Current nutrition management of patients undergoing bariatric surgery
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摘要
The evolution of surgical modalities for the treatment of morbidly obesity will likely continue during the next decade. As a result, the anesthesiologist will likely find him or herself managing the bariatric patient. Because of the complexity of bariatric procedures, as well as the unique challenges in managing this population, it is imperative that all anesthesiologists familiarize themselves with this subspecialty so that optimal anesthesia care can be delivered. The care of the morbidly obese patient requires preparation, diligence, and vigilance; however, as with all new and developing fields in medicine, the anesthesiologist will be greatly rewarded in this new arena in anesthesiology.

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Surgery for Obesity and Related Diseases

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Surgery for Obesity and Related DiseasesVolume 4, Issue 2March-April 2008, Pages 144-149
Alessandro de Moura Almeida, Helma Pinchemel Cotrim, Adimeia Souza Santos, Almir Galvão Vieira Bitencourt, Daniel Batista Valente Barbosa, Ana Piedade Lobo, Adriano Rios, Erivaldo Alves

Abstract
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class="h4">Background

Obesity has been shown to be an important risk factor for several gastrointestinal diseases. However, the indication for preoperative upper gastrointestinal endoscopy (UGE) for all patients before bariatric surgery is controversial. The aim of the present study was to evaluate the spectrum of gastrointestinal diseases detected during preoperative UGE in patients undergoing bariatric surgery and the relevance of this procedure.

class="h4">Methods

<p>A series of severely obese patients, who had undergone UGE before Roux-en-pan style='font-family : sans-serif'>Ypan> gastric bypass from October 2004 to May 2005 were consecutively enrolled in this study. The demographic and clinical data and endoscopic diagnoses were evaluated. Gastric biopsies were performed in elective patients according to the endoscopic findings.

class="h4">Results

<p>The study included 162 patients, 69.8%of whom were women. The mean age was 36.7 ± 10.8 years. Abnormal findings were observed in 77.2%of patients. Esophagitis was present in 38.9%, gastritis in 51.2%(erosive gastritis in 49.3%and nonerosive gastritis in 50.7%), gastric ulcers in 1.9%, hiatal hernia, in 8.6%, gastric polyp in .6%, and duodenitis in 6.8%of patients. No patient had esophageal or gastric varices. pan style='font-style: italic'>Helicobacter pyloripan> infection was investigated in 96 patients and was detected in 37.5%. Gastric biopsies were performed in 36 patients, with chronic inflammation found in 72.2%, inflammatory activity in 30.6%, and intestinal metaplasia in 11.1%. Glandular atrophy was not found in any patient.

class="h4">Conclusion

<p>The results of our study have shown that the spectrum of gastrointestinal diseases observed in severely obese patients who underwent bariatric surgery is broad. Although this issue remains highly controversial, these findings suggest that systematic preoperative UGE and pan style='font-style: italic'>H. pyloripan> testing should be performed in all patients scheduled to undergo bariatric surgery.

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Surgery for Obesity and Related Diseases

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Surgery for Obesity and Related DiseasesVolume 2, Issue 3May-June 2006, Page 303
Ruth O’Mahony, Tolga Erim, Samuel Szomstein, Raul Rosenthal

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class="h4">Abstract

class="articleTitle"><p>Current nutrition management of patients undergoing bariatric surgery

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