Nutritional and hematological changes after sleeve gastrectomy

Abstract

Background and aims: In this century, obesity is one of the most important health problems responsible for mortalities and morbidities worldwide. Bariatric surgery is an effective treatment modality used in the treatment of obesity. We aimed to elucidate the effect of bariatric surgery on hematological and nutritional parameters at postoperative 3rd, 6th, and 12th months after sleeve gastrectomy(SG).

Subjects and Methods: Totally 298 patients, who underwent SG in general surgery clinic between 2015 and 2017, were included in the study. We evaluated the levels of complete blood cell parameters [hemoglobin (Hb), hematocrit (Htc), white blood cell (WBC), lymphocyte (LYM), neutrophil (NTRL), mean corpuscular volume (MCV), platelet (PLT) counts], serum iron (SI), serum iron-binding capacity (SIBC), serum ferritin (FER), serum folate (FOL) and serum vitamin B12 (Vit B12) at the preoperative visit, and postoperative 3rd, 6th and 12th-month visits.

 Results: Hb, Htc, WBC and PLT levels decreased significantly at 12th month after SG (p< 0.001 for both comparisons). LYM and NTRL levels were found to be decreased in the postoperative period (p= 0.006 and p<0.001 respectively).MCV levels were higher than preoperative values (p<0.001). Vitamin B12 levels did not change after SG. Folate values were lower in postoperative visits than preoperative visit (p<0.001). Serum iron and ferritin levels were increased after SG, whereas, serum iron-binding capacity levels were observed to be decreased(P<0.001).

Conclusions: Long term results of Sleeve gastrectomy has not been elucidated adequately.Although this procedure has better outcomes on diabetes, hypertension, hyperlipidemia it can cause deleterious multisystemic consequences. Close follow-up of the patients in the postoperative period will prevent, unfavorable outcomes.