Exploratory Assessment of Preoperative GLP-1 Receptor Agonists Before Sleeve Gastrectomy: A Retrospective Matched Analysis.

IF 3.1 3区医学 Q1 SURGERY

Obesity Surgery Pub Date : 2025-10-01 Epub Date: 2025-09-10 DOI:10.1007/s11695-025-08258-w

Guillaume Luc, Arnaud Dedieu, Guillaume Canard, Amélie Cesard, Amandine Brunet, Camille Furois, Angèle Leterrier, Barbara Daridon, Lea Mendes, Emilie Brighen, Lucie Fournet, Anaelle David, Ludivine Muzard

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引用次数: 0

Abstract

Background: Preoperative treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) before bariatric surgery has not been studied. Therefore, we investigated the impact of neoadjuvant treatment with GLP-1 RAs on weight loss and postoperative outcomes in patients who underwent sleeve gastrectomy for severe obesity.

Method: A retrospective single-center study was conducted between January 2022 and December 2023. Patients with morbid obesity who were treated preoperatively with a GLP-1 RA (GLP-1 group) were matched with patients who were not preoperatively treated with a GLP-1 RA (No GLP-1 group) using propensity scores calculated according to age and body mass index (BMI). Between-group differences in demographics, comorbidities, surgical parameters, complications, weight loss, and comorbidity outcomes were analyzed.

Results: Fourteen patients were included in the GLP-1 group and matched with 28 controls (1:2 ratio). Preoperative weight loss was significantly greater in the GLP-1 group (7.8 ± 6.8 kg) than in the control group (0.2 ± 4.5 kg), with a mean difference of + 7.54 kg (95% CI: [3.47;11.6], p = 0.001, Cohen's d = 1.41). Mixed-effects ANOVA revealed a significant effect of time, with progressive BMI reduction in both groups (p = 0.019), no main effect of group (p = 0.080), and no group-time interaction (p = 0.972), indicating similar BMI trajectories throughout the perioperative period and no between-group difference at 12 months. Postoperative vomiting occurred in 21.4% of patients in the GLP-1 group versus 0% in the No GLP-1 group (p = 0.031). No significant differences in surgical parameters or the comorbidity resolution rate at one year were found.

Conclusion: Neoadjuvant GLP-1 RA treatment increased preoperative weight loss before sleeve gastrectomy, but the benefit was not sustained postoperatively. Preoperative GLP-1 RA use could be considered to optimize surgical preparation, but further data regarding postoperative outcomes and long-term weight benefits are needed.

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套筒胃切除术前GLP-1受体激动剂的探索性评估：回顾性匹配分析。

背景：减肥手术前术前胰高血糖素样肽-1受体激动剂（GLP-1 RAs）的治疗尚未研究。因此，我们研究了GLP-1 RAs新辅助治疗对因严重肥胖而行袖式胃切除术患者体重减轻和术后结局的影响。方法：于2022年1月至2023年12月进行回顾性单中心研究。术前接受GLP-1 RA治疗的病态肥胖患者（GLP-1组）与术前未接受GLP-1 RA治疗的患者（No GLP-1组）使用根据年龄和体重指数（BMI）计算的倾向评分进行匹配。分析了人口统计学、合并症、手术参数、并发症、体重减轻和合并症结果的组间差异。结果：GLP-1组14例，对照组28例（1:2）。GLP-1组术前体重减轻（7.8±6.8 kg）明显大于对照组（0.2±4.5 kg），平均差值为+ 7.54 kg （95% CI: [3.47;11.6], p = 0.001, Cohen’s d = 1.41）。混合效应方差分析显示，时间的影响显著，两组患者BMI均呈渐进式下降（p = 0.019），组间无主要影响（p = 0.080），组间无交互作用（p = 0.972），表明围手术期BMI轨迹相似，12个月时组间无差异。GLP-1组术后呕吐发生率为21.4%，无GLP-1组为0% （p = 0.031）。手术参数和合并症一年内的清除率无显著差异。结论：新辅助GLP-1 RA治疗增加了袖胃切除术前术前体重减轻，但术后获益不持久。术前使用GLP-1 RA可以考虑优化手术准备，但需要关于术后结果和长期体重益处的进一步数据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity Surgery 医学-外科

CiteScore

5.80

自引率

24.10%

发文量

567

审稿时长

3-6 weeks

期刊介绍： Obesity Surgery is the official journal of the International Federation for the Surgery of Obesity and metabolic disorders (IFSO). A journal for bariatric/metabolic surgeons, Obesity Surgery provides an international, interdisciplinary forum for communicating the latest research, surgical and laparoscopic techniques, for treatment of massive obesity and metabolic disorders. Topics covered include original research, clinical reports, current status, guidelines, historical notes, invited commentaries, letters to the editor, medicolegal issues, meeting abstracts, modern surgery/technical innovations, new concepts, reviews, scholarly presentations and opinions. Obesity Surgery benefits surgeons performing obesity/metabolic surgery, general surgeons and surgical residents, endoscopists, anesthetists, support staff, nurses, dietitians, psychiatrists, psychologists, plastic surgeons, internists including endocrinologists and diabetologists, nutritional scientists, and those dealing with eating disorders.