title: Preoperative Regular Diet of 900 kcal/day vs Balanced Energy High-Protein Formula vs Immunonutrition Formula: Effect on Preoperative Weight Loss and Postoperative Pain, Complications and Analytical Acute Phase Reactants After Laparoscopic Sleeve Gastrectomy.
abstract: Between 2 and 8 weeks before surgery, most bariatric surgery groups establish strict dietary treatments with a total caloric intake of less than 1,000 kcal/day in order to maximize weight loss during this period of time.
  
  
  
  A prospective randomized clinical trial of all the patients undergoing laparoscopic sleeve gastrectomy (LSG) was performed. Patients were randomly assigned into 3 groups: those patients receiving a preoperative regular diet of 900 kcal/day (group 1), those receiving a preoperative balanced energy high-protein formula (group 2) and those receiving preoperative Immunonutrition (group 3). Preoperative weight loss, postoperative pain, complications and analytical acute phase reactants were investigated.
  
  
  
  Sixty patients were included in the study, 20 in each group. Preoperative excess weight loss was 7.7 % in group 1, 12.3 % in group 2 and 15.3 % in group 3 (p = 0.014). Median postoperative pain was 3.5 in group 1, 3 in group 2 and 2 in group 3 (p = 0.048). C-reactive protein determined 24 h after surgery was significantly lower in group 3 than in the other groups. AST and ALT values were significantly lower in group 3 than in the other groups, without significant differences between groups 1 and 2.
  
  
  
  Preoperative diet with Immunonutrition formulas during 2 weeks achieves a greater preoperative weight loss, lower postoperative pain and lower values of CRP and liver enzymes than high-protein formulas or regular diet, all of them with similar caloric intake.
authors.affiliation: Bariatric Surgery Unit, University Hospital Rey Juan Carlos, Madrid, Spain. jruiztovar@gmail.com.|, Corazon de Maria, 64, 7J, 28002, Madrid, Spain. jruiztovar@gmail.com.
authors.forename: Jaime
authors.initials: J
authors.lastname: Ruiz-Tovar
authors.affiliation: Department of Surgery, Bariatric Surgery Unit, General University Hospital Elche, Alicante, Spain.
authors.forename: Lorea
authors.initials: L
authors.lastname: Zubiaga
authors.affiliation: Department of Surgery, Bariatric Surgery Unit, General University Hospital Elche, Alicante, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Diez
authors.affiliation: Department of Pharmacy, Bariatric Surgery Unit, General University Hospital Elche, Alicante, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Murcia
authors.affiliation: Department of Endocrinology, Bariatric Surgery Unit, General University Hospital Elche, Alicante, Spain.
authors.forename: Evangelina
authors.initials: E
authors.lastname: Boix
authors.affiliation: Department of Anesthesiology, Bariatric Surgery Unit, General University Hospital Elche, Alicante, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Muñoz
authors.affiliation: Department of Surgical Nursery, Hospital Sureste, Madrid, Spain.
authors.forename: Carolina
authors.initials: C
authors.lastname: Llavero
mesh_terms: D000209:Acute-Phase Proteins / Q000378:metabolism; D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects* / Q000379:methods; D002097:C-Reactive Protein / Q000378:metabolism; D004038:Diet, Reducing; D004724:Endoscopy; D002149:Energy Intake; D004750:Enteral Nutrition / Q000379:methods; D005247:Feeding Behavior; D005260:Female; D005526:Food, Formulated; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D010149:Postoperative Pain / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D000209:Acute-Phase Proteins; D007155:Immunologic Factors; D002097:C-Reactive Protein
keywords: ALT; AST; C-reactive protein; Immunonutrition; Postoperative pain; Preoperative excess weight loss; Sleeve gastrectomy