Surgery Department, Neuchâtel Hospital, 2000, Neuchâtel, Switzerland.
Unit of Visceral Surgery, Department of Surgery, Geneva University Hospital, 1205, Geneva, Switzerland.
Obes Surg. 2022 Oct;32(10):3375-3383. doi: 10.1007/s11695-022-06224-4. Epub 2022 Aug 1.
Return to a normal diet is a crucial step after bariatric surgery. Proximal anastomosis is a source of concern for early feeding as the passage of solid food through a recent anastomosis could well increase pressure and the risk of leakage. This study aims to assess the safety of an early normal diet after a laparoscopic Roux-en-Y gastric bypass (LRYGB).
All consecutive patients undergoing primary LRYGB between January 2015 and December 2020 were included prospectively. Three postoperative pureed diets were compared at 4 weeks, 2 weeks, and 1 week. All-cause morbidity at 90 days was the main outcome. Overall complications, severe complications (Clavien-Dindo ≥ grade 3a), length of hospital stay, number of emergency, and unplanned consultations during the 3 postoperative months were recorded for each group.
Three hundred and sixty-seven patients with a mean BMI of 42.10 kg/m (± SD: 4.78) were included. All-cause morbidity at 90 days was 11.7% (43/367) and no significant difference was observed between the 3 groups. Adjustment for patients and operative cofounders did not demonstrate any increased risk of postoperative complications between the 3 groups, with an odds ratio of 1, 1.23(95% CI [0. 55-2.75]), and 1.14 (95% CI [0.49, 2.67]) for groups 1, 2, and 3 respectively. Severe complications (Clavien-Dindo ≥ grade 3a) and emergency or unplanned consultations were also similar in the 3 groups.
Return to a normal diet 1 week after LRYGB did not increase short-term morbidity and unplanned consultations. It may be safe and contribute to patient comfort.
减重手术后恢复正常饮食是一个关键步骤。近端吻合口是早期喂养的关注点，因为固体食物通过最近的吻合口可能会增加压力和渗漏的风险。本研究旨在评估腹腔镜 Roux-en-Y 胃旁路术（LRYGB）后早期正常饮食的安全性。
所有 2015 年 1 月至 2020 年 12 月期间接受初次 LRYGB 的连续患者均前瞻性纳入研究。术后 4 周、2 周和 1 周时比较了 3 种术后纯饮食。90 天的全因发病率是主要结局。记录每组的总并发症、严重并发症（Clavien-Dindo≥3a 级）、住院时间、急诊次数和术后 3 个月内的非计划就诊次数。
共纳入 367 例 BMI 平均为 42.10kg/m（±SD：4.78）的患者。90 天的全因发病率为 11.7%（43/367），3 组间无显著差异。对患者和手术混杂因素进行调整后，3 组间术后并发症的风险无显著增加，优势比分别为 1、1.23（95%CI[0.55-2.75]）和 1.14（95%CI[0.49-2.67]）。3 组间严重并发症（Clavien-Dindo≥3a 级）和急诊或非计划就诊也相似。
LRYGB 后 1 周恢复正常饮食不会增加短期发病率和非计划就诊次数。它可能是安全的，并有助于患者的舒适度。
