BACKGROUND Obesity is a global health problem that is continuing to increase in the young population.In Brazil,the frequency of obesity in 2018 was 19.8%.Several comorbidities are directly associated with obesity,such...BACKGROUND Obesity is a global health problem that is continuing to increase in the young population.In Brazil,the frequency of obesity in 2018 was 19.8%.Several comorbidities are directly associated with obesity,such as non-alcoholic fatty liver disease(NAFLD),which is considered the most common liver disorder in Western countries and affects up to 46%of adults.Bariatric surgery is effective in treating obesity and can improve NAFLD;however,the effect of bariatric surgery on body composition,phase angle(PA),and improving NAFLD needs to be further studied.AIM To analyze the PA in the postoperative period of bariatric surgery and to correlate it with changes in body composition and liver disease.METHODS This study is a retrospective cohort study of the analysis of the medical records of patients undergoing bariatric surgery in a reference center of a teaching hospital in Porto Alegre over a 2-year period.Patients older than 18 years whose record contained all information relevant to the study were included.The data analyzed were body composition and PA through electrical bioimpedance and NAFLD through liver biopsy in the pre-and postoperative period.The level of significance adopted for the statistical analyses was 5%.RESULTS We evaluated 379 patients with preoperative data.Regarding PA,169 patients were analyzed,and 33 patients had liver biopsy pre-and postoperatively with NAFLD information.In total,79.4%were female,with a mean age of 39.1±10.6 years.The average body mass index(BMI)was 45.9±7.5 kg/m².The PA showed a mean of 5.8±0.62°in the preoperative period and a significant reduction in the postoperative period.A postoperative reduction in body composition data(skeletal muscle mass,fat percentage,fat mass,body cell mass,BMI and visceral fat area)was shown as well.Regarding liver disease,all patients presented a reduction in the degrees and stages of liver disease in the postoperative period,and some had no degree of liver disease at all.CONCLUSION PA decreased after bariatric surgery,with a direct correlation with weight loss and changes in body composition.The decrease in PA was not correlated with the improvement in NAFLD.展开更多
Substantial advances have been made in preoperative patient assessment,the reduction of postsurgical stress,and oral feeding recovery after surgery during the past few years.The use of“prehabilitation”protocols can ...Substantial advances have been made in preoperative patient assessment,the reduction of postsurgical stress,and oral feeding recovery after surgery during the past few years.The use of“prehabilitation”protocols can improve the preoperative nutritional status of patients,optimizing their body composition and increasing their physical performance.Within enhanced recovery protocols,early oral feeding is possible following the majority of surgical procedures.When oral intake is not adequate,the enteral route is the first choice to nourish surgical patients,since the gut has been identified as a major regulator of the postoperative inflammatory response.The perioperative supplementation of nutrients with specific metabolic effects and the early recovery of oral feeding following surgery reduce the postoperative morbidity and shorten the hospital stay.展开更多
文摘BACKGROUND Obesity is a global health problem that is continuing to increase in the young population.In Brazil,the frequency of obesity in 2018 was 19.8%.Several comorbidities are directly associated with obesity,such as non-alcoholic fatty liver disease(NAFLD),which is considered the most common liver disorder in Western countries and affects up to 46%of adults.Bariatric surgery is effective in treating obesity and can improve NAFLD;however,the effect of bariatric surgery on body composition,phase angle(PA),and improving NAFLD needs to be further studied.AIM To analyze the PA in the postoperative period of bariatric surgery and to correlate it with changes in body composition and liver disease.METHODS This study is a retrospective cohort study of the analysis of the medical records of patients undergoing bariatric surgery in a reference center of a teaching hospital in Porto Alegre over a 2-year period.Patients older than 18 years whose record contained all information relevant to the study were included.The data analyzed were body composition and PA through electrical bioimpedance and NAFLD through liver biopsy in the pre-and postoperative period.The level of significance adopted for the statistical analyses was 5%.RESULTS We evaluated 379 patients with preoperative data.Regarding PA,169 patients were analyzed,and 33 patients had liver biopsy pre-and postoperatively with NAFLD information.In total,79.4%were female,with a mean age of 39.1±10.6 years.The average body mass index(BMI)was 45.9±7.5 kg/m².The PA showed a mean of 5.8±0.62°in the preoperative period and a significant reduction in the postoperative period.A postoperative reduction in body composition data(skeletal muscle mass,fat percentage,fat mass,body cell mass,BMI and visceral fat area)was shown as well.Regarding liver disease,all patients presented a reduction in the degrees and stages of liver disease in the postoperative period,and some had no degree of liver disease at all.CONCLUSION PA decreased after bariatric surgery,with a direct correlation with weight loss and changes in body composition.The decrease in PA was not correlated with the improvement in NAFLD.
文摘Substantial advances have been made in preoperative patient assessment,the reduction of postsurgical stress,and oral feeding recovery after surgery during the past few years.The use of“prehabilitation”protocols can improve the preoperative nutritional status of patients,optimizing their body composition and increasing their physical performance.Within enhanced recovery protocols,early oral feeding is possible following the majority of surgical procedures.When oral intake is not adequate,the enteral route is the first choice to nourish surgical patients,since the gut has been identified as a major regulator of the postoperative inflammatory response.The perioperative supplementation of nutrients with specific metabolic effects and the early recovery of oral feeding following surgery reduce the postoperative morbidity and shorten the hospital stay.
