de Lima Karla Vanessa Gomes, Costa Maria José de Carvalho, Gonçalves Maria da Conceição Rodrigues, Sousa Bruno Soares
Arq Bras Cir Dig. 2013;26 Suppl 1:63-6. doi: 10.1590/s0102-67202013000600014.
Data already demonstrated the increased prevalence of obesity in various segments of the population. In this context, bariatric surgery is accepted nowadays as the most effective tool in the treatment and control of morbid obesity. Several studies have evaluated the nutritional status after bariatric surgery, especially mixed by detecting a reduction in food intake of protein, vitamins and minerals. However, other studies have investigated the presence of nutritional deficiencies prior to surgery, which may be aggravated by the surgical procedure, resulting in serious postoperative complications.
To analyze the literature in relationship to micronutrient deficiencies in obese patients before bariatric surgery.
Was carried out a systematic review in several electronic databases, such as PubMed/ Medline, Scielo, Lilacs and Bireme. The following keywords were used alone or in combination: bariatric surgery, obesity, preoperative, gastric bypass, vitamin deficiencies, deficiencies and mineral nutrient absorption. Were included 40 review and original articles published between 2005 to 2012.
There were consensus on the combination of preoperative nutritional deficiencies, restrictions and malabsorption, possibly induced by bariatric surgery that can lead patients to experience significant nutritional deficits during the late postoperative period, especially of micronutrients, resulting in serious complications.
The high occurrence of micronutrient deficiencies preoperatively detected in morbidly obese candidates for bariatric surgery, plus a malabsorptive procedure, may involve worse prognosis during the late postoperative period. Preoperative evaluation of nutritional parameters and food intake is recommended in conjunction with surgical interventions.
已有数据表明肥胖在不同人群中的患病率有所上升。在此背景下，如今减重手术被公认为治疗和控制病态肥胖最有效的手段。多项研究评估了减重手术后的营养状况，特别是通过检测蛋白质、维生素和矿物质的食物摄入量减少情况来综合评估。然而，其他研究调查了手术前营养缺乏的情况，而手术过程可能会使这些缺乏情况加重，从而导致严重的术后并发症。
分析与减重手术前肥胖患者微量营养素缺乏相关的文献。
在多个电子数据库中进行了系统综述，如PubMed/Medline、Scielo、Lilacs和Bireme。单独或组合使用了以下关键词：减重手术、肥胖、术前、胃旁路手术、维生素缺乏、营养素缺乏和矿物质吸收。纳入了2005年至2012年发表的40篇综述和原创文章。
对于术前营养缺乏、限制和吸收不良的综合情况存在共识，减重手术可能导致患者在术后晚期出现显著的营养缺乏，尤其是微量营养素缺乏，进而引发严重并发症。
在病态肥胖的减重手术候选者中术前检测到的微量营养素缺乏发生率较高，再加上吸收不良的手术过程，可能会导致术后晚期预后较差。建议在进行手术干预的同时对营养参数和食物摄入量进行术前评估。
