Tags

Type your tag names separated by a space and hit enter

Anemia, iron and vitamin B12 deficiencies after sleeve gastrectomy compared to Roux-en-Y gastric bypass: a meta-analysis.

Abstract

BACKGROUND

The effective treatment of postoperative anemia and nutritional deficiencies is critical for the successful management of bariatric patients. However, the evidence for nutritional risk or support of bariatric patients remains scarce. The aims of this study were to assess current evidence of the association between 2 methods of bariatric surgery, sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), and postoperative anemia and nutritional deficiencies.

METHODS

MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for English-language studies using a list of keywords. Reference lists from relevant review articles were also searched. In the authors' meta-analysis, they included studies with a duration of>12 months, those comparing SG with RYGB, and those with available outcome data for postoperative anemia and iron and vitamin B12 deficiencies. Of 36 potentially relevant studies, 9 met the inclusion criteria. Data were combined by means of a fixed-effects model or random-effects model.

RESULTS

Compared with the SG group, the odds ratio for postoperative vitamin B12 deficiency in the RYGB group was 3.55 (95% confidence interval, 1.26-10.01; P<.001). In the subgroup analysis, studies in which prophylactic iron or vitamin B12 was administered lost significance in the odds ratio for postoperative vitamin B12 deficiency.

CONCLUSION

The authors' findings suggest that SG is more beneficial than RYGB with regard to postoperative vitamin B12 deficiency risk, whereas the 2 methods are comparable with regard to the risk of postoperative anemia and iron deficiency. Postoperative prophylactic iron and B12 supplementation, in addition to general multivitamin and mineral supplementation, is recommended based on the comparable deficiency risk of the 2 methods as indicated by subgroup analysis.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Division of Upper Gastrointestinal Surgery, Department of Surgery, Korea University College of Medicine, Seoul, Korea.

    ,

    Institute for Evidence-based Medicine, The Korean Branch of Australasian Cochrane Center, Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.

    ,

    Bariatric and Metabolic Institute, Section of Minimally Invasive Surgery, Cleveland Clinic Florida, Weston, Florida.

    ,

    Division of Upper Gastrointestinal Surgery, Department of Surgery, Korea University College of Medicine, Seoul, Korea. Electronic address: kugspss@korea.ac.kr.

    ,

    Bariatric and Metabolic Institute, Section of Minimally Invasive Surgery, Cleveland Clinic Florida, Weston, Florida.

    Bariatric and Metabolic Institute, Section of Minimally Invasive Surgery, Cleveland Clinic Florida, Weston, Florida.

    Source

    MeSH

    Anemia, Iron-Deficiency
    Gastrectomy
    Gastric Bypass
    Humans
    Obesity, Morbid
    Vitamin B 12 Deficiency

    Pub Type(s)

    Comparative Study
    Journal Article
    Meta-Analysis

    Language

    eng

    PubMed ID

    24582411

    Citation

    Kwon, Yeongkeun, et al. "Anemia, Iron and Vitamin B12 Deficiencies After Sleeve Gastrectomy Compared to Roux-en-Y Gastric Bypass: a Meta-analysis." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 10, no. 4, 2014, pp. 589-97.
    Kwon Y, Kim HJ, Lo Menzo E, et al. Anemia, iron and vitamin B12 deficiencies after sleeve gastrectomy compared to Roux-en-Y gastric bypass: a meta-analysis. Surg Obes Relat Dis. 2014;10(4):589-97.
    Kwon, Y., Kim, H. J., Lo Menzo, E., Park, S., Szomstein, S., & Rosenthal, R. J. (2014). Anemia, iron and vitamin B12 deficiencies after sleeve gastrectomy compared to Roux-en-Y gastric bypass: a meta-analysis. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 10(4), pp. 589-97. doi:10.1016/j.soard.2013.12.005.
    Kwon Y, et al. Anemia, Iron and Vitamin B12 Deficiencies After Sleeve Gastrectomy Compared to Roux-en-Y Gastric Bypass: a Meta-analysis. Surg Obes Relat Dis. 2014;10(4):589-97. PubMed PMID: 24582411.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Anemia, iron and vitamin B12 deficiencies after sleeve gastrectomy compared to Roux-en-Y gastric bypass: a meta-analysis. AU - Kwon,Yeongkeun, AU - Kim,Hyun Jung, AU - Lo Menzo,Emanuele, AU - Park,Sungsoo, AU - Szomstein,Samuel, AU - Rosenthal,Raul J, Y1 - 2013/12/17/ PY - 2013/09/13/received PY - 2013/11/22/revised PY - 2013/12/09/accepted PY - 2014/3/4/entrez PY - 2014/3/4/pubmed PY - 2015/5/29/medline KW - Anemia KW - Iron KW - Roux-en-Y gastric bypass KW - Sleeve gastrectomy KW - Vitamin B(12) SP - 589 EP - 97 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 10 IS - 4 N2 - BACKGROUND: The effective treatment of postoperative anemia and nutritional deficiencies is critical for the successful management of bariatric patients. However, the evidence for nutritional risk or support of bariatric patients remains scarce. The aims of this study were to assess current evidence of the association between 2 methods of bariatric surgery, sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), and postoperative anemia and nutritional deficiencies. METHODS: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for English-language studies using a list of keywords. Reference lists from relevant review articles were also searched. In the authors' meta-analysis, they included studies with a duration of>12 months, those comparing SG with RYGB, and those with available outcome data for postoperative anemia and iron and vitamin B12 deficiencies. Of 36 potentially relevant studies, 9 met the inclusion criteria. Data were combined by means of a fixed-effects model or random-effects model. RESULTS: Compared with the SG group, the odds ratio for postoperative vitamin B12 deficiency in the RYGB group was 3.55 (95% confidence interval, 1.26-10.01; P<.001). In the subgroup analysis, studies in which prophylactic iron or vitamin B12 was administered lost significance in the odds ratio for postoperative vitamin B12 deficiency. CONCLUSION: The authors' findings suggest that SG is more beneficial than RYGB with regard to postoperative vitamin B12 deficiency risk, whereas the 2 methods are comparable with regard to the risk of postoperative anemia and iron deficiency. Postoperative prophylactic iron and B12 supplementation, in addition to general multivitamin and mineral supplementation, is recommended based on the comparable deficiency risk of the 2 methods as indicated by subgroup analysis. SN - 1878-7533 UR - https://www.unboundmedicine.com/medline/citation/24582411/Anemia_iron_and_vitamin_B12_deficiencies_after_sleeve_gastrectomy_compared_to_Roux_en_Y_gastric_bypass:_a_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(13)00399-7 DB - PRIME DP - Unbound Medicine ER -