Skip to main content
Erschienen in: Obesity Surgery 8/2016

15.12.2015 | Original Contributions

Comparison of Preoperative Diets Before Bariatric Surgery: a Randomized, Single-Blinded, Non-inferiority Trial

verfasst von: Ruben Schouten, Inge van der Kaaden, Gerhard van ’t Hof, Pierre G. B. M. Feskens

Erschienen in: Obesity Surgery | Ausgabe 8/2016

Einloggen, um Zugang zu erhalten

Abstract

Objective

In order to increase weight loss and minimize complications, a preoperative diet before bariatric has been advocated. However, some diets are poorly tolerated by patients and this can lead to low compliance and too little weight loss. In this study, we aim to compare two preoperative diets in order to find the most suitable for this patient population.

Methods

Comparison of preoperative diets before bariatric surgery with a randomized non-inferiority trial in order to compare the standard very low calorie diet (VLCD) by protein shakes (Prodimed) with a standard diet using ordinary products. The primary outcome parameter was preoperative weight loss. Secondary outcome parameters were operation time, difficulty of surgery, short-term complications, short-term weight loss and compliance, tolerance, and acceptance of the diets.

Results

Two hundred twelve patients suitable for gastric bypass surgery were included and randomized. The Prodimed group contained 105 patients, the standard diet group 107 patients. Preoperative weight loss and 4 weeks after the procedure were not significantly different between the two diet groups. Operation time, difficulty of surgery, short-term complications, and short-term weight loss were also comparable without significant differences between the diet groups. However, most of the parameters measuring patients’ compliance, tolerance, and acceptance of the diets were significantly better in the standard diet group as compared to the patients in the Prodimed group.

Conclusion

Protein shakes and standard diets are capable of achieving good and comparable results on preoperative weight loss before bariatric surgery. However, patients’ compliance, tolerance, and acceptance were all significantly better after a standard diet. We recommend giving patients a choice in preoperative diets in order to achieve the best possible weight loss and results.
Literatur
2.
Zurück zum Zitat Peeters A, O’Brien PE, Laurie C, et al. Substantial intentional weight loss and mortality in the severely obese. Ann Surg. 2007;246:1028–33.CrossRefPubMed Peeters A, O’Brien PE, Laurie C, et al. Substantial intentional weight loss and mortality in the severely obese. Ann Surg. 2007;246:1028–33.CrossRefPubMed
3.
Zurück zum Zitat O’Brien PE, McPhail T, Chaston TB, et al. Systematic review of medium-term weight loss after bariatric operations. Obes Surg. 2006;16:1032–40.CrossRefPubMed O’Brien PE, McPhail T, Chaston TB, et al. Systematic review of medium-term weight loss after bariatric operations. Obes Surg. 2006;16:1032–40.CrossRefPubMed
4.
Zurück zum Zitat O’Brien PE, Dixon JB, Laurie C, et al. Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program: a randomized trial. Ann Intern Med. 2006;144:625–33.CrossRefPubMed O’Brien PE, Dixon JB, Laurie C, et al. Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program: a randomized trial. Ann Intern Med. 2006;144:625–33.CrossRefPubMed
5.
Zurück zum Zitat Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.CrossRefPubMed Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.CrossRefPubMed
6.
Zurück zum Zitat Karlsson J, Taft C, Ryden A, et al. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Int J Obes (Lond). 2007;31:1248–61.CrossRef Karlsson J, Taft C, Ryden A, et al. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Int J Obes (Lond). 2007;31:1248–61.CrossRef
8.
Zurück zum Zitat Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2008. Obes Surg. 2009;19:1605–11.CrossRefPubMed Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2008. Obes Surg. 2009;19:1605–11.CrossRefPubMed
9.
Zurück zum Zitat Picot J, Jones J, Colquitt JL, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13:1–190. 215–357, iii-iv.CrossRef Picot J, Jones J, Colquitt JL, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13:1–190. 215–357, iii-iv.CrossRef
10.
Zurück zum Zitat Cassie S, Menezes C, Birch DW, et al. Effect of preoperative weight loss in bariatric surgical patients: a systematic review. Surg Obes Relat Dis. 2011;7:760–7. discussion 767.CrossRefPubMed Cassie S, Menezes C, Birch DW, et al. Effect of preoperative weight loss in bariatric surgical patients: a systematic review. Surg Obes Relat Dis. 2011;7:760–7. discussion 767.CrossRefPubMed
11.
Zurück zum Zitat Van Nieuwenhove Y, Dambrauskas Z, Campillo-Soto A, et al. Preoperative very low-calorie diet and operative outcome after laparoscopic gastric bypass: a randomized multicenter study. Arch Surg. 2011;146:1300–5.CrossRefPubMed Van Nieuwenhove Y, Dambrauskas Z, Campillo-Soto A, et al. Preoperative very low-calorie diet and operative outcome after laparoscopic gastric bypass: a randomized multicenter study. Arch Surg. 2011;146:1300–5.CrossRefPubMed
12.
Zurück zum Zitat Alami RS, Morton JM, Schuster R, et al. Is there a benefit to preoperative weight loss in gastric bypass patients? A prospective randomized trial. Surg Obes Relat Dis. 2007;3:141–5. discussion 145–146.CrossRefPubMed Alami RS, Morton JM, Schuster R, et al. Is there a benefit to preoperative weight loss in gastric bypass patients? A prospective randomized trial. Surg Obes Relat Dis. 2007;3:141–5. discussion 145–146.CrossRefPubMed
13.
Zurück zum Zitat Schouten R, Japink D, Meesters B, et al. Systematic literature review of reoperations after gastric banding: is a stepwise approach justified? Surg Obes Relat Dis. 2011;7:99–109.CrossRefPubMed Schouten R, Japink D, Meesters B, et al. Systematic literature review of reoperations after gastric banding: is a stepwise approach justified? Surg Obes Relat Dis. 2011;7:99–109.CrossRefPubMed
14.
Zurück zum Zitat Schouten R, van Dielen FM, van Gemert WG, et al. Conversion of vertical banded gastroplasty to Roux-en-Y gastric bypass results in restoration of the positive effect on weight loss and co-morbidities: evaluation of 101 patients. Obes Surg. 2007;17:622–30.CrossRefPubMedPubMedCentral Schouten R, van Dielen FM, van Gemert WG, et al. Conversion of vertical banded gastroplasty to Roux-en-Y gastric bypass results in restoration of the positive effect on weight loss and co-morbidities: evaluation of 101 patients. Obes Surg. 2007;17:622–30.CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat van Gemert WG, van Wersch MM, Greve JW, et al. Revisional surgery after failed vertical banded gastroplasty: restoration of vertical banded gastroplasty or conversion to gastric bypass. Obes Surg. 1998;8:21–8.CrossRefPubMed van Gemert WG, van Wersch MM, Greve JW, et al. Revisional surgery after failed vertical banded gastroplasty: restoration of vertical banded gastroplasty or conversion to gastric bypass. Obes Surg. 1998;8:21–8.CrossRefPubMed
16.
Zurück zum Zitat Chapman AE, Kiroff G, Game P, et al. Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic literature review. Surgery. 2004;135:326–51.CrossRefPubMed Chapman AE, Kiroff G, Game P, et al. Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic literature review. Surgery. 2004;135:326–51.CrossRefPubMed
17.
Zurück zum Zitat Gonzalez-Perez J, Sanchez-Leenheer S, Delgado AR, et al. Clinical impact of a 6-week preoperative very low calorie diet on body weight and liver size in morbidly obese patients. Obes Surg. 2013;23:1624–31.CrossRefPubMed Gonzalez-Perez J, Sanchez-Leenheer S, Delgado AR, et al. Clinical impact of a 6-week preoperative very low calorie diet on body weight and liver size in morbidly obese patients. Obes Surg. 2013;23:1624–31.CrossRefPubMed
18.
Zurück zum Zitat Edholm D, Kullberg J, Haenni A, et al. Preoperative 4-week low-calorie diet reduces liver volume and intrahepatic fat, and facilitates laparoscopic gastric bypass in morbidly obese. Obes Surg. 2011;21:345–50.CrossRefPubMed Edholm D, Kullberg J, Haenni A, et al. Preoperative 4-week low-calorie diet reduces liver volume and intrahepatic fat, and facilitates laparoscopic gastric bypass in morbidly obese. Obes Surg. 2011;21:345–50.CrossRefPubMed
19.
Zurück zum Zitat Carbajo MA, Castro MJ, Kleinfinger S, et al. Effects of a balanced energy and high protein formula diet (Vegestart complet(R)) vs. low-calorie regular diet in morbid obese patients prior to bariatric surgery (laparoscopic single anastomosis gastric bypass): a prospective, double-blind randomized study. Nutr Hosp. 2010;25:939–48.PubMed Carbajo MA, Castro MJ, Kleinfinger S, et al. Effects of a balanced energy and high protein formula diet (Vegestart complet(R)) vs. low-calorie regular diet in morbid obese patients prior to bariatric surgery (laparoscopic single anastomosis gastric bypass): a prospective, double-blind randomized study. Nutr Hosp. 2010;25:939–48.PubMed
20.
Zurück zum Zitat Adrianzen Vargas M, Cassinello Fernandez N, Ortega SJ. Preoperative weight loss in patients with indication of bariatric surgery: which is the best method? Nutr Hosp. 2011;26:1227–30.PubMed Adrianzen Vargas M, Cassinello Fernandez N, Ortega SJ. Preoperative weight loss in patients with indication of bariatric surgery: which is the best method? Nutr Hosp. 2011;26:1227–30.PubMed
21.
Zurück zum Zitat Alger-Mayer S, Polimeni JM, Malone M. Preoperative weight loss as a predictor of long-term success following Roux-en-Y gastric bypass. Obes Surg. 2008;18:772–5.CrossRefPubMed Alger-Mayer S, Polimeni JM, Malone M. Preoperative weight loss as a predictor of long-term success following Roux-en-Y gastric bypass. Obes Surg. 2008;18:772–5.CrossRefPubMed
22.
Zurück zum Zitat Still CD, Benotti P, Wood GC, et al. Outcomes of preoperative weight loss in high-risk patients undergoing gastric bypass surgery. Arch Surg. 2007;142:994–8. discussion 999.CrossRefPubMed Still CD, Benotti P, Wood GC, et al. Outcomes of preoperative weight loss in high-risk patients undergoing gastric bypass surgery. Arch Surg. 2007;142:994–8. discussion 999.CrossRefPubMed
23.
Zurück zum Zitat Schouten R, Rijs CS, Bouvy ND, et al. A multicenter, randomized efficacy study of the EndoBarrier Gastrointestinal Liner for presurgical weight loss prior to bariatric surgery. Ann Surg. 2010;251:236–43.CrossRefPubMed Schouten R, Rijs CS, Bouvy ND, et al. A multicenter, randomized efficacy study of the EndoBarrier Gastrointestinal Liner for presurgical weight loss prior to bariatric surgery. Ann Surg. 2010;251:236–43.CrossRefPubMed
Metadaten
Titel
Comparison of Preoperative Diets Before Bariatric Surgery: a Randomized, Single-Blinded, Non-inferiority Trial
verfasst von
Ruben Schouten
Inge van der Kaaden
Gerhard van ’t Hof
Pierre G. B. M. Feskens
Publikationsdatum
15.12.2015
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 8/2016
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-015-1989-8

Weitere Artikel der Ausgabe 8/2016

Obesity Surgery 8/2016 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.