الفهرس | Only 14 pages are availabe for public view |
Abstract Excess of body fat that frequently results in impairment of health push patients to bariatric surgery centers. Obesity is the second leading cause of preventable death in the United States. Obesity is most common in minorities, low-income groups, rural populations, and women, but is increasing in all socioeconomic groups. Obesity is a multifactorial disease, it develops from integration of genetic, environmental, social, behavioral, physiological, metabolic, neuroendocrinal and psychological factors, and the exact etiology is unknown. The complications of obesity may be endocrinal, respiratory, cardiovascular, abdominal, cancer psychological, articular, gynaecological complications. Bariatric operations produce weight loss through two mechanisms; restriction of intake & malabsorption. Postoperative follow-up for the various operations has some common overall themes to determine wound healing, tolerance of oral intake, adjustment to the operation and return to activity to confirm the postoperative nutrition and exercise plan. A multidisciplinary team approach including the nutritionist is essential. Psychologic support and patient-oriented support groups can add significant value to preparation for surgery and afterward. An estimation of the patient’s motivation to change eating habits is important. Medical treatment for severe obesity is aimed at reducing body weight through combination of decreased caloric intake and accompanying increases in energy expenditure from moderate exercise. Pulmonary system, intravenous fluid therapy, anesthetic considerations, nutritional therapy are considered perioperative evaluation.Vomiting can be problematic after bariatric surgery , dumping syndrome is common in the first several months after surgery , patients with symptoms and signs suggestive of hypoglycemia warrant close evaluation. Prophylaxis for thrombotic disorders in bariatric surgical patients remains controversial, the goals of dietary treatment in the immediate postoperative phase are to facilitate weight loss and reduce the risk of nutritional deficiencies. Change occurs rapidly after bariatric surgery, and medical evaluation and biochemical testing at follow-up visits should be tailored to the patient’s profile of obesity associated comorbidities. Nutritional deficiencies are frequent after malabsorptive types of bariatric surgery as iron, calcium, vitamin D, vitamins A, E, and K, vitamin B1, vitamin B12, minerals and trace elements. Diabetes mellitus, hypertension and obstructive sleep apnea are common in obese individuals. Bariatric surgery has been shown to have a positive effect on these diseases . Finally simple surgical intervention in bariatric surgeries result in simple Perioperative management of bariatric patients. |