The safety, tolerability and clinical impact of pre-operative very low-calorie diet prior to non-bariatric abdominal surgery: a systematic review.
Body mass index
Hepatic steatosis
Non-bariatric surgery
Obesity
Peri-operative complications
Very-low calorie diet
Journal
Langenbeck's archives of surgery
ISSN: 1435-2451
Titre abrégé: Langenbecks Arch Surg
Pays: Germany
ID NLM: 9808285
Informations de publication
Date de publication:
28 Oct 2024
28 Oct 2024
Historique:
received:
24
07
2024
accepted:
12
10
2024
medline:
28
10
2024
pubmed:
28
10
2024
entrez:
28
10
2024
Statut:
epublish
Résumé
The use of pre-operative very low-calorie diets (VLCD) is established within bariatric and gallbladder surgery. However, their use in patients with high BMI and hepatic steatosis (HS) requiring upper abdominal procedures is unclear. This review aims to assess the safety, adherence, and outcomes of a pre-operative VLCD prior to non-bariatric elective surgery. A systematic search on PubMed MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL and AMED was performed to identify the included studies. Studies were included, if they administered a VLCD to patients undergoing non-bariatric elective surgery and reported on outcomes. Eight studies were included in this review and all administered a VLCD through either dietician led diet plans or meal replacement shakes. The adherence to the VLCD was heterogeneously measured but was excellent overall with a good safety profile. The VLCD was able to significantly reduce HS and resulted in a less technically difficult operation with reduced intra-operative blood loss. There was no significant impact on intraoperative or early post-operative outcomes. This review highlights that a VLCD can be administered safely during the pre-operative period and overall adherence is excellent, however heterogeneously measured. There was an overall positive impact on reducing hepatic steatosis, operative difficulty and intraoperative blood loss, however no significant impact on overall morbidity and mortality.
Sections du résumé
BACKGROUND
BACKGROUND
The use of pre-operative very low-calorie diets (VLCD) is established within bariatric and gallbladder surgery. However, their use in patients with high BMI and hepatic steatosis (HS) requiring upper abdominal procedures is unclear. This review aims to assess the safety, adherence, and outcomes of a pre-operative VLCD prior to non-bariatric elective surgery.
METHODS
METHODS
A systematic search on PubMed MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL and AMED was performed to identify the included studies. Studies were included, if they administered a VLCD to patients undergoing non-bariatric elective surgery and reported on outcomes.
RESULTS
RESULTS
Eight studies were included in this review and all administered a VLCD through either dietician led diet plans or meal replacement shakes. The adherence to the VLCD was heterogeneously measured but was excellent overall with a good safety profile. The VLCD was able to significantly reduce HS and resulted in a less technically difficult operation with reduced intra-operative blood loss. There was no significant impact on intraoperative or early post-operative outcomes.
CONCLUSION
CONCLUSIONS
This review highlights that a VLCD can be administered safely during the pre-operative period and overall adherence is excellent, however heterogeneously measured. There was an overall positive impact on reducing hepatic steatosis, operative difficulty and intraoperative blood loss, however no significant impact on overall morbidity and mortality.
Identifiants
pubmed: 39466418
doi: 10.1007/s00423-024-03509-3
pii: 10.1007/s00423-024-03509-3
doi:
Types de publication
Journal Article
Systematic Review
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
327Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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