General Situation,Prophylaxis And Treatment Of Anemia In Metabolic Surgery

Background: metabolic surgery is one of the safest and most effective ways to keep the weight loss for obese patients steadily and steadily,but it can also cause anemia in patients after surgery?A metabolic surgery is not really successful without the effectively prevention and treatment for anemia.The purpose of this article is to compare and analyze the anemia before and after laparoscopic sleeve gastrectomy(LSG)and laparoscopic gastric bypass surgery(LRYGB),and the prevention and treatment for it.Methods: We collect the data of 218 patients who accepted metabolic surgery in the First Affiliated Hospital of Soochow University from 2010.05 to 2017.01.They are divided into two groups according to the different surgical methods,of which 78 with LSG and 140 with LRYGB.The patients are divided into three groups according to their sex and menopause,including men,un-menopausal women and menopausal women.The patients were followed up at these time point: before operation,1 month,3 months,6 months,12 months after operation.Data as the body weight,waist circumference,body mass index(BMI),hemoglobin(Hb),blood routine and biochemical are detected at each time point,and the level of ferritin,folic acid and vitamin B12 were also detected for the patients with anemia after operation.Results: The BMI of the patients with BMI>27.5kg/m2 before operation decreased significantly 1 year after surgery,with both LSG and LRYGB,and the difference was statistically significant(P<0.001).There was no significant difference in the reduction of BMI between the two operation methods(P>0.05).The incidence of anemia after metabolic surgery was 13.1%.Among the 78 people who accepted LSG and with BMI>27.5kg/m2 before operation,the incidence of anemia after surgery was 9.1%.The postoperative hemoglobin was significantly lower compared with that before operation(137.55 + 18.13 vs 143.79 + 13.29),and the difference was statistically significant(P<0.001).140 patientsaccepted LRYGB,of which 42 with BMI<27.5kg/m2,and the incidence of anemia after operation was 34.5%.The postoperative hemoglobin was significantly lower than that before operation(122.59 + 18.29 vs 136.07 + 12.89).The difference was significant(P<0.001).For the rest of the 98 patients,the incidence of anemia after operation was 8.6%.The hemoglobin was significantly lower than that before operation(131.47 + 22.21 vs139.44 + 20.32),and the difference was statistically significant(P<0.001).The incidence of anemia in one year was not significantly different between LSG and LTYGB(confidence interval,including 1).The incidence of anemia in non-obese patients undergoing LRYGB was significantly higher than that of obese patients with significant statistical differences(the confidence interval did not include 1).Conclusions: the incidence of anemia in 1 years after LSG and LRYGB is significantly higher,but there is no significant difference between the two ways of operation.The incidence of anemia in patients with non-obese type 2 diabetes after LRYGB is significantly higher than that in obese patients.The most common form of anemia is the iron deficiency anemia,and anemia is more likely to occur in un-menopausal women than that in men and menopausal women.Long term and regular use of compound vitamin microelement tablets is recommended to prevent and treat postoperative anemia.