GLP-1 Receptor Agonists versus Bariatric Surgery: A Global Health Network Analysis of Panniculectomy Outcomes.

IF 3.6 2区医学 Q1 SURGERY

Plastic and reconstructive surgery Pub Date : 2026-10-01 Epub Date: 2025-10-09 DOI:10.1097/PRS.0000000000012955

Savannah C Braud, Peyton Terry, Saïd C Azoury

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引用次数: 0

Abstract

Background: With the increase in medically assisted weight loss, procedures such as panniculectomy are becoming more common. The surgical impact of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) remains unclear, particularly compared with bariatric surgery. The authors compared panniculectomy outcomes and perioperative laboratory values in patients with previous GLP-1 RA use versus bariatric surgery.

Methods: The TriNetX Global Research Network was queried to identify patients who underwent panniculectomy after either GLP-1 RA use or bariatric surgery. Cohorts were formed using codes (eg, Current Procedural Terminology, International Classification of Diseases, 10th Revision) and perioperative laboratory values were compared between groups, including hemoglobin A1c (HgA1c), body mass index (BMI), low-density lipoprotein, triglycerides, and albumin. Propensity score matching for age, sex, race, HbA1c, BMI, and triglyceride levels was performed to stabilize baseline metabolic profiles and allow balanced comparison of postoperative outcomes, including cellulitis, hematoma, seroma, hemorrhage, wound dehiscence, surgical site infection, and abscess formation.

Results: Data from 177,467,699 patients across 150 health care organizations (2020 through 2025) were analyzed. Among all patients who underwent panniculectomy ( n = 24,645), 6060 had preoperative GLP-1 RA use and 4142 had previous bariatric surgery. GLP-1 RA users exhibited higher perioperative triglycerides, HbA1c, BMI, and low-density lipoprotein (all P < 0.05). Multivariable regression demonstrated lower odds of cellulitis (odds ratio [OR], 0.62 [95% CI, 0.47 to 0.83]; P = 0.0015), seroma (OR, 0.77 [95% CI, 0.59 to 0.89]; P = 0.026), and hemorrhage (OR, 0.51 [95% CI, 0.30 to 0.89]; P = 0.016) in the GLP-1 RA cohort.

Conclusion: Patients who achieve weight loss with GLP-1 RAs, as opposed to bariatric surgery, may experience fewer postoperative complications after panniculectomy.

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GLP-1激动剂与减肥手术：胰腺切除术结果的全球健康网络分析。

背景：随着医学辅助减肥的增加，胰管切除术等手术越来越普遍。胰高血糖素样肽-1 （GLP-1）受体激动剂的手术效果尚不清楚，特别是与减肥手术相比。目的：比较既往使用GLP-1的患者与减肥手术患者的胰腺切除术结果和围手术期实验室值。方法：对TriNetX全球研究网络进行查询，以确定在使用GLP-1或减肥手术后接受胰管切除术的患者。采用CPT和ICD-10等编码形成队列，并比较各组围手术期实验室值，包括血红蛋白A1c （HgA1c）、体重指数（BMI）、低密度脂蛋白（LDL）、甘油三酯和白蛋白。对年龄、性别、种族、HbA1c、BMI和甘油三酯水平进行匹配倾向评分，以稳定基线代谢谱，并允许平衡比较术后结果，包括蜂窝织炎、血肿、血肿、出血、伤口裂开、手术部位感染和脓肿形成。结果：分析了来自150个医疗保健组织（2020-2025）的177,467,699名患者的数据。在所有接受输卵管切除术的患者中（n=24,645）， 6,060例术前使用GLP-1, 4,142例既往有减肥手术。GLP-1使用者围手术期甘油三酯、HbA1c、BMI和LDL较高（均p < 0.05）。多变量回归显示，GLP-1队列中蜂窝织炎（OR 0.62, 95% CI 0.47-0.83, p=0.0015）、血肿（OR 0.77, 95% CI 0.59-0.89, p=0.026）和出血（OR 0.51, 95% CI 0.30-0.89, p=0.016）的发生率较低。结论：尽管最初的担忧，术前通过GLP-1受体激动剂实现减肥的患者，与减肥手术相比，可能会经历更少的胰管切除术后并发症。

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

Plastic and reconstructive surgery 医学-外科

CiteScore

5.00

自引率

13.90%

发文量

1436

审稿时长

1.5 months

期刊介绍： For more than 70 years Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. Plastic and Reconstructive Surgery® , the official journal of the American Society of Plastic Surgeons, is a benefit of Society membership, and is also available on a subscription basis. Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, cosmetic surgery, as well as news on medicolegal issues. The cosmetic section provides expanded coverage on new procedures and techniques and offers more cosmetic-specific content than any other journal. All subscribers enjoy full access to the Journal''s website, which features broadcast quality videos of reconstructive and cosmetic procedures, podcasts, comprehensive article archives dating to 1946, and additional benefits offered by the newly-redesigned website.