Preoperative liver shrinking diet for bariatric surgery may impact wound healing: a randomized controlled trial

Saurav Chakravartty, Gillian Vivian, Nicola Mullholland, Hizbullah Shaikh, John McGrath, Paul S. Sidhu, Ounali Jaffer, Ameet G. Patel

研究成果: Article同行評審

27 引文 斯高帕斯(Scopus)

摘要

Background: In bariatric surgery, preoperative very low-calorie diets (VLCD) may better meet the technical demands of surgery by shrinking the liver. However, diets may affect tissue healing and influence bowel anastomosis in an as-yet-undefined manner. Objective: This randomized controlled trial aimed to examine the effect on collagen deposition in wounds in patients on a 4-week VLCD before laparoscopic gastric bypass. Setting: University hospital. Methods: The trial was undertaken in patients undergoing laparoscopic Roux-en-Y gastric bypass, with a control group (n = 10) on normal diet and an intervention group (n = 10) on VLCD (800 kcal) for 4 weeks. The primary outcome measured was expression of collagen I and III in skin wounds, with biopsies taken before and after the diet and 7 days postoperatively as a surrogate of anastomotic healing. Secondary outcome measures included liver volume and fibrosis score, body composition, operating time, blood loss, hospital stay, and complications. Results: Patients in both groups were similar in age, sex, body mass index (53.4 versus 52.8 kg/m 2 ), co-morbidities, liver volume, and body composition. Expression of mature collagen type I was significantly decreased in diet patients compared with controls after 4 weeks of diet and 7 days after surgery. This was significant decrease in liver volume (23% versus 2%, P =.03) but no difference in operating times (129 versus 139 min, P =.16), blood loss, length of stay, or incidence of complications. Conclusions: Preoperative diets shrink liver volume and decrease expression of mature collagen in wounds after surgery. Whether the latter has a detrimental effect on clinical outcomes requires further evaluation.

原文English
頁(從 - 到)117-125
頁數9
期刊Surgery for Obesity and Related Diseases
15
發行號1
DOIs
出版狀態Published - 2019 1月

All Science Journal Classification (ASJC) codes

  • 手術

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