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Acute post-gastric reduction surgery (APGARS) neuropathy
Craig G Chang1, Beverley Adams-Huet, David A Provost
1Fellow, Minimally Invasive Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
Obesity Surgery
|March 17, 2004
Summary
Acute post-gastric reduction surgery (APGARS) neuropathy is a serious complication after weight loss surgery. This study found its incidence to be 5.9 per 10,000 operations, highlighting the need for surgeon awareness and prompt treatment.
Area of Science:
- Bariatric Surgery
- Neurology
- Nutritional Science
Background:
- Neurologic complications are known sequelae of weight loss surgery.
- Acute post-gastric reduction surgery (APGARS) neuropathy is a newly defined polynutritional, multisystem disorder.
- The precise incidence, associations, and prognosis of APGARS remain unclear.
Purpose of the Study:
- To define the incidence and characteristics of APGARS.
- To identify potential associations and outcomes of APGARS.
- To raise surgeon awareness of this postoperative complication.
Main Methods:
- A survey was distributed to members of the American Society for Bariatric Surgery (ASBS).
- Surgeons reported on their experience and cases suggestive of APGARS.
- Data collected included patient diagnosis and surgical procedure.
Main Results:
- The survey achieved a 31.8% response rate, covering 168,010 bariatric procedures.
- 109 neuropathy cases were reported, with 99 identified as APGARS.
- Vitamin B12 and/or thiamine deficiencies were present in 40% of APGARS cases; 59% had no noted deficiencies. Gastric bypass was the most common surgery.
Conclusions:
- The incidence of APGARS was determined to be 5.9 cases per 10,000 bariatric operations.
- APGARS is a potentially reversible condition.
- Surgeons should be informed about APGARS presentation and management.