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Roux-en-Y Gastric Bypass Operation in Rats
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Intentional weight reduction before surgery - A systematic review.

Erik Stenberg1, Anna Laurenius2, Anders Thorell3

  • 1Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.

Clinical Nutrition (Edinburgh, Scotland)
|January 17, 2025
PubMed
Summary
This summary is machine-generated.

Preoperative low energy diets (LED) or very low energy diets (VLED) can shorten operation times and reduce complications for specific surgeries. Evidence supports their use before bariatric, cholecystectomy, colorectal, and hernia repair procedures.

Keywords:
Meta-analysisObesityOperation timePostoperative complicationSystematic reviewWeight loss

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Area of Science:

  • Surgical Outcomes
  • Obesity Management
  • Dietary Interventions

Background:

  • Obesity increases surgical complexity and perioperative risks.
  • Low Energy Diets (LED) and Very Low Energy Diets (VLED) show promise for weight reduction.
  • Evidence for LED/VLED use in general surgery is uncertain.

Purpose of the Study:

  • To systematically review the scientific evidence for routine preoperative LED/VLED use.
  • To evaluate the impact of LED/VLED on surgical outcomes.
  • To assess the safety and efficacy of preoperative weight reduction diets.

Main Methods:

  • Searched Medline, Embase, Web of Science, and Cochrane databases.
  • Assessed study quality using Cochrane and NIH tools.
  • Analyzed operation time, complications, and efficacy using a random-effects model.

Main Results:

  • 18 studies (9 RCTs, 9 observational) with 1733 patients were included.
  • Preoperative LED/VLED significantly shortened operation time (SMD 0.36, p=0.002).
  • Reduced postoperative complications observed in bariatric, cholecystectomy, colorectal, and hernia repair surgeries (RR 0.63, p<0.001).

Conclusions:

  • Preoperative LED/VLED is supported for weight reduction before bariatric, cholecystectomy, colorectal, and hernia repair.
  • Further research is needed for routine use in other surgical procedures.
  • High heterogeneity for operation time, low for complications.