Obesity Surgery最新文献

{"title":"\"Impenetrable\" Is a Subjective Term and Bariatric Procedures Can Provide a Safer Treatment Option for Patients with Obesity and Complex Abdominal Wall Hernias-\"Laparocele\".","authors":"Mohamed H Zidan, Hassan El-Masry, Ahmed Amgad, Ahmed Abokhozima","doi":"10.1007/s11695-024-07573-y","DOIUrl":"https://doi.org/10.1007/s11695-024-07573-y","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Ultrasound-Guided Erector Spinae Plane Block on Postoperative Opioid Consumption and Respiratory Recovery in Laparoscopic Sleeve Gastrectomy: A Randomized Controlled Study.","authors":"Arzu Karaveli, Serdar Kaplan, Ali Sait Kavakli, Mehmet Nuri Kosar, Burhan Mayir","doi":"10.1007/s11695-024-07576-9","DOIUrl":"https://doi.org/10.1007/s11695-024-07576-9","url":null,"abstract":"<p><strong>Background: </strong>The aim of this prospective, randomized, controlled study was to evaluate the effect of ultrasound (US)-guided bilateral erector spinae plane (ESP) block on postoperative opioid consumption and respiratory recovery in patients with obesity undergoing laparoscopic sleeve gastrectomy (LSG).</p><p><strong>Methods: </strong>The study was conducted on 40 patients scheduled for LSG. The patients were randomly allocated into either the ESP block group or the control group. The US-guided bilateral ESP block was performed preoperatively. The control group received no intervention.</p><p><strong>Results: </strong>Postoperative median [IQR] tramadol consumption was significantly lower in the ESP block group [150.0 [100-200] mg vs 450.0 [400-500] mg, p < 0.0001]. Postoperative spirometric variables were significantly impaired in both groups, compared with preoperative variables (p < 0.0001). Intraoperative median [IQR] fentanyl consumption was 200.0 [200-200] µg in the ESP block group, and 350.0 [300-400] µg in the control group (p < 0.0001). Postoperative mean pain scores at rest and during movement were significantly lower in the ESP block group, at all time points (p < 0.05). In terms of mean arterial PH, Horowitz ratio, and PaCO₂, there was no statistically significant difference between the groups (p > 0.05). None of the patients experienced postoperative respiratory adverse events and/or block-related complications.</p><p><strong>Conclusions: </strong>US-guided bilateral ESP block significantly reduced both intraoperative and postoperative analgesic consumptions and provided effective postoperative pain control for patients with obesity undergoing bariatric surgery. Following bariatric surgery, all patients' postoperative pulmonary functions deteriorated. The effect of US-guided bilateral ESP block on postoperative respiratory recovery could not be clearly demonstrated. Randomized controlled studies with a larger patient population are necessary.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of One-Anastomosis Gastric Bypass Versus Roux-en-Y Gastric Bypass for Gastroesophageal Reflux Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Nikolaos Kapellas, Samer Alkhalil, Metin Senkal","doi":"10.1007/s11695-024-07571-0","DOIUrl":"https://doi.org/10.1007/s11695-024-07571-0","url":null,"abstract":"<p><p>This study aimed to investigate the efficacy of one-anastomosis gastric bypass (OAGB) on gastroesophageal reflux disease (GERD) compared with Roux-en-Y gastric bypass (RYGB) in patients with obesity. Three databases (Medline, Cochrane Central, and Scopus) were searched for relevant articles published until August 12, 2024. A total of nine randomized controlled trials, including 643 patients, were selected. OAGB was statistically significantly associated with a higher risk of GERD than RYGB (OR = 3.14, 95% CI 1.23-8.03, p < 0.05). The odds for de novo GERD after OAGB are almost six times higher than after RYGB (OR = 5.65, 95% CI 1.53-20.82, p < 0.05). RYGB has a lower incidence of de novo GERD cases and is more effective than OAGB in reducing GERD.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity Is Increasing in Liver Transplant Recipients and Exacerbates Cardiovascular Risk: A Single-Centre European Study.","authors":"Simone Cremona, Gabriela Chullo Llerena, Ana de Hollanda, Christian Jorge Robles, Giulia Pagano, Ainize Ibarzabal, Helena Hernández-Évole, Yiliam Fundora Suárez, Gonzalo Crespo","doi":"10.1007/s11695-024-07553-2","DOIUrl":"https://doi.org/10.1007/s11695-024-07553-2","url":null,"abstract":"<p><strong>Purpose: </strong>Recent changes in the profile of liver transplant (LT) recipients include an increasing number of patients with metabolic-associated steatotic liver disease (MASLD), which is associated with obesity and cardiovascular risk. We aimed to investigate the trend in the presence of obesity among LT recipients and its association with cardiovascular risk.</p><p><strong>Materials and methods: </strong>Single-centre retrospective study, which included LT recipients between 2015 and 2020. Obesity and patient's demographic were assessed before LT and 12 months thereafter. Cardiovascular risk factors including ASCVD score were recorded and compared between patients with and without obesity.</p><p><strong>Results: </strong>During the study period, 358 LT were performed. The mean BMI before LT significantly increased over time during the study period (p_trend = 0.04). Pre-LT, patients with obesity were older and had a higher prevalence of MASLD, diabetes, hypertension and dyslipidaemia. Twelve months after LT, most patients gained weight, although mean BMI did not significantly increase over time (p_trend = 0.072). LT recipients with obesity 12 months after LT more frequently presented with diabetes and hypertension and had higher ASCVD score than LT recipients with BMI < 30 kg/m². One-year mortality was similar between patients with or without obesity before LT (p = 0.816).</p><p><strong>Conclusion: </strong>In the past few years, there has been a significant increase in the prevalence of obesity in LT recipients. LT recipients with obesity present a higher cardiovascular risk as assessed by the presence of cardiovascular risk factors and the ASCVD score. Our results may be useful when designing strategies to directly target obesity and weight management in this population.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of One Anastomosis Gastric Bypass Versus Sleeve Gastrectomy and Roux-en-Y Gastric Bypass for the Treatment of Type 2 Diabetes Mellitus: a Systematic Review and Meta-Analysis of Randomized Clinical Trials.","authors":"Mohammad Kermansaravi, Sonja Chiappetta, Radwan Kassir, Alfonso Bosco, Xavier Giudicelli, Panagiotis Lainas, Maissa Safieddine","doi":"10.1007/s11695-024-07564-z","DOIUrl":"https://doi.org/10.1007/s11695-024-07564-z","url":null,"abstract":"<p><p>The worldwide prevalence of type 2 diabetes mellitus (T2DM) is increasing in parallel with obesity. One anastomosis gastric bypass (OAGB) is considered effective to treat both T2DM and obesity. The aim of this study was to evaluate the efficacy of OAGB versus sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) for treatment of T2DM, analyzing data exclusively from randomized control trials (RCTs). Α systematic review of published RCTs comparing OAGB versus RYGB or SG (control groups) in T2DM patients regarding diabetes remission and weight loss was performed. Primary endpoints were T2DM remission rate and 1-year and 5-year % weight loss postoperatively. Initial search identified 39 references, of which 8 RCTs were considered eligible for meta-analysis inclusion, comprising 636 patients (311 OAGB, 122 RYGB, 203 SG patients). Main meta-analysis findings were: i) higher 1-year %EWL for OAGB than control group (p = 0.04); ii) higher 5-year %EWL for OAGB than control group (p < 0.01); iii) no difference in 1-year remission rate of T2DM between OAGB and control group (p = 0.14); iv) 28% higher 5-year remission rate of T2DM for OAGB than control group (p < 0.01). OAGB had statistically significant better outcomes compared to RYGB and SG regarding T2DM remission and %EWL at 5 years. Further pathophysiologic studies are needed to indicate the most potent bariatric procedure in patients with T2DM and obesity.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narrative Comments Regarding the Efficacy of Aprepitant in Preventing Post-bariatric Surgery Nausea and Vomiting: Evidence from Clinical Trials.","authors":"Jing Wang, Jichun Ma","doi":"10.1007/s11695-024-07575-w","DOIUrl":"https://doi.org/10.1007/s11695-024-07575-w","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dasiglucagon: a New Hope for Managing Post-prandial Hypoglycemia After Gastric Bypass Surgery?","authors":"Laiba Amjad, Rabiya Aamir, F N U Shahana, Ali Waris Khan, Muhammad Talha","doi":"10.1007/s11695-024-07574-x","DOIUrl":"https://doi.org/10.1007/s11695-024-07574-x","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global 30-Day Morbidity and Mortality of Primary Bariatric Surgery Combined with Another Procedure: The BLEND Study.","authors":"Alessandro Martinino, Kushan D L Nanayakkara, Brij Madhok, Geoffrey Yuet Mun Wong, Mohamed Abouelazayem, Juan Pablo Scarano Pereira, Ishaan Wazir, Vignesh Balasubaramaniam, Amira Said, Cláudia Marques, Amr Abdelbaeth, Khayry Al-Shami, Muna Albashari, Akram Alkaseek, Mohammad Abdullah Almayouf, Mohammad Aloulou, Awadh Robaan Alqahtan, Alan Askari, Meena Faiez Assad Attia, Ahmed K Awad, Muhammed Rasid Aykota, Nicolae Bacalbasa, Francisco J Barrera-Rodriguez, Domenico Benavoli, Srikar Billa, Vincenzo Borrelli, İsmail Çalıkoğlu, Michela Campanelli, Miguel A Carbajo, Sharfuddin Chowdhury, Luca Cristin, Giovanni Dapri, Zhiyong Dong, Mohamad Hayssam Elfawal, Amr Elgazar, Muhammed Elhadi, Paolo Gentileschi, Yitka Graham, Bassel Haj, Joseph Andrew Johnson, Abd-Elfattah Morsi Kalmoush, Ayman Kamal, Anna Kamocka, Almu'atasim Khamees, Giorgio Lisi, Edgard Efren Lozada Hernandez, Giuseppe M Marinari, Gennaro Martines, Serhat Meric, Fernando Mier, Ahmed Mohamed Ali, Diyaaldeen Mohammed, Karim Mostafa Mohamed, Francesk Mulita, Mario Musella, William Edward O'Malley, Stefano Olmi, Taryel Omarov, Omnya Osama, HMinali R Perera, Giovanni Piscitelli, Tigran Poghosyan, David Ramírez, Masoud Rezvani, Rui Ribeiro, Aaron Sabbota, Nasser Sakran, Khaled Ahmad Sawaftah, Kaci Schiavone, Ozan Şen, Maria Sotiropoulou, Nicola Tartaglia, Merve Tokocin, Manuela Trotta, Ahmet Gökhan Türkçapar, Matteo Uccelli, Cesar Vargas, Georgios -Ioannis Verras, Cunchuan Wang, Zhuoqi Wei, Wah Yang, Carlos Zerrweck, Eloise Owen, Georgios V Gkoutos, Victor Roth Cardoso, Rishi Singhal, Kamal Mahawar","doi":"10.1007/s11695-024-07296-0","DOIUrl":"10.1007/s11695-024-07296-0","url":null,"abstract":"<p><strong>Background: </strong>No robust data are available on the safety of primary bariatric and metabolic surgery (BMS) alone compared to primary BMS combined with other procedures.</p><p><strong>Objectives: </strong>The objective of this study is to collect a 30-day mortality and morbidity of primary BMS combined with cholecystectomy, ventral hernia repair, or hiatal hernia repair.</p><p><strong>Setting: </strong>This is as an international, multicenter, prospective, and observational audit of patients undergoing primary BMS combined with one or more additional procedures.</p><p><strong>Methods: </strong>The audit took place from January 1 to June 30, 2022. A descriptive analysis was conducted. A propensity score matching analysis compared the BLEND study patients with those from the GENEVA cohort to obtain objective evaluation between combined procedures and primary BMS alone.</p><p><strong>Results: </strong>A total of 75 centers submitted data on 1036 patients. Sleeve gastrectomy was the most commonly primary BMS (N = 653, 63%), and hiatal hernia repair was the most commonly concomitant procedure (N = 447, 43.1%). RYGB accounted for the highest percentage (20.6%) of a 30-day morbidity, followed by SG (10.5%). More than one combined procedures had the highest morbidities among all combinations (17.1%). Out of overall 134 complications, 129 (96.2%) were Clavien-Dindo I-III, and 4 were CD V. Patients who underwent a primary bariatric surgery combined with another procedure had a pronounced increase in a 30-day complication rate compared with patients who underwent only BMS (12.7% vs. 7.1%).</p><p><strong>Conclusion: </strong>Combining BMS with another procedure increases the risk of complications, but most are minor and require no further treatment. Combined procedures with primary BMS is a viable option to consider in selected patients following multi-disciplinary discussion.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Leptin-Melanocortin Pathway Genetic Variants on Weight Loss Outcomes After Endoscopic Transoral Outlet Reduction.","authors":"Khushboo Gala, Wissam Ghusn, Sima Fansa, Diego Anazco, Andrew C Storm, Barham K Abu Dayyeh, Andres Acosta","doi":"10.1007/s11695-024-07547-0","DOIUrl":"10.1007/s11695-024-07547-0","url":null,"abstract":"<p><strong>Purpose: </strong>Variants in the leptin-melanocortin pathway (LMP) are associated with severe obesity. We evaluated weight loss of patients with or without heterozygous LMP variants, with weight recurrence after Roux-en-Y gastric bypass, who underwent endoscopic transoral outlet reduction (TORe).</p><p><strong>Materials and methods: </strong>We retrospectively reviewed patients genotyped for an LMP who had undergone TORe, classified as \"carriers\" or \"non-carriers\" of genetic variants.</p><p><strong>Results: </strong>We included 54 patients (22 carriers, 32 non-carriers). We identified 34 genetic variants in 21 different genes in 22 patients. Total body weight loss (%TBWL) after TORe was significantly different at 9 and 12 months (12 months: 0.68 ± 7.5% vs. 9.6 ± 8.2%, p < 0.01). This difference in weight loss was present even when analyzed in subgroups of patients who had undergone tubular TORe technique, and TORe plus APC. At 3, 6, and 12 months, the percentage of carriers achieving ≥ 5% and ≥ 10% TBWL was lower than non-carriers.</p><p><strong>Conclusions: </strong>Patients with LMP variant who underwent RYGB had decreased weight loss 1 year after undergoing TORe.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3dct Conduit and Oesophageal Metrics, a Valuable Method to Diagnose Post Sleeve Gastrectomy Abnormalities.","authors":"S T Alhayo, M Guirgis, C Siriwardene, L Dong, S A Said, M L Talbot","doi":"10.1007/s11695-024-07528-3","DOIUrl":"10.1007/s11695-024-07528-3","url":null,"abstract":"<p><strong>Purpose: </strong>Reflux after laparoscopic sleeve gastrectomy (LSG) may result from anatomical and functional anomalies in the gastric conduit. Three-dimensional CT scans (3DCT) offer a comprehensive view of gastric anatomy. This study aims to establish specific measurements associated with sleeve abnormalities to standardise the reporting of 3DCT which may help in management of LSG complications.</p><p><strong>Materials and methods: </strong>This retrospective study analysed 64 post-LSG patients who underwent gastric 3DCT. Data included clinical demographics, pre-LSG BMI, BMI at 3DCT, and the duration between surgery and examination. Symptomatology prompts the scan and other concurrent investigations. Various 3DCT measurements were taken, including angularis angle (AA), surface area (ASA), conduit length (CL), proximal maximal surface area (PMSA), and distal maximal surface area (DMSA) of the gastric conduit. Patients were categorised based on endoscopy findings and symptomatology. Outcomes post-revisional surgery were assessed and analysed.</p><p><strong>Results: </strong>20.3% were male. Pre-LSG BMI and BMI at 3DCT were 45.57 (± 8.3) and 36.3 (± 8.7), respectively. Mean surgery-to-scan period was 6.2 years. 71.8% of patients presented with reflux, regurgitation, or dysphagia, whilst the remainder primarily exhibited weight regain. Patients with endoscopic evidence of stenosis/reflux demonstrated significantly lower gastric volume, ASA, and DMSA (p = 0.002 and p = 0.007, respectively). Oesophageal diameter above the conduit and an ASA to DMSA ratio ≤ 0.5 were negatively associated with AA (p = 0.008 and p = 0.08, respectively). Patients with improved outcomes after revisional bypass and gastrogastrostomy displayed a negative correlation with ASA and positive correlation with the ASA to PMSA ratio (≤ 0.5).</p><p><strong>Conclusion: </strong>3DCT measurements have a potential role in defining post-LSG stenosis and predicting outcomes of revisional surgery. Patients with anatomic abnormalities that are shown on CT appear to improve with anatomic correction.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11541335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}