Manejo nutricional perioperatorio en pacientes con cirugía bariátrica
DOI:
https://doi.org/10.30944/20117582.260Palabras clave:
obesidad, obesidad mórbida, cirugía bariátrica, nutriciónResumen
La cirugía bariátrica es hasta el momento la mejor solución para el problema de obesidad y la diabetes, e incluso, influye en la mejoría de las enfermedades no transmisibles relacionadas con la nutrición. Sin embargo, no está exenta de complicaciones, entre las cuales son frecuentes las metabólicas y nutricionales que, afortunadamente, son predecibles, prevenibles y tratables. Es necesario que el médico, el equipo de salud y el paciente se encuentren conscientes de la importancia de la nutrición, no solamente antes de la cirugía e inmediatamente después de ella, sino el resto de la vida.
Es fundamental cumplir diariamente con las necesidades de proteína del paciente, la cual debe seleccionarse en la forma más tolerable y absorbible, con el objeto de prevenir deficiencias nutricionales importantes que muchas veces se atribuyen equivocadamente a déficits de otros nutrientes. Finalmente, el cambio de estilo de vida debe incorporarse al tratamiento, para prevenir de esta manera la nueva ganancia de peso y las implicaciones que esto conlleva.
Descargas
Referencias bibliográficas
World Health Organization. Obesity and overweight: WHO; 2011. Fecha de consulta: 17 de octubre de 2011. Disponible en: http://www.who.int/mediacentre/factsheets/fs311/en.
World Health Organization. Obesity and overweight. Geneva: WHO; 2006. Fecha de consulta: 30 de abril de 2009. Disponible en: http://www.who.int/mediacentre/factsheets/fs311/en/print.html.
Centers for Disease Control and Prevention. NCHS- Health E Stats. Prevalence of overweight, obesity and extreme obesity among adults: United States trends 1960-62 through 2005- 2006. November 19, 2009. Fecha de consulta: 8 de enero de 2010. Disponible en: http://www.cdc.gov/nchs/data/hestat/ overweight_adult.htm.
ICBF. Encuesta Nacional de la Situación Nutricional en Colombia 2005. Bogotá: Panamericana Formas e Impresos, S.A.; 2006.
Resumen Ejecutivo ENSIN. Fecha de consulta: 18 de octubre de 2011. Disponible en: 2010 http://www.bogotamasactiva.gov.co/files/Resumen%20Ejecutivo%20ENSIN%202010.pdf.
Abeles D, Shikora S. Bariatric surgery: Current concepts and future directions. Aesthetic Surg J. 2008;28:79-84. https://doi.org/10.1016/j.asj.2007.09.007
Bjorntop P. Treatment of obesity. Int J Obes Relat Metab Disord. 1992;16(Suppl.3):S81-4.
Patiño J. Cirugía bariátrica. Rev Colomb Cir. 2003;18:28-50.
Zhao Y, Encinosa W. Bariatric surgery utilization outcomes in 1998 and 2004. Statistical brief # 23. January 2007. Agency for Healthcare Research and Quality. Rockville, Md. Fecha de consulta: 18 de octubre de 2011. Disponible en: http://www.hcup-us.ahrq.gov/reports/statbriefs/sb23.pdf.
Fujioka K, DiBaise J, Martindale RG. Nutrition and metabolic complications after bariatric surgery and their treatment. J Parenter Enteral Nutrition. 2011;35:S52-9. https://doi.org/10.1177/0148607111413600
Torres A, Rubio M. The endocrine society's clinical practice guideline on endocrine and nutritional management of the post-bariatric surgery patient: Commentary from a European perspective. Eur J Endocrinol. 2011;165:171-6. https://doi.org/10.1530/EJE-11-0357
Nicholas C, May R. HealthGrades fifth annual bariatric surgery trends in American hospitals study. May 2010. HealthGrades. Golden, Colorado. Fecha de consulta: 18 de octubre de 2011. Disponible en: http://www.healtgrades.com/media/DMS/pdf/HealthGradesBariatricSurgeryTrendsStudy2010.pdf.
Schouten R, Japink D, Messters B, Nelemans P, Greve J. Systematic literature review of reoperations after gastric banding: Is a stepwise approach justified? Surg Obes Relat Dis. 2011;7:99-109. https://doi.org/10.1016/j.soard.2010.10.010
Langer F, Bohdjalian A, Shakeri-Manesch S, Felberbauer F, Zacherl J, Prager G. Inadequate weight loss Vs. secondary weight regain: Laparoscopic conversion from gastric banding to Roux-en-Y gastric bypass. Obes Surg. 2008;18:1381-6. https://doi.org/10.1007/s11695-008-9479-x
van Wageningen B, Berends F, van Ramshorst B, Janssen I. Revision of failed laparoscopic adjustable gastric banding to Roux-en-Y gastric bypass. Obes Surg. 2006;16:137-41. https://doi.org/10.1381/096089206775565212
Mognol P, Chosidow D, Marmuse J. Laparoscopic conversion of laparoscopic gastric banding to Roux-en-Y gastric bypass: A review of 70 patients. Obes Surg. 2004;14:1349-53. https://doi.org/10.1381/0960892042584003
Schouten R, van Dielen F, Greve J. Re-operation after laparos- copic adjustable gastric banding leads to a further decrease in BMI and obesity-related co-morbidities: Results in 33 patients. Obes Surg. 2006;16:821-8. https://doi.org/10.1381/096089206777822386
O'Brien P, McPhail T, Chaston T, Dixon J. Systematic review of medium-term weight loss after bariatric operations. Obes Surg. 2006;16:1032-40. https://doi.org/10.1381/096089206778026316
Heber D, Greenway F, Kaplan L, Livingston E, Salvador J, Still C. Endocrine and nutritional management of the post-bariatric surgery patient: An endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2010;95:4823-43. https://doi.org/10.1210/jc.2009-2128
Avari M. Is type 2 diabetes a surgical disease? Can J Surg. 2007;50:4:249-50.
Rosero G. Es la diabetes mellitus tipo 2 una enfermedad de tratamiento quirúrgico? Rev Colomb Cir. 2010;25:27-36.
Metabolic and Bariatric Surgery. ASMBS. Mayo de 2011. Fecha de consulta: 24 de octubre de 2011. Disponible en: http://s3.amazonaws.com/publicASMBS/MediaPressKitMetabolicBariatricSurgeryOverviewJuly2011.pdf.
Poirier P, Cornier M, Mazzone T, Stiles S, Cummings S, Klein S, et al. Bariatric surgery and cardiovascular risk factors; a scientific statement from the American Heart Association. Circulation. 2011;123:1683-701. https://doi.org/10.1161/CIR.0b013e3182149099
American Diabetes Association. Standards of medical care in diabetes - 2009. Diabetes care. 2009;32:S13-61. https://doi.org/10.2337/dc09-S013
InternationalDiabetesFederation.Bariatricsurgicalandproce- dural interventions in the treatment of obese patients with type 2 diabetes. Fecha de consulta: 24 de octubre de 2011. Disponible en: http://www.idf.org/webdata/docs/IDF-Position-Statement-Bariatric-Surgery.pdf.
American College of Obstetricians and Gynecologists. Bariatric surgery and pregnancy, 2009. Practice Bulletin N° 105.
Kominiarek M. Pregnancy alters bariatric surgery. Obstet Gynecol Clin North Am. 2010;37:305-20. https://doi.org/10.1016/j.ogc.2010.02.010
Gallagher D, Delegue M. Body composition (sarcopenia) in obese patients: Implications for care in the intensive care unit. J Parenter Enteral Nutrition. 2011;35(Suppl.):S21-8. https://doi.org/10.1177/0148607111413773
Hurt R, Frazier T, McClave S, Cave M. Pharmaconutrition for the obese critically ill patient. J Parenter Enteral Nutrition. 2011;35(Suppl.):S60-72. https://doi.org/10.1177/0148607111413775
Ochoa J, McClave S, Saavedra J. Issues involved in the process of developing a medical food. J Parenter Enteral Nutrition. 2011;35(Suppl.):S73-9. https://doi.org/10.1177/0148607111415281
Martindale R, Delegue M, McClave S, Monroe C, Smith V, Kiraly L. Nutrition delivery for obese ICU patients: Delivery issues, lack of guidelines, and missed opportunities. J Parenter Enteral Nutrition. 2011;35(Suppl.):S80-7. https://doi.org/10.1177/0148607111415532
McClave S, Kushner R, van Way III CW, Cave M, DeLegge M, Dibaise J, et al. Nutrition therapy of the severely obese, critically ill patient: Summation of conclusions and recommen- dations. J Parenter Enteral Nutrition. 2011;35(Suppl.):S88-96. https://doi.org/10.1177/0148607111415111
Aills L, Blankenship J, Buffington C, Furtado M, Parrot J. ASMBS Allied Health Nutritional Guidelines for the Surgical Weight Loss Patient. Surg Obes and Relat Dis. 2008;4:S73-108. https://doi.org/10.1016/j.soard.2008.03.002
Carrasco F, Manrique M, Maza MP, Moreno M, Albala C, Gar- cía J, et al. Tratamiento farmacológico o quirúrgico del paciente con sobrepeso u obesidad. Rev Méd Chile. 2009;137:972-81. https://doi.org/10.4067/S0034-98872009000700017
Gropper S, Smith J, Groff J. Advanced nutrition and human metabolism. 4th edition. Belmont: Wadsworth publishing, 2005. p. 47.
ASMBS Bariatric Nutrition Guidelines. Agosto 2008. Fecha de consulta 8 de enero 2012. Disponible en: www.pamtremble. com/wp.../vitamin_and Nutrition_Guidelines.pdf.
Cassie S, Menezes C, Birch D, Shi X, Karmali S. Effect of preoperative weight loss in bariatric surgical patients: A sys- tematic review. Surg Obes Relat Dis. 2011;7:760-8. https://doi.org/10.1016/j.soard.2011.08.011
Colles S, Dixon J, Marks P, Strauss B, O'Brien P. Preopera- tive weight loss with a very-low-energy diet: Quantitation of changes in liver and abdominal fat by serial imaging. Am j Clin Nutr. 2006;84:304-11. https://doi.org/10.1093/ajcn/84.2.304
Livhits M, Mercado C, Yermilov I, Parikh J, Dutson E, Mehran A, et al. Does weight loss immediately before bariatric surgery improve outcomes? A systematic review. Surg Obes Relat Dis. 2009;5:713-21. https://doi.org/10.1016/j.soard.2009.08.014
Fris R. Preoperative low energy diet diminishes liver size. Obes Surg. 2004;14:1165-70. https://doi.org/10.1381/0960892042386977
Lewis M, Phillips M, Slavotinek J, Kow L, Thompson C, Toouli J. Change in liver size and fat content after treatment with Optifast® very low calorie diet. Obes Surg. 2006;16:697-701. https://doi.org/10.1381/096089206777346682
Craggs-Dino L. Medical nutrition therapy for gastroparesis. Bariatric and Metabolic Institute Cleveland Clinic Florida. Fecha de consulta: 20 de enero de 2012. Disponible en: http://my.clevelandclinic.org/Documents/Florida/Nutriton_Gastro-paresis_Manual_0509.pdf
Goldenberg L. Carbohydrate, fat, and protein: What do we know about the macronutrient composition of the diet following bariatric-surgery? Mayo 2008. Bariatric Times. Fecha de consulta: 19 de diciembre de 2011. Disponible en: http://bariatrictimes.com
Lim R, Blackburn G, Jones D. Benchmarking best practices in weight loss surgery. Curr Probl Surg. 2010;47:79-174. https://doi.org/10.1067/j.cpsurg.2009.11.003
Mechanick J, Kushner R, Sugerman H, González-Campoy M, Collazo-Clavell M, Spitz A, et al. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Medical guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Obesity. 2009;17:S1-70. https://doi.org/10.1038/oby.2009.28
Mechanick J, Kushner R, Sugerman H, González-Campoy M, Collazo-Clavell M, Spitz A, et al. American Association of Clinical Endocrinologist, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Medical guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Surg Obes and Relat Dis. 2008;4:S109-84.
Rubio M. Nutrición adaptada a diferentes técnicas de cirugía bariátrica. Nutr Clin Med. 2008;2:167-81.
Castellanos V, Linchford M, Campbell W. Modular protein supplements and their application for long term care. Nut Clin Pract. 2006;21:485. https://doi.org/10.1177/0115426506021005485
Clifton P, Keogh J. Metabolic effects of high protein diets. Curr Atheroscler Rep. 2007;9:472-8. https://doi.org/10.1007/s11883-007-0063-y
Veldhorst M, Nieurwenhuizen A, Hoschstenbach-Waelen A, van Vught AJ, Westerterp K, Engelen M, et al. Dose-dependent satiating effect of why relative to casein or soy. Phyisiol Behav. 2009;96:1647-54. https://doi.org/10.1016/j.physbeh.2009.01.004
Miller M, Choban P. Surgical management of obesity: Current state of procedure evolution and strategies to optimize outcomes. Nut Clin Pract. 2011;26:526-33. https://doi.org/10.1177/0884533611418336
Álvarez-Leite J. Nutrient deficiencies secondary to bariatric surgery. Curr Opin Clin Nutr Metab Care. 2004;7:569-75. https://doi.org/10.1097/00075197-200409000-00010
Malinowski S. Nutritional and metabolic complications of bariatric surgery. Am J Med Scie. 2006;331:219-25. https://doi.org/10.1097/00000441-200604000-00009
Malone M. Recommended nutritional supplements for bariatric surgery. Ann of Pharmacother. 2008;42:1851-7. https://doi.org/10.1345/aph.1L321
Faintuch J. Nutritional consequences of bariatric surgery. En: Sobotka L. Basics in clinical nutrition ESPEN. 4th edition. Prague: House Galen; 2011. p. 528-40.
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2013 Revista Colombiana de Cirugía
![Creative Commons License](http://i.creativecommons.org/l/by-nc-nd/4.0/88x31.png)
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
Todos los textos incluidos en la Revista Colombiana de Cirugía están protegidos por derechos de autor. Las opiniones expresadas en los artículos firmados son las de los autores y no coinciden necesariamente con las de los directores o los editores de la Revista Colombiana de Cirugía. Las sugerencias diagnósticas o terapéuticas como elección de productos, dosificación y métodos de empleo corresponden a la experiencia y al criterio de los autores.