screening associated with nutritional deficiencies should be performed preoperatively to optimize the postoperative outcomes and the nutritional status of patients. Bariatric surgeries such as Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion with duodenal switch (BPD-DS) reduce nutrient absorption. Moreover, bariatric surgery can exacerbate preexisting nutritional deficiencies. Patients who have undergone bariatric surgery should be followed up for common micronutrient deficiencies and protein-calorie malnutrition. There are gaps in the postoperative follow-up of these patients. This review aimed to focus on the postoperative nutritional strategies and nutritional complications in patients who have undergone bariatric surgery.
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