Ruiz-Tovar Jaime, Llavero Carolina, Zubiaga Lorea, Boix Evangelina
Department of Surgery, Bariatric Surgery Unit, University Hospital Rey Juan Carlos, Madrid, Spain.
Department of Surgical Nursery, Hospital Sureste, Madrid, Spain.
Obes Surg. 2016 Oct;26(10):2324-30. doi: 10.1007/s11695-016-2084-5.
After all bariatric procedures, multivitamin supplements are uniformly prescribed to minimize eventual deficiencies. These supplements are usually maintained long time, even during the whole life after malabsorptive techniques, while these are maintained at least during 1 year after restrictive procedures. Given that sleeve gastrectomy does not alter intestinal absorption, the supplements are possibly unnecessary, once the patient can take an adequate diet.
A prospective randomized study of patients undergoing a laparoscopic sleeve gastrectomy was performed. Patients were randomized into two groups: those patients receiving the multivitamin supplement (Multicentrum, Pfizer, 1 tablet/day) during 3 months (group 1) and those receiving the supplement during 12 months (group 2). Laboratory data were recorded: vitamins (D, B12 and folic acid) and oligoelements (calcium, iron, phosphorus, magnesium and zinc) at 3, 6 and 12 months after surgery.
Eighty patients were included, 40 in each group. At 3 months, 7.5 % of the patients presented iron deficiency and 2.5 % ferritin one, similarly in both groups, that was corrected with specific extra iron supplements. At 6 months, one patient (2.5 %) in group 1 presented iron deficiency and one in group 2 vitamin D deficiency (NS). At 12 months, only one patient in group 2 presented vitamin D deficiency, treated with specific supplements.
The maintenance of multivitamin supplements more than 3 months postoperatively seems to be of no benefit. It is preferable monitoring laboratory values and adding specific supplements when necessary. CLINICALTRIALS.
NCT02620137.
在所有减肥手术后，都会统一开具多种维生素补充剂，以尽量减少最终出现的营养缺乏。这些补充剂通常需要长期服用，在采用吸收不良技术后的一生中都要服用，而在采用限制性手术的情况下，至少要服用1年。鉴于袖状胃切除术不会改变肠道吸收，一旦患者能够摄入充足的饮食，补充剂可能就没有必要了。
对接受腹腔镜袖状胃切除术的患者进行了一项前瞻性随机研究。患者被随机分为两组：一组患者在3个月内服用多种维生素补充剂（Multicentrum，辉瑞公司，每日1片）（第1组），另一组患者在12个月内服用补充剂（第2组）。记录实验室数据：术后3、6和12个月时的维生素（D、B12和叶酸）和微量元素（钙、铁、磷、镁和锌）。
共纳入80例患者，每组40例。3个月时，两组患者中均有7.5%出现缺铁，2.5%出现铁蛋白缺乏，通过额外补充特定的铁剂得以纠正。6个月时，第1组有1例患者（2.5%）出现缺铁，第2组有1例患者出现维生素D缺乏（无统计学差异）。12个月时，只有第2组的1例患者出现维生素D缺乏，通过补充特定的补充剂进行治疗。
术后服用多种维生素补充剂超过3个月似乎没有益处。最好监测实验室值，并在必要时添加特定的补充剂。临床试验。
NCT02620137。
