Preoperative XXXX utilizing a novel nutritional supplement.

@entity1 @entity409 @entity6178 @entity28
BACKGROUND: One of the most common reasons for conversion in bariatric surgery is hepatomegaly caused by inadequate exposure of the proximal stomach. This study utilizes a novel nutritional supplement with a calorie-restricted diet to reduce liver volume preoperatively. METHODS: A consecutive series of morbidly @entity28 @entity1 consumed a nutritional supplement called Nuvista(  ) for 4 weeks preoperatively. Preoperatively, each @entity1 completed baseline demographics, blood work, urine @entity6178 analysis, ultrasonography of the left lateral segment, and multiple questionnaires. At the time of surgery, these studies were repeated. Data were analyzed using a paired t-test and bivariate analysis where appropriate. A P<.05 was considered significant. RESULTS: Four @entity1 and 17 @entity1 were recruited with a mean preoperative weight and body mass index of 122.7  15.9    kg and 44.5  3.9, respectively. Mean preoperative liver volume of the left lateral segment was 562.5  291.3    cm(3). After 4 weeks of Nuvista, the mean weight and body mass index decreased significantly to 118.9  15.5    kg and 43.1  3.4, respectively (P<.001). The mean liver volume of the left lateral segment was significantly reduced to 299.9  162.1    cm(3) (P<.001). Mean @entity409 was 43.4%  17.2% (13.6%-81.9%, P<.05). Urinary @entity6178 scores did not show any evidence of starvation. No preoperative factors correlated with @entity409 . CONCLUSION: Utilizing Nuvista, as part of a preoperative 4-week calorie-restricted regimen, significantly reduced lateral segment liver volume by 43.4%. This preoperative regimen incorporates healthy behavioral changes that are necessary to sustain long-term weight loss.
