The relationship between preoperative weight loss and intra and post-bariatric surgery complications: an appraisal of the current preoperative nutritional strategies

Sarno, Gerardo; Calabrese, P; Frías-Toral, Evelyn; Ceriani, Florencia; Fuchs-Tarlovsky, Vanessa; Spagnuolo, Maria; Cucalón, Gabriela; Córdova, Ludwig Roberto Álvarez; Schiavo, Luigi; Pilone, Vincenzo

doi:10.1080/10408398.2022.2074963

Cited by 6 publications

(5 citation statements)

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“…Another challenge during bariatric surgery is increased intra-abdominal fat, especially in patients with central obesity. This can reduce the working space and make it difficult to expose anatomical landmarks, as well as impair complex surgical tasks, such as knotting and suturing [13,110,111]. Therefore, preoperative interventions to reduce body weight, hepatomegaly, and intra-abdominal fat before laparoscopic bariatric surgery could benefit both surgeons and patients by reducing surgical risk [13,110,111].…”

Section: Extubationmentioning

confidence: 99%

“…This can reduce the working space and make it difficult to expose anatomical landmarks, as well as impair complex surgical tasks, such as knotting and suturing [13,110,111]. Therefore, preoperative interventions to reduce body weight, hepatomegaly, and intra-abdominal fat before laparoscopic bariatric surgery could benefit both surgeons and patients by reducing surgical risk [13,110,111]. However, there is no clear consensus on the most effective dietary approach.…”

Section: Extubationmentioning

confidence: 99%

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Very Low-Calorie Ketogenic Diet (VLCKD) as Pre-Operative First-Line Dietary Therapy in Patients with Obesity Who Are Candidates for Bariatric Surgery

et al. 2023

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Bariatric surgery is currently the most effective method for achieving long-term weight loss and reducing the risk of comorbidities and mortality in individuals with severe obesity. The pre-operative diet is an important factor in determining patients’ suitability for surgery, as well as their post-operative outcomes and success in achieving weight loss. Therefore, the nutritional management of bariatric patients requires specialized expertise. Very low-calorie diets and intragastric balloon placement have already been studied and shown to be effective in promoting pre-operative weight loss. In addition, the very low-calorie ketogenic diet has a well-established role in the treatment of obesity and type 2 diabetes mellitus, but its potential role as a pre-operative dietary treatment prior to bariatric surgery has received less attention. Thus, this article will provide a brief overview of the current evidence on the very low-calorie ketogenic diet as a pre-operative dietary treatment in patients with obesity who are candidates for bariatric surgery.

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Section: Extubationmentioning

confidence: 99%

Section: Extubationmentioning

confidence: 99%

Very Low-Calorie Ketogenic Diet (VLCKD) as Pre-Operative First-Line Dietary Therapy in Patients with Obesity Who Are Candidates for Bariatric Surgery

et al. 2023

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“…Sarno et al recently reported that when comparing different types of diet, such as preoperative low-calorie diet (LCD), very-low-calorie diet (VLCD), low-fat diet, intermittent fasting, or a Mediterranean diet in relation to BS complications, it seems that LCD has shown better tolerance and adherence than VLCD. Nonetheless, the authors suggest that better controlled research is still needed to define the optimum diet plan for weight loss before BS, since this issue has controversial positions [26]. It is also relevant to remember that complex patients with comorbid obesity conditions should be supervised with combined strategies before BS, including weight loss and the consumption of omega-3 fatty acids, which have been shown to reduce liver steatosis and systemic inflammation, thus improving postoperative outcomes [27].…”

Section: Is a Specific Bmi Cut-off Point In Patients That Makes Baria...mentioning

confidence: 99%

The Impact and Effectiveness of Weight Loss on Kidney Transplant Outcomes: A Narrative Review

et al. 2023

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Obesity is a worldwide epidemic that leads to several non-communicable illnesses, including chronic kidney disease (CKD). Diet and lifestyle modifications have shown a limited impact in the treatment of obesity. Because the group of end-stage renal disease (ESRD) patients examined in this study had limited access to kidney transplantation (KT), patients with obesity were thought to be at an increased risk of intraoperative and postoperative KT complications. Although bariatric surgery (BS) is now recognized as the gold standard treatment for morbid obesity, its role in ESRD or kidney transplant patients remains unknown. It is critical to know the correlation between weight loss and complications before and after KT, the impact of the overall graft, and patients’ survival. Hence, this narrative review aims to present updated reports addressing when to perform surgery (before or after a KT), which surgical procedure to perform, and again, if strategies to avoid weight regain must be specific for these patients. It also analyzes the metabolic alterations produced by BS and studies its cost-effectiveness pre- and post-transplantation. Due to the better outcomes found in KT recipients, the authors consider it more convenient to perform BS before KT. However, more multicenter trials are required to provide a solid foundation for these recommendations in ERSD patients with obesity.

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“…There is currently no definite information regarding the optimal diet protocol to be implemented before surgery, nor the duration of which this should be adhered to. Several protocols are advised, including the placement of an intragastric balloon, adherence to a very low-calorie diet (VLCD), implementation of a low-calorie diet, following a very low calorie ketogenic diet, making lifestyle change, and other related options [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Diet before Bariatric Surgery on Ghrelin Level through DNA Methylation

Güçlü,

Işıksaçan,

Seyit

et al. 2024

Ann Nutr Metab

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Introduction: The ghrelin system, which generates the appetite hormone, is harmed by obesity, a problem of worldwide public health. An efficient way to cure obesity is through bariatric surgery. This randomized controlled study's objective was to assess preoperative diet-related DNA methylation of Ghrelin (GHRL) levels in patients undergoing bariatric surgery. Methods: The 50 patients who volunteered to participate in the trial were randomly divided into two groups. The study group followed the very low-calorie diet (VLCD) for two weeks. The control group did not follow any diet. The physiological parameters, weight, and DNA methylation levels of the patients were assessed. Results: The percentage of excess weight loss (EWL) in the control and study groups was determined as 47.1% and 51.5%, respectively. The study group's GHRL percentage of methylated reference (PMR) was 76.8%, whereas the control group's was 67.3%. It was concluded that the EWL and GHRL gene DNA methylation of the diet-treated study group were significantly higher than the control group (p<0.05). Conclusion: According to the findings, the pre-op diet had a favorable effect on the patient's behavior modification. It has also been shown to increase post-operative weight loss and DNA methylation of the Ghrelin gene. The ghrelin gene has been muted by methylation, making hunger regulation more manageable.

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The relationship between preoperative weight loss and intra and post-bariatric surgery complications: an appraisal of the current preoperative nutritional strategies

Cited by 6 publications

References 62 publications

Very Low-Calorie Ketogenic Diet (VLCKD) as Pre-Operative First-Line Dietary Therapy in Patients with Obesity Who Are Candidates for Bariatric Surgery

Very Low-Calorie Ketogenic Diet (VLCKD) as Pre-Operative First-Line Dietary Therapy in Patients with Obesity Who Are Candidates for Bariatric Surgery

The Impact and Effectiveness of Weight Loss on Kidney Transplant Outcomes: A Narrative Review

Effect of Diet before Bariatric Surgery on Ghrelin Level through DNA Methylation

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