الفهرس 
Anatomy of the stomachOnly 14 pages are availabe for public view
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Abstract
Obesity has become an important public health priority because it increases the risk of comorbid conditions including Diabetes, cardiovascular disease and several types of cancers. In addition, it affects life expectancy.
OAGP has several possible advantages such as shorter operative time, fewer sites for anastomotic leaks and internal herniation, ease of reversibility and revision with equivalent or even superior results in terms of weight loss and co-morbidity resolution.
Substantial improvements in health and anthropometric parameters are found in the short-term follow-up after OAGB, with a satisfactory reported quality of life and adherence to recommendations. However, a high prevalence of some gastrointestinal side effects and nutritional deficiencies is a matter of concern.
Iron, vitamin B12 and folate deficiency have been well documented after gastric bypass operations performed for morbid obesity. Currently there are no specific nutritional guidelines for OAGB patients. So, the aim of the study is to assess the impact of OAGB on patients’ serum iron and vitamin B12 during the post-operative period.
To elucidate our aim, this is a prospective randomized study that was conducted on 30 morbid obese patients underwent OAGB at General Surgery Department, Menoufia University. During a period time from November 2019 to December 2022.
Methods
Pre-surgery demographic data, anthropometrics, comorbidities, blood tests, and supplementation use were obtained from the patients’ medical records. Follow-up evaluations were performed 1-3-6-12 months postsurgery and data collected included: Anthropometric measurements for weight height and BMI. Blood tests collected for vitamin B12, vitamin D, iron, ferritin, hemoglobin, calcium and albumin. Micronutrient deficiencies were defined if serum levels exceeded the Health Medical Organization (HMO) laboratory determined normal range values, according to the micronutrient type. Serum vitamin B12 deficiency was defined also as levels <350 pg/ml, since it has been demonstrated to have higher sensitivity and specificity for detecting deficiency compared to the laboratory lower normal range value. The severity of anemia at sea level was assessed as per the WHO criteria.
The results of this study could be summarized as follows:
There were no significant differences among the studied groups regarding age (P=0.703) and sex (P=0.240). Weight and BMI were significantly increased among supplement when needed (137.73±12.82, 52.25±5.99) than supplement after one month (125.27±12.98, 46.85±4.81) respectively, (P<0.05). While, there were no significant differences among the studied groups regarding height (P=0.914). Iron preoperative was significantly decreased among supplement after one month (15.96±7.86) than supplement when needed (22.22±8.17), (P=0.041). However, there was no significant differences among the studied groups regarding iron at 3 months (P=0.658), 6 months (P=0.132) and 12 months (P=0.083).
Mean change of serum ferritin improved post-operative compared preoperative (P<0.05). The most improvement was achieved after 12 months (9.95±22.89) compared 3 and 6 months. Mean change of Hb improved post-operative compared preoperative (P<0.05). The most improvement was achieved after 3 months (1.20±1.00) compared 6 and 12 months. Mean change of vitamin B12 improved post-operative compared preoperative (P<0.05). The most improvement was achieved after 12 months (-200.14±226.33) compared 3 and 6 months.