Post-bariatric surgery weight regain: evaluation of nutritional profile of candidate patients for endoscopic argon plasma coagulation

Abstract

BackgroundBariatric surgery is effective treatment for weight loss, but demand continuous nutritional care and physical activity. They regain weight happens with inadequate diets, physical inactivity and high alcohol consumption.AimTo investigate in patients undergoing Roux-Y-of gastroplasty weight regain, nutritional deficiencies, candidates for the treatment with endoscopic argon plasma, the diameter of the gastrojejunostomy and the size of the gastric pouch at the time of treatment with plasma.MethodsA prospective 59 patients non-randomized study with no control group undergoing gastroplasty with recurrence of weight and candidates for the endoscopic procedure of argon plasma was realized. The surgical evaluation consisted of investigation of complications in the digestive system and verification of the increased diameter of the gastrojejunostomy. Nutritional evaluation was based on body mass index at the time of operation, in the minimum BMI achieved after and in which BMI was when making the procedure with plasma. The laboratory tests included hemoglobin, erythrocyte volume, ferritin, vitamin D, B12, iron, calcium, zinc and serum albumin. Clinical analysis was based on scheduled follow-up.ResultsOf the 59 selected, five were men and 51 women; were included 49 people (four men and 44 women) with all the complete data. The exclusion was due to the lack of some of the laboratory tests. Of this total 19 patients (38.7%) had a restrictive ring, while 30 (61.2%) did not. Iron deficiency anemia was common; 30 patients (61.2%) were below 30 with ferritin (unit); 35 (71.4%) with vitamin B12 were below 300 pg/ml; vitamin D3 deficiency occurred in more than 90%; there were no cases of deficiency of protein, calcium and zinc; glucose levels were above 99 mg/dl in three patients (6.12%). Clinically all had complaints of labile memory, irritability and poor concentration. All reported that they stopped treatment with the multidisciplinary team in the first year after the operation.ConclusionsThe profile of patients submitted to argon plasma procedure was: anastomosis in average with 27 mm; multiple nutritional deficiencies with predominance of iron deficiency anemia; ferritin below 30; vitamin B12 levels below 300 pg/ml; labile memory complaints, irritability and poor concentration.

Re-sleeve gastrectomy as revisional bariatric procedure after biliopancreatic diversion with duodenal switch

“…In our series, we identified 17 patients with weight regain at a median follow-up of more than 5 years In bariatric surgery, weight regain is a common problem [7,17,18]. Even after satisfactory weight loss, weight regain can occur if patients go back to bad eating habits and sedentary lifestyle [8,19]. The reasons for weight regain has to be thoroughly investigated.…”

“…Psychological disorders or changes in eating behavior have been correlated with changes in body weight, independent of the reported dietary intake and physical activity [8,19]. In cases of hyperphagia linked to a dilatated gastric sleeve, we offered patients re-SG after BPD-DS.…”

Condições periodontais e de higiene bucal, qualidade de vida e satisfação com a vida em pacientes obesos diabéticos e não diabéticos submetidos à cirurgia bariátrica

“…O abandono do acompanhamento multiprofissional após o primeiro ano da CB tem sido evidenciado, bem como o reganho de peso, retorno das comorbidades e deficiência nutricionais graves (ferro, vitaminas B12 e D3), atribuídos ao retorno aos hábitos alimentares desregrados, sedentarismo e aumento significativo no consumo de álcool (CAMBI et al, 2015).…”

“…Foi observada a baixa satisfação entre os indivíduos em G1 (4,72±1,63) (CAMBI et al, 2015). Foram realizadas várias tentativas de contato com os indivíduos que não compareceram às avaliações agendadas nos períodos de pós-operatório, porém não houve colaboração destes participantes para com o acompanhamento odontológico realizado durante esta pesquisa.…”

“…As avaliações após a Cirurgia Bariátrica evidenciaram a remissão destas comorbidades em quase todos os indivíduos, assim como o observado na literatura científica (CAMBI et al, 2015;PEDROSA et al, 2009). As cirurgias gastrointestinais podem promover a melhora do controle glicêmico por meio da restrição alimentar e da perda de peso, assim os procedimentos cirúrgicos que induzem a perda de peso também podem promover a remissão do DM2 consideravelmente entre indivíduos obesos mórbidos (CELIK et al, 2015).…”