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    • Effect of Two Bariatric Procedures on Macro- and Micronutrient Levels Inspite of Multivitamin Supplementation

    Mohammed Matar,1 MD, FACS, Ahmed Shoka,1 MD, MRCS, Heba Nader,2 MD
    1Department of General Surgery, Ain Shams University, Cairo, Egypt 2Department of Clinical Pathology, Ain Shams University, Cairo, Egypt

    Background: Bariatric surgery is getting popular especially for patients with body mass index (BMI) >35kg/m2 . Consequent alterations in micronutrient absorption may lead to undesired metabolic side effects. Objective: To compare changes in nutritional status after 2 bariatric surgical techniques in a period of 24 months. Patients and methods: A prospective double armed randomized clinical trial was conducted at the Surgical Department of Ain Shams University hospitals. 69 patients (BMI >35kg/m2 ) were allocated to either vertical sleeve gastrectomy (VSG) as group 1 or mini-gastric bypass (MGBP) as group 2. Micronutrient and vitamins levels were followed up for 24 months. Clinical data collected at 3, 9, 18 and 24 months were tabulated and analyzed. Results: Out of 69 surgically treated patients, 67 completed the 2 year follow-up period. Microcytic anemia was significant in both study groups but significant in MGBP patients by 3, 6 and 18 months postoperative, but normalized by the end of 24 months. Macrocytic anemia was significant during the 3 and 6 postoperative months in the VSG compared to MGBP, but again improved following appropriate vitamin supplementation by the end of the study period. Vitamin D concentrations declined at 6 months postoperative in MGBP patients compared to VSG patients. There were no significant changes in mean serum calcium levels during the postoperative period in both groups. Conclusion: Comparing the effect of MGBP and VSG on nutritional deficiencies postoperatively, showed micronutrient and vitamin deficiencies which require different monitoring and supplementation regimens in the following years after surgery. Key words: Bariatric surgery, Sleeve gastrectomy, Mini gastric bypass, Nutritional deficiencies. 

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