gms | German Medical Science

Background: The standard recommendations for nutritional supplementation after sleeve gastrectomy consist of supplementation with multivitamins (MV), calcium, vitamin D and B12. Yet, the benefits of such a broad supplementation after a non-malabsorptive procedure remain unknown, especially in the light that many patients have low adherence to such recommendations. The purpose of this study was to evaluate the effects of nutritional supplementation with MV on risk for malnutrition, patient satisfaction and quality of life.

Materials and methods: From our prospectively collected database, we selected patients who underwent sleeve gastrectomy and were taking MV postoperatively only. These patients were compared with such who discontinued the recommended supplementation on their own for at least 6 months (Total n=29). We investigated the effects on risk for malnutrition as well as patient’s satisfaction and quality of life (Aldert-Moorehead-Questionnaire) 12 months after surgery. Lab-values were defined as deficiencies, when they were out of the standard range assessed by our laboratory.

Results: Twenty-nine patients (15 with /14 without MV-supplementation) with no preoperative differences were included into this study. There were no differences regarding the risk for malnutrition, related to the total number of deficiencies between these two groups (1,6 vs 1,5; p=0,952). Patient who followed the recommended MV-supplementation had a higher quality of life than such who did not (1,8 (good quality) vs 2,1 (very good quality); p=0,226), especially regarding the general feeling (0,29 vs0,38; p=0,007) as one part of the A.-M.-Questionnaire . Furthermore, it appears that patients taking supplementation tended to be more satisfied with the follow-up program (79% vs 93%: p=0,276) and appeared more frequently in the outpatient clinic (3/4 vs 4/4 (visits per year); p=0,296).

Conclusion: Cessation of nutritional supplementation after sleeve gastrectomy appears to not increase the risk for malnutrition 1 year postoperatively. Further studies should address whether a broad general supplementation is justified in every patient after sleeve gastrectomy. No conclusion can be made from this study, whether regular nutritional supplementation improves quality of life or a better quality of live improves adherence for nutrition supplementation. However, it seems that quality of live is associated with better compliance for follow-up visits, which are necessary for tight individual adjustment of nutritional supplementation.