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Erschienen in: World Journal of Surgery 7/2022

28.03.2022 | Original Scientific Report

Anemia After Sleeve Gastrectomy and One-Anastomosis Gastric Bypass: An Investigation Based on the Tehran Obesity Treatment Study (TOTS)

verfasst von: Maryam Barzin, Erfan Tasdighi, Amir Ebadinejad, Alireza Khalaj, Maryam Mahdavi, Majid Valizadeh, Farhad Hosseinpanah

Erschienen in: World Journal of Surgery | Ausgabe 7/2022

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Abstract

Background

Bariatric surgery has been associated with iron, folate, and vitamin B12 deficiencies, which can lead to anemia. This study compares the incidence of anemia between sleeve gastrectomy (SG) and one-anastomosis gastric bypass (OAGB).

Methods

Patients from a prospectively collected database of patients with morbid obesity undergoing a primary bariatric procedure from April 2013 to September 2018 were included. Statistical analysis was performed using the general estimation equation. Patients were followed for 6, 12, 24, and 36 months post-surgery.

Results

The present study included 2618 patients, of whom 72.3% underwent SG and 27.6% underwent OAGB. The majority of the study population were women (75.7%), and the mean age of the participants was 39.5 ± 11.7 years. At the end of the follow-up, the excess weight loss percentage was 66.15 in the SG group and 75.41 in the OAGB group (P <  0.05). The incidence of anemia at 12-, 24-, and 36-month was 16.2, 19.7, and 24.3% in the SG group and 28.4, 37.6, and 56.5% in the OAGB group, showing significantly higher incidence in the OAGB than the SG group (\(P_{\text{between groups}}\) < 0.001). However, there was no significant difference between the SG and OAGB groups regarding the incidence of iron and vitamin B12 deficiency.

Conclusions

The patients undergoing bariatric surgery, especially OAGB, should be closely monitored post-surgery regarding the incidence of anemia, and supplementation in developing countries could be continued even after the first year.
Literatur
1.
Zurück zum Zitat Colquitt JL, Pickett K, Loveman E, Frampton GK (2018) Surgery for weight loss in adults. Cochrane Database Syst Rev, (8) Colquitt JL, Pickett K, Loveman E, Frampton GK (2018) Surgery for weight loss in adults. Cochrane Database Syst Rev, (8)
2.
Zurück zum Zitat Wiggins T, Guidozzi N, Welbourn R, Ahmed AR, Markar SR (2021) Association of bariatric surgery with all-cause mortality and incidence of obesity-related disease at a population level: a systematic review and meta-analysis. PLoS med 17(7):e1003206CrossRef Wiggins T, Guidozzi N, Welbourn R, Ahmed AR, Markar SR (2021) Association of bariatric surgery with all-cause mortality and incidence of obesity-related disease at a population level: a systematic review and meta-analysis. PLoS med 17(7):e1003206CrossRef
3.
Zurück zum Zitat Spaniolas K, Kasten KR, Brinkley J, Sippey ME, Mozer A, Chapman WH et al (2015) The changing bariatric surgery landscape in the USA. Obes Surg 25(8):1544–1546CrossRefPubMed Spaniolas K, Kasten KR, Brinkley J, Sippey ME, Mozer A, Chapman WH et al (2015) The changing bariatric surgery landscape in the USA. Obes Surg 25(8):1544–1546CrossRefPubMed
4.
Zurück zum Zitat Qi L, Guo Y, Liu CQ, Huang ZP, Sheng Y, Zou DJ (2017) Effects of bariatric surgery on glycemic and lipid metabolism, surgical complication and quality of life in adolescents with obesity: a systematic review and meta-analysis. Surg Obes Relat Dis Off J Am Soc Bariatr Surg 13(12):2037–2055CrossRef Qi L, Guo Y, Liu CQ, Huang ZP, Sheng Y, Zou DJ (2017) Effects of bariatric surgery on glycemic and lipid metabolism, surgical complication and quality of life in adolescents with obesity: a systematic review and meta-analysis. Surg Obes Relat Dis Off J Am Soc Bariatr Surg 13(12):2037–2055CrossRef
5.
Zurück zum Zitat Weng TC, Chang CH, Dong YH, Chang YC, Chuang LM (2015) Anaemia and related nutrient deficiencies after Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis. BMJ open 5(7):e006964CrossRefPubMedPubMedCentral Weng TC, Chang CH, Dong YH, Chang YC, Chuang LM (2015) Anaemia and related nutrient deficiencies after Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis. BMJ open 5(7):e006964CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Angrisani L, Santonicola A, Iovino P, Vitiello A, Higa K, Himpens J et al (2018) IFSO Worldwide Survey 2016: primary, endoluminal, and revisional procedures. Obes Surg 28(12):3783–3794CrossRefPubMed Angrisani L, Santonicola A, Iovino P, Vitiello A, Higa K, Himpens J et al (2018) IFSO Worldwide Survey 2016: primary, endoluminal, and revisional procedures. Obes Surg 28(12):3783–3794CrossRefPubMed
8.
9.
Zurück zum Zitat Lewis C-A, de Jersey S, Seymour M, Hopkins G, Hickman I, Osland E (2020) Iron vitamin B 12, folate and copper deficiency after bariatric surgery and the impact on anaemia: a systematic review. Obes Surg 30:1–50CrossRef Lewis C-A, de Jersey S, Seymour M, Hopkins G, Hickman I, Osland E (2020) Iron vitamin B 12, folate and copper deficiency after bariatric surgery and the impact on anaemia: a systematic review. Obes Surg 30:1–50CrossRef
10.
Zurück zum Zitat Kular KS, Manchanda N, Rutledge R (2014) Analysis of the five-year outcomes of sleeve gastrectomy and mini gastric bypass: a report from the Indian sub-continent. Obes Surg 24(10):1724–1728CrossRefPubMed Kular KS, Manchanda N, Rutledge R (2014) Analysis of the five-year outcomes of sleeve gastrectomy and mini gastric bypass: a report from the Indian sub-continent. Obes Surg 24(10):1724–1728CrossRefPubMed
11.
Zurück zum Zitat Jammu GS, Sharma R (2016) A 7-year clinical audit of 1107 cases comparing sleeve gastrectomy, Roux-En-Y gastric bypass, and mini-gastric bypass, to determine an effective and safe bariatric and metabolic procedure. Obes Surg 26(5):926–932CrossRefPubMed Jammu GS, Sharma R (2016) A 7-year clinical audit of 1107 cases comparing sleeve gastrectomy, Roux-En-Y gastric bypass, and mini-gastric bypass, to determine an effective and safe bariatric and metabolic procedure. Obes Surg 26(5):926–932CrossRefPubMed
12.
Zurück zum Zitat Barzin M, Hosseinpanah F, Motamedi MA, Shapoori P, Arian P, Daneshpour MA et al (2016) Bariatric surgery for morbid obesity: Tehran obesity treatment study (TOTS) rationale and study design. JMIR Res Protoc 5(1):e8CrossRefPubMedPubMedCentral Barzin M, Hosseinpanah F, Motamedi MA, Shapoori P, Arian P, Daneshpour MA et al (2016) Bariatric surgery for morbid obesity: Tehran obesity treatment study (TOTS) rationale and study design. JMIR Res Protoc 5(1):e8CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Parrott J, Frank L, Rabena R, Craggs-Dino L, Isom KA, Greiman L (2017) American society for metabolic and bariatric surgery integrated health nutritional guidelines for the surgical weight loss patient 2016 update: micronutrients. Surg Obes Relat Dis Off J Am Soc Bariatr Surg 13(5):727–741CrossRef Parrott J, Frank L, Rabena R, Craggs-Dino L, Isom KA, Greiman L (2017) American society for metabolic and bariatric surgery integrated health nutritional guidelines for the surgical weight loss patient 2016 update: micronutrients. Surg Obes Relat Dis Off J Am Soc Bariatr Surg 13(5):727–741CrossRef
15.
Zurück zum Zitat Enani G, Bilgic E, Lebedeva E, Delisle M, Vergis A, Hardy K (2020) The incidence of iron deficiency anemia post-Roux-en-Y gastric bypass and sleeve gastrectomy: a systematic review. Surg Endosc 34(7):3002–3010CrossRefPubMed Enani G, Bilgic E, Lebedeva E, Delisle M, Vergis A, Hardy K (2020) The incidence of iron deficiency anemia post-Roux-en-Y gastric bypass and sleeve gastrectomy: a systematic review. Surg Endosc 34(7):3002–3010CrossRefPubMed
16.
Zurück zum Zitat Baksi A, Kamtam DN, Aggarwal S, Ahuja V, Kashyap L, Shende DR (2020) Should surveillance endoscopy be routine after one anastomosis gastric bypass to detect marginal ulcers: initial outcomes in a tertiary referral centre. Obes Surg 30:1–7CrossRef Baksi A, Kamtam DN, Aggarwal S, Ahuja V, Kashyap L, Shende DR (2020) Should surveillance endoscopy be routine after one anastomosis gastric bypass to detect marginal ulcers: initial outcomes in a tertiary referral centre. Obes Surg 30:1–7CrossRef
17.
Zurück zum Zitat Robert M, Espalieu P, Pelascini E, Caiazzo R, Sterkers A, Khamphommala L et al (2019) Efficacy and safety of one anastomosis gastric bypass versus Roux-en-Y gastric bypass for obesity (YOMEGA): a multicentre, randomised, open-label, non-inferiority trial. Lancet 393(10178):1299–1309CrossRefPubMed Robert M, Espalieu P, Pelascini E, Caiazzo R, Sterkers A, Khamphommala L et al (2019) Efficacy and safety of one anastomosis gastric bypass versus Roux-en-Y gastric bypass for obesity (YOMEGA): a multicentre, randomised, open-label, non-inferiority trial. Lancet 393(10178):1299–1309CrossRefPubMed
19.
Zurück zum Zitat Aarts EO, Janssen IM, Berends FJ (2011) The gastric sleeve: losing weight as fast as micronutrients? Obes Surg 21(2):207–211CrossRefPubMed Aarts EO, Janssen IM, Berends FJ (2011) The gastric sleeve: losing weight as fast as micronutrients? Obes Surg 21(2):207–211CrossRefPubMed
20.
Zurück zum Zitat Alexandrou A, Armeni E, Kouskouni E, Tsoka E, Diamantis T, Lambrinoudaki I (2014) Cross-sectional long-term micronutrient deficiencies after sleeve gastrectomy versus Roux-en-Y gastric bypass: a pilot study. Surg Obes Relat Dis 10(2):262–268CrossRefPubMed Alexandrou A, Armeni E, Kouskouni E, Tsoka E, Diamantis T, Lambrinoudaki I (2014) Cross-sectional long-term micronutrient deficiencies after sleeve gastrectomy versus Roux-en-Y gastric bypass: a pilot study. Surg Obes Relat Dis 10(2):262–268CrossRefPubMed
21.
Zurück zum Zitat Saif T, Strain GW, Dakin G, Gagner M, Costa R, Pomp A (2012) Evaluation of nutrient status after laparoscopic sleeve gastrectomy 1, 3, and 5 years after surgery. Surg Obes Relat Dis 8(5):542–547CrossRefPubMedPubMedCentral Saif T, Strain GW, Dakin G, Gagner M, Costa R, Pomp A (2012) Evaluation of nutrient status after laparoscopic sleeve gastrectomy 1, 3, and 5 years after surgery. Surg Obes Relat Dis 8(5):542–547CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Moizé V, Andreu A, Flores L, Torres F, Ibarzabal A, Delgado S et al (2013) Long-term dietary intake and nutritional deficiencies following sleeve gastrectomy or Roux-En-Y gastric bypass in a mediterranean population. J Acad Nutr Diet 113(3):400–410CrossRefPubMed Moizé V, Andreu A, Flores L, Torres F, Ibarzabal A, Delgado S et al (2013) Long-term dietary intake and nutritional deficiencies following sleeve gastrectomy or Roux-En-Y gastric bypass in a mediterranean population. J Acad Nutr Diet 113(3):400–410CrossRefPubMed
23.
Zurück zum Zitat Hood MM, Corsica J, Bradley L, Wilson R, Chirinos DA, Vivo A (2016) Managing severe obesity: understanding and improving treatment adherence in bariatric surgery. J Behav Med 39(6):1092–1103CrossRefPubMed Hood MM, Corsica J, Bradley L, Wilson R, Chirinos DA, Vivo A (2016) Managing severe obesity: understanding and improving treatment adherence in bariatric surgery. J Behav Med 39(6):1092–1103CrossRefPubMed
24.
Zurück zum Zitat Behrns KE, Smith CD, Sarr MG (1994) Prospective evaluation of gastric acid secretion and cobalamin absorption following gastric bypass for clinically severe obesity. Dig Dis Sci 39(2):315–320CrossRefPubMed Behrns KE, Smith CD, Sarr MG (1994) Prospective evaluation of gastric acid secretion and cobalamin absorption following gastric bypass for clinically severe obesity. Dig Dis Sci 39(2):315–320CrossRefPubMed
25.
Zurück zum Zitat Spak E, Björklund P, Helander HF, Vieth M, Olbers T, Casselbrant A et al (2010) Changes in the mucosa of the Roux-limb after gastric bypass surgery. Histopathology 57(5):680–688CrossRefPubMed Spak E, Björklund P, Helander HF, Vieth M, Olbers T, Casselbrant A et al (2010) Changes in the mucosa of the Roux-limb after gastric bypass surgery. Histopathology 57(5):680–688CrossRefPubMed
26.
Zurück zum Zitat Jedamzik J, Eilenberg M, Felsenreich DM, Krebs M, Ranzenberger-Haider T, Langer FB et al (2020) Impact of limb length on nutritional status in one-anastomosis gastric bypass: 3-year results. Surg Obes Relat Dis 16(4):476–484CrossRefPubMed Jedamzik J, Eilenberg M, Felsenreich DM, Krebs M, Ranzenberger-Haider T, Langer FB et al (2020) Impact of limb length on nutritional status in one-anastomosis gastric bypass: 3-year results. Surg Obes Relat Dis 16(4):476–484CrossRefPubMed
28.
Zurück zum Zitat Lakhani SV, Shah HN, Alexander K, Finelli FC, Kirkpatrick JR, Koch TR (2008) Small intestinal bacterial overgrowth and thiamine deficiency after Roux-en-Y gastric bypass surgery in obese patients. Nutr Res 28(5):293–298CrossRefPubMed Lakhani SV, Shah HN, Alexander K, Finelli FC, Kirkpatrick JR, Koch TR (2008) Small intestinal bacterial overgrowth and thiamine deficiency after Roux-en-Y gastric bypass surgery in obese patients. Nutr Res 28(5):293–298CrossRefPubMed
29.
Zurück zum Zitat Majumder S, Soriano J, Cruz AL, Dasanu CA (2013) Vitamin B12 deficiency in patients undergoing bariatric surgery: preventive strategies and key recommendations. Surg Obes Relat Dis 9(6):1013–1019CrossRefPubMed Majumder S, Soriano J, Cruz AL, Dasanu CA (2013) Vitamin B12 deficiency in patients undergoing bariatric surgery: preventive strategies and key recommendations. Surg Obes Relat Dis 9(6):1013–1019CrossRefPubMed
30.
Zurück zum Zitat Mechanick JI, Apovian C, Brethauer S, Garvey WT, Joffe AM, Kim J et al (2019) clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures-2019 update: cosponsored by american association of clinical endocrinologists/american college of endocrinology, the obesity society, american society for metabolic & bariatric surgery, obesity medicine association, and american society of anesthesiologists-executive summary. Endocr Pract Off J Am Coll Endocrinol Am Assoc Clin Endocrinol 25(12):1346–1359 Mechanick JI, Apovian C, Brethauer S, Garvey WT, Joffe AM, Kim J et al (2019) clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures-2019 update: cosponsored by american association of clinical endocrinologists/american college of endocrinology, the obesity society, american society for metabolic & bariatric surgery, obesity medicine association, and american society of anesthesiologists-executive summary. Endocr Pract Off J Am Coll Endocrinol Am Assoc Clin Endocrinol 25(12):1346–1359
31.
Zurück zum Zitat Ben-Porat T, Elazary R, Goldenshluger A, Dagan SS, Mintz Y, Weiss R (2017) Nutritional deficiencies four years after laparoscopic sleeve gastrectomy—are supplements required for a lifetime? Sur Obes Relat Dis 13(7):1138–1144CrossRef Ben-Porat T, Elazary R, Goldenshluger A, Dagan SS, Mintz Y, Weiss R (2017) Nutritional deficiencies four years after laparoscopic sleeve gastrectomy—are supplements required for a lifetime? Sur Obes Relat Dis 13(7):1138–1144CrossRef
Metadaten
Titel
Anemia After Sleeve Gastrectomy and One-Anastomosis Gastric Bypass: An Investigation Based on the Tehran Obesity Treatment Study (TOTS)
verfasst von
Maryam Barzin
Erfan Tasdighi
Amir Ebadinejad
Alireza Khalaj
Maryam Mahdavi
Majid Valizadeh
Farhad Hosseinpanah
Publikationsdatum
28.03.2022
Verlag
Springer International Publishing
Erschienen in
World Journal of Surgery / Ausgabe 7/2022
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-022-06528-7

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