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Complications nutritionnelles de la chirurgie de l’obésité : prévalence, prévention, traitement. Revue systématique de littérature

Abstract : BackgroundIn France, the use of obesity surgery is increasing sharply. Yet effective on severe obesity and its comorbidities, it exposes to the risk of serious postoperative complications, including nutritional issues. We aimed to synthesize the research-based evidence concerning these nutritional complications: prevalence, risk factors, recommendations on their treatment and prevention.MethodsWe carried out a PRISMA systematic review, the articles included were analyzed into a synoptic table, allowing the development of summary tables.ResultsPostoperative nutritional deficiencies are frequent (vitamin D 25-100%, B12 7-70%, iron 7-63%). A lifelong micronutrient supplementation is essential (multivitamin and minerals, vitamin D-calcium, iron, vitamin B12) to prevent the hematological, neurological, or musculoskeletal consequences of deficiencies. Their prevention-screening-treatment are part of a global postoperative management which must be multimodal and interdisciplinary. Severe malnutrition exists (<5%) and could lead to serious complications ("nutritional disasters") that may require artificial nutrition. Studies with high level of evidence on postoperative follow-up and supplementation are rare, not allowing the development of consensus guidelines. To prevent nutritional deficiencies and their consequences, the collaboration between general practitioners and medico-surgical teams should be strengthened.ConclusionNutritional complications are common after obesity surgery. Potentially serious, they are accessible to screening and prevention, through lifelong biochemical and clinical monitoring, and micronutrient supplementation. A coordinated follow-up, as part of a tailored "community care-hospital" patient healthcare pathway, could improve postoperative outcomes.
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Submitted on : Wednesday, June 16, 2021 - 3:26:27 PM
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Guiho et al - 2020 - Complicat...
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Mylène Guiho, Laurence Lacaze, Damien Bergeat, Emmanuel Allory, Ronan Thibault. Complications nutritionnelles de la chirurgie de l’obésité : prévalence, prévention, traitement. Revue systématique de littérature. Nutrition Clinique et Métabolisme, Elsevier Masson, 2020, 34 (4), pp.263-280. ⟨10.1016/j.nupar.2020.06.002⟩. ⟨hal-03101315⟩

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