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Complications Requiring Intensive Nutritional Care After Bariatric Surgery Result in More Long-Term Weight Loss but Has No Impact on Nutritional Deficiencies and Depression-Anxiety Scores

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Abstract

Purpose

Bariatric surgery is associated with significant weight loss and improvement in comorbid conditions but in rare cases can expose to complications requiring intensive nutritional care (INC). INC in this context is poorly described and no data are available concerning long-term impact.

Materials and Methods

We retrospectively reviewed charts of bariatric patients who were hospitalized in our institution between 2013 and 2018. We identified patients with a postoperative complication requiring INC and we described their nutritional management (INC group). These patients were compared with controls matched to age, gender, preoperative BMI, and type of surgery selected from our database (control group). The primary endpoint was the percentage of total weight loss (%TWL) at 2.5 years. Secondary endpoints were improvement of co-morbidities, vitamin deficiencies, and depression/anxiety scores.

Results

The INC group consisted of 18 patients among which 77.8% had sleeve gastrectomy (SG). Half of these patients underwent revisional surgery. The most common complication was fistula formation (66.7%). Patients in the INC group, compared to the control group, showed a significantly higher %TWL at 2.5 years (33.6% vs 26.1%, P = 0.03). There was no significant difference in either reduction of preoperative comorbidities or depression/anxiety scores between the two groups. The number of patients with more than three nutritional deficiencies was similar in both groups. Thiamine deficiency was only observed in the INC group.

Conclusion

Complications requiring INC after bariatric surgery occur mainly after revisional surgery and may increase long-term %TWL but have no impact on nutritional deficiencies or symptoms of anxiety/depression.

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Authors and Affiliations

  1. Department of Endocrinology-Nutrition, Ambroise Paré Hospital, AP-HP, EA4340 Research Unit, University Paris-Saclay, 92100, Boulogne-Billancourt, France

    Marion Bretault, Ramona Zaharia, Marie-Laure Raffin-Sanson & Mirella Hage

  2. Clinical Research Unit, AP-HP, Paris-Saclay, Hôpital Ambroise Pare, Boulogne-Billancourt, France

    Marie Vigan

  3. Department of Surgery and Oncology, Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, France

    Karina Vychnevskaia

  4. Department of Gastro-enterology, Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, France

    Pascal Crenn

Authors
  1. Marion Bretault
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  2. Ramona Zaharia
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  3. Marie Vigan
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  4. Karina Vychnevskaia
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  5. Marie-Laure Raffin-Sanson
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  6. Pascal Crenn
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  7. Mirella Hage
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Corresponding author

Correspondence to Marion Bretault.

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Ethics Approval

This retrospective study was validated by the Research Ethics Committee of Paris Saclay University.

Informed Consent Statement

Informed consent was obtained from all individual participants included in the study. This study has been the object of a simplified declaration to data protection authority.

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The authors declare no conflict of interest.

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Key Points

1. Complications requiring intensive nutritional care (INC) after bariatric surgery mainly occur after revisional surgery and are mostly fistula formations.

2. Patients requiring INC for bariatric complications have more long-term weight loss at 2.5 years compared to patients without complications, and weight regain was not different between groups.

3. Complications requiring INC have no impact on nutritional deficiencies, reduction of comorbidities, and depression/anxiety scores.

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Bretault, M., Zaharia, R., Vigan, M. et al. Complications Requiring Intensive Nutritional Care After Bariatric Surgery Result in More Long-Term Weight Loss but Has No Impact on Nutritional Deficiencies and Depression-Anxiety Scores. OBES SURG 31, 4767–4775 (2021). https://doi.org/10.1007/s11695-021-05623-3

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  • DOI: https://doi.org/10.1007/s11695-021-05623-3

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