Refeeding syndrome after bariatric surgery: a systematic review of the literature

Author:

Triantafyllidis Konstantinos Katsikas1,Giannos Panagiotis2,Geropoulos Georgios3,Stathi Dimitra2,Kechagias Konstantinos2,McCabe Gerard4,Lucocq James4,Robertson Andrew G4

Affiliation:

1. Homerton University Hospital

2. Society of Meta-Research and Biomedical innovation

3. Addenbrooke's Hospital

4. Edinburgh Royal Infirmary

Abstract

Abstract

Background Refeeding syndrome (RFS) is defined as a set of metabolic and electrolyte abnormalities after nutrition initiation following prolonged starvation. Bariatric surgery and the associated rapid weight loss have been proposed as potential triggering factors for RFS. Objective The aim of this study was to examine the currently available literature and provide an overview of the reported cases of RFS in patients who underwent bariatric surgery. Method We performed a systematic screen of Embase, Medline and Scopus until June 2024. The review was conducted according to PRISMA guidelines. Results We identified a total of 9 patients with RFS who had a history of bariatric surgery with mean age of 37.25 years. Five participants (55.5%) were females and 2 were males (22.2%). Adjustable gastric band was the main bariatric procedure performed in almost half of the patients (44.4%, 4/9) followed by gastric bypass (22.2%, 2/9). Post-operatively all patients experienced weight loss that ranged from 29.7–78.1% of the pre-operative weight. Most common symptoms included vomiting (44.4%, 4/9) and abdominal pain (22.2%, 2/9). Most of the patients (66.6%, 6/9) received vitamin supplementation, followed by electrolyte replacement (55.5%, 5/9). Most of patients (88.8%, 8/9) improved and one patient died (11%, 1/9). Conclusion Refeeding syndrome is a rarely reported complication after bariatric surgery, but as the frequency of bariatric surgery increases, RFS is expected to become more common. Clinical awareness among bariatric specialists is important for the identification of high-risk individuals as well as for the early diagnosis and successful management of patients with RFS.

Publisher

Springer Science and Business Media LLC

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