title: [Effect of a multidisciplinar protocol on the clinical results obtained after bariatric surgery].
abstract: BACKGROUND
  Bariatric surgery has been shown to be an effective therapy for weight loss in patients with severe obesity, and the implementation of a multidisciplinar management protocol is recommended.
  
  
  OBJECTIVE
  To assess the usefulness of the implementation of a management protocol in obesity surgery based on the Spanish Consensus Document of the SEEDO.
  
  
  METHODS
  Retrospective comparative study of the outcomes in patients previously operated (51 patients) and after the implementation of the protocol (66 patients). The following data were gathered: anthropometry, pre-and post-surgery comorbidities, post-surgical nutritional and surgical complications, validated Quality of Life questionnaire, and dietary habits.
  
  
  RESULTS
  Withdrawals (l7.6%) and alcoholism (5.8%) were higher in patients pre- versus post-implementation of the protocol (4.5% vs. 3%, respectively), the differences being statistically significant. The mortality rate was 2% in the pre-protocol group and 0% in the postprotocol group. The dietary habits were better in the post-protocol group, the pre-protocol group presenting a higher percentage of feeding-behavior disorders (5.1%) although not reaching a statistical significance. The improvement in quality of life was higher in the post-protocol group for all items, but only reaching statistical significance in sexual activity (p = 0.004). In the pre-protocol group, 70.5% of the patients had more than one nutritional complication vs. 32.8% in the post-protocol group (p < 0.05). There were no differences regarding the percentage of weight in excess lost at two years (> 50% in 81.3% in the pre-protocol group vs. 74.8% in the pos-protocol group) or the comorbidities.
  
  
  CONCLUSIONS
  Bariatric surgery achieves excellent outcomes in weight loss, comorbidities, and quality of life, but presents nutritional, surgical, and psychiatric complications that require a protocol-based and multidisciplinary approach. Our protocol improves the outcomes regarding the withdrawal rates, feeding-behavior disorders, dietary habits, nutritional complications, and quality of life.
authors.affiliation: Hospital Virgen de la Salud, Toledo, España. barbaracanovas@yahoo.es
authors.forename: B
authors.initials: B
authors.lastname: Cánovas Gaillemin
authors.forename: J
authors.initials: J
authors.lastname: Sastre Martos
authors.forename: G
authors.initials: G
authors.lastname: Moreno Segura
authors.forename: O
authors.initials: O
authors.lastname: Llamazares Iglesias
authors.forename: C
authors.initials: C
authors.lastname: Familiar Casado
authors.forename: S
authors.initials: S
authors.lastname: Abad de Castro
authors.forename: R
authors.initials: R
authors.lastname: López Pardo
authors.forename: M A
authors.initials: MA
authors.lastname: Sánchez-Cabezudo Muñoz
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D002985:Clinical Protocols; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery* / Q000628:therapy; D010348:Patient Care Team; D010349:Patient Compliance; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss