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Effect of Parenteral Nutrition on Nutrition Status After Bariatric Surgery for Morbid Obesity

M. A. Martínez Olmos, MD^*, M. J. Martínez Vázquez, PharmD, PhD, M. J. Morales Gorría, MD^*, P. Parada González, MD, PhD, I. Otero Martínez, MD, I. Maruri Chimeno, MD, E. Pena González, MD^*, M. T. Inaraja Bobo, PharmD, PhD and J. E. Casal Núñez, MD, PhD

From ^* Endocrinology and Nutrition, Hospital Pharmacy, and General Surgery, Hospital do Meixoeiro, Complejo Hospitalario Universitario de Vigo, Spain

Correspondence: M. A. Martínez Olmos, Endocrinología y Nutrición, Hospital do Meixoeiro, Cno Meixoeiro S/N, 36.200 Vigo (Pontevedra), Spain. Electronic mail may be sent to miguel.angel.martinez.olmos{at}sergas.es.

Background: To evaluate the influence of nutrition support (parenteral nutrition [PN] vs no parenteral nutrition [nPN]) on nutrition outcome, complications, and hospital stay after bariatric surgery (BS). Methods: Sixty-seven consecutive BS patients (17 gastric bypass and 50 biliopancreatic diversion). The first 38 received PN and the next 29 did not (nPN) during the fasting postoperative (PO) period. In both groups, after fasting, a progressive oral diet was introduced. Data related to nutrition status, perioperative complications, and postsurgical hospital stay were compared. Results: Sixty-seven patients (58 women), mean age 39.4 ± 11.0 years, body mass index (BMI) 50.7 ± 6.1 kg/m², were included. Thirty-eight patients received PN during 8.7 ± 2.6 days. Ingestion was initiated at a median 8 PO days in PN vs 6.5 PO days in nPN (p < .04). No significant differences between groups were found in age, final fasting serum albumin (SA), and 30 days postoperative SA, with a similar weight loss. Nonsignificant differences were found in non–catheter-related infectious complications, being mainly urinary tract infections. Catheter-related infections were present in 21.1% in the PN group and 13.8% in the nPN (p= .33). Median hospital stay after surgery was 14 ± 10 days in PN and 12 ± 10 days in nPN (p = .003). Conclusions: (1) Nutrition status after BS PO and 30 days postsurgery was no different between PN and nPN. (2) Postsurgery hospital stay was significantly decreased in the nPN group, without a greater incidence of complications. (3) According to nutrition outcome, PN seems unnecessary at the perioperative period in BS unless there are other postsurgical complications.

Journal of Parenteral and Enteral Nutrition, Vol. 29, No. 6, 445-450 (2005)
DOI: 10.1177/0148607105029006445


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