Obesity Surgery最新文献

{"title":"Applications of Artificial Intelligence in Bariatric Surgery: Enhancing Education, Monitoring, and Outcomes.","authors":"Manuel Andrey Felix Castro, Martha Patricia Sánchez Muñoz, Carlos Manuel Moreno Mendoza, Gabriela Zamudio Martínez","doi":"10.1007/s11695-025-07985-4","DOIUrl":"https://doi.org/10.1007/s11695-025-07985-4","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326450","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":"Comments on: Frailty Index as a Predictor of Operative Safety and Efficacy in Patients Undergoing Laparoscopic Sleeve Gastrectomy.","authors":"Zhantao Cao, Jun Chen, Yunsu Wang","doi":"10.1007/s11695-025-07981-8","DOIUrl":"https://doi.org/10.1007/s11695-025-07981-8","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333575","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":"Editorial Opinion: Methodological Rigor in Metabolic and Bariatric Surgery Research-Learning from History.","authors":"Ala Wafa, Mohammad Kermansaravi, Ricardo Cohen","doi":"10.1007/s11695-025-07982-7","DOIUrl":"https://doi.org/10.1007/s11695-025-07982-7","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326451","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":"Quantitative CT Imaging Radiomics-Based Prediction of Bone Mineral Density Changes After Sleeve Gastrectomy.","authors":"Deyao Hu, Jilu Ruan, Chengjian Liu, Zhengrong Liang, Xuetao Mu","doi":"10.1007/s11695-025-07994-3","DOIUrl":"https://doi.org/10.1007/s11695-025-07994-3","url":null,"abstract":"<p><strong>Background: </strong>This study focuses on extracting preoperative vertebral quantitative CT (QCT) radiomic features and developing models to predict changes in bone mineral density (BMD) after sleeve gastrectomy (SG).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 203 patients who underwent SG at Qujing Second People's Hospital between June 2022 and February 2024. Patients were divided into two groups based on changes in lumbar vertebra 1 QCT values: BMD decreased and BMD stable/increased. Data were randomly split into training and test sets (7:3 ratio) using stratified sampling. Radiomic features were extracted and normalized, and feature selection was performed using ICC, variance thresholding, mutual information, and LASSO. XGBoost models were built for clinical, radiomic, and combined data, with performance evaluated using ROC curves, AUC, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Significant differences were observed in BMI, erector spinae average CT value, AST, and ALT between groups. Based on clinical and radiomic features, the AUC values of the XGBoost models in the training and test sets were as follows: clinical model 0.94, 0.88; radiomic model 0.98, 0.96; combined model 0.97, 0.96. DCA showed that the combined model provided the highest net benefit across all threshold values.</p><p><strong>Conclusion: </strong>Vertebral QCT combined with clinical features can effectively predict postoperative BMD changes after SG.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326453","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":"Postoperative Nausea and Vomiting After Metabolic Bariatric Surgery: a Comprehensive Review.","authors":"Nozim Jumaev, Oktyabr Teshaev, Azamat Rajapov, Irina Lim","doi":"10.1007/s11695-025-07998-z","DOIUrl":"https://doi.org/10.1007/s11695-025-07998-z","url":null,"abstract":"<p><strong>Background and purpose: </strong>Metabolic bariatric surgery (MBS) has become an increasingly common treatment for morbid obesity and its comorbidities. Despite significant advances in surgical techniques and anesthesiological management, postoperative nausea and vomiting (PONV) remain frequent complications that significantly affect patient recovery. This review examines the epidemiology, pathophysiological mechanisms, risk factors, clinical features, prevention strategies, and treatment approaches for PONV in patients undergoing metabolic bariatric surgery.</p><p><strong>Methods: </strong>A systematic search was conducted in Cochrane Library, PubMed, and MEDLINE databases for relevant literature published between 2000 and 2024. Keywords included \"metabolic bariatric surgery,\" \"postoperative nausea and vomiting,\" \"PONV,\" \"laparoscopic gastric bypass,\" \"sleeve gastrectomy,\" \"PONV prevention,\" and \"PONV treatment.\" Randomized controlled trials, prospective and retrospective cohort studies, systematic reviews, and meta-analyses were included.</p><p><strong>Results: </strong>The incidence of PONV after metabolic bariatric procedures ranges from 20% to 70%, depending on the type of surgical intervention, anesthesia techniques, and patient characteristics. PONV after MBS is multifactorial, involving neurohormonal, inflammatory, mechanical, and pharmacological mechanisms. Female gender, non-smoking status, history of PONV or motion sickness, and postoperative opioid use are established risk factors. Multimodal prophylaxis based on individual risk assessment, including 5-HT3 antagonists, NK-1 antagonists, dexamethasone, and non-pharmacological approaches, has shown efficacy. The integration of PONV management into Enhanced Recovery After Surgery protocols has reduced PONV incidence and shortened hospital stays.</p><p><strong>Conclusions: </strong>Effective PONV management in metabolic bariatric patients requires a multimodal approach to prevention and treatment based on individual risk assessment and application of current pharmacological and non-pharmacological methods. Further research is needed to develop MBS-specific guidelines that consider the unique characteristics of these patients and contemporary surgical techniques.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326452","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":"Letter to Editor regarding \"Exploring the Acceptability of Post-bariatric Nutritional-Behavioral and Supervised Exercise Intervention (BARI-LIFESTYLE): A Mixed Methods Evaluation\".","authors":"Ziad Khan","doi":"10.1007/s11695-025-07983-6","DOIUrl":"https://doi.org/10.1007/s11695-025-07983-6","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317544","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 Bariatric Metabolic Surgery on Cardiovascular, Kidney, and Mortality Outcomes Among Adults with Obesity and Chronic Kidney Disease Across Different Time Frames.","authors":"Yu-Min Lin, Chia-Li Kao, Kuo-Chuan Hung, Tsung Yu, Mei-Yuan Liu, Chih-Cheng Lai, Jheng-Yan Wu","doi":"10.1007/s11695-025-07939-w","DOIUrl":"https://doi.org/10.1007/s11695-025-07939-w","url":null,"abstract":"<p><strong>Objective: </strong>Bariatric metabolic surgery (BMS) is an effective intervention for obesity, with proven benefits in reducing cardiovascular events and mortality. However, its impact on patients with chronic kidney disease (CKD) remains unclear. This study aims to evaluate the long-term outcomes of BMS compared to nonsurgical management in CKD patients with obesity, focusing on major adverse cardiovascular events (MACE), major adverse kidney events (MAKE), and all-cause mortality.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the TriNetX database, including adult patients with CKD and obesity. Patients who underwent BMS (Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy) were compared to those receiving lifestyle interventions. Propensity score matching (PSM) was applied to balance baseline characteristics. The primary outcome was a composite of all-cause mortality, MACE, and MAKE. Secondary outcomes included individual components of the primary outcome. Cox proportional hazards models and Kaplan-Meier survival analyses were used to assess outcomes across short-term (1 month-1 year), intermediate (up to 3 years), and long-term (up to 5 years) follow-up periods. Subgroup analyses were conducted by CKD stage (1-3 vs. 4-5) to evaluate effect heterogeneity across different levels of kidney function.</p><p><strong>Results: </strong>After matching, 5,221 patients were included in each group. Over a 5-year follow-up, BMS was associated with significantly lower risk of the primary composite outcome (HR 0.75, 95% CI 0.70-0.81; p < 0.001). Subgroup analyses showed that this protective effect was observed across all CKD stages, with a more pronounced reduction in MAKE among patients with advanced CKD (stages 4-5) compared to early-stage CKD (stages 1-3). BMS was also associated with greater preservation of eGFR over time compared to controls.</p><p><strong>Conclusion: </strong>Among adults with obesity and CKD, BMS was associated with lower risks of mortality, MACE, and MAKE, as well as slower decline in kidney function. The benefits were consistent across CKD stages and appeared particularly pronounced in patients with advanced CKD (stages 4-5), highlighting the potential role of BMS in high-risk kidney populations. Further randomized trials are needed to validate these results and refine patient selection criteria.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317543","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":"Comparing Anastomotic Leak Rate Between Robotic and Laparoscopic Bariatric Procedures: A Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Database Study.","authors":"Alexandria Jones, Alexander Hall, Kalyana Nandipati","doi":"10.1007/s11695-025-07935-0","DOIUrl":"https://doi.org/10.1007/s11695-025-07935-0","url":null,"abstract":"<p><p>In this MBSAQIP database study of over 560,000 bariatric procedures, the overall incidence of anastomotic leaks was 0.21%. Robotic sleeve gastrectomy (SG) was associated with a significantly higher leak rate compared to the laparoscopic approach. No significant differences in leak rates were observed between robotic and laparoscopic techniques for Roux-en-Y gastric bypass or duodenal switch. Prior foregut surgery and intraoperative drain placement were independently associated with increased risk of leak across all procedures.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317542","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":"Translation and Psychometric Evaluation of the Arabic Version of the Eating Disorders After Bariatric Surgery Questionnaire (EDABS‑Q‑Arabic18).","authors":"Mohamed Hany, Kareem El-Ansari, Walid El Ansari","doi":"10.1007/s11695-025-07910-9","DOIUrl":"https://doi.org/10.1007/s11695-025-07910-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;There is no validated Arabic questionnaire to assess eating disorders (ED) after metabolic and bariatric surgery (MBS) without the need for an interview. We undertook this task.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The English-published Eating Disorder Examination-Self-report Questionnaire Bariatric Surgery Version (EDABS-Q) was translated and adapted following international guidelines (forward/backward translation, expert panel review, and pretesting). Randomly selected adult patients (n = 1145) who had MBS since ≥ 1 year completed the Arabic questionnaire (EDABS-Q-Arabic). Psychometric properties of EDABS-Q-Arabic were assessed, including face validity (expert panel), construct validity (exploratory factor analysis, confirmatory factor analysis, structural model), internal consistency (Cronbach's α), and discriminant validity [heterotrait-monotrait (HTMT) ratio criterion]. Multiple logistic regression analyses tested associations between patient/surgical characteristics and various factors of the Arabic questionnaire.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Exploratory factor analysis generated a three-factor solution (18 items): 'concerns' about shape/weight/eating (9 items), 'restraint' behaviors (4 items), and 'purging' behaviors (5 items), explaining 22% of the total variance. Confirmatory factor analysis confirmed this factor structure displayed good model-data fit, with comparative fit index (0.96) and Tucker-Lewis index (0.95) both &gt; 0.95 threshold; χ&lt;sup&gt;2&lt;/sup&gt;/df ratio = 1.52 (recommended value ≤ 2); root mean square error of approximation = 0.031 (90%CI:0.022-0.040, p = 1.000) and standardized root mean square residual = 0.047 (recommended values ≤ 0.05). Cronbach's alpha (internal consistency) was 0.80 for 'concerns' (95%CI:0.78-0.82), 0.62 for 'restraint' (95%CI:0.55-0.68), and 0.61 for 'purging' behavior (95%CI:0.51-0.69). EDABS-Q-Arabic18's discriminant validity was excellent, confirming the distinctiveness of each factor, with 0.208 HTMT ratio between 'concerns' and 'restraint' factors, 0.198 between 'concerns' and 'purging', and 0.257 between 'restraint' and 'purging' factors (recommended thresholds &lt; 0.85-0.90). The prevalence of 'concerns' was 98.4%, with patients experiencing mild (31.1%), moderate (48.9%), severe (18.4%), or no (1.6%) concerns. The prevalence of 'restraint' behaviors was high (79.7%) but mostly mild (53.1%) or moderate (22.5%). 'Purging' behaviors had a lower prevalence (44.2%), with 40.1% mild, 3.8% moderate, and 0.3% severe purging. Logistic regression showed that for severe 'concerns', increasing age and pre-operative BMI displayed lower odds OR = 0.98, 95%CI 0.96-1.00, p = 0.013; OR = 0.96, 95%CI 0.93-0.98, p = 0.001 respectively), while current BMI and time since surgery exhibited significant positive associations (OR = 1.19, 95%CI 1.14-1.24, p &lt; 0.001; OR = 1.10, 95%CI 1.02-1.18, p = 0.011, respectively). For severe 'restraint' behaviors, only pre-operative BMI displayed significant","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317545","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":"Paragastric Neural Blockade Effectively Controls Visceral Pain After Primary Laparoscopic Sleeve Gastrectomy.","authors":"Dongwon Lim, Yoona Chung, Bomina Paik, Yong Jin Kim","doi":"10.1007/s11695-025-07991-6","DOIUrl":"https://doi.org/10.1007/s11695-025-07991-6","url":null,"abstract":"<p><strong>Background: </strong>Surgical advancements and the implementation of Enhanced Recovery After Surgery (ERAS) protocols have contributed to reduced postoperative pain and faster recovery. Despite these improvements in perioperative care, pain remains one of the most distressing symptoms, particularly during the early postoperative period. Visceral pain (VP), rather than somatic pain, is the predominant source of discomfort and is often difficult to manage with standard pain control methods. This study aims to replicate the findings of previous randomized controlled trials (RCTs) on the effectiveness of paragastric neural blockade (PGNB) in controlling VP, addressing the ongoing clinical challenge of inadequate pain control despite standard multimodal analgesia (MMA).</p><p><strong>Methods: </strong>A retrospective study was conducted from January to September 2024, comparing a control group (standard MMA including transversus abdominis plane [TAP] block, n=50) with a PGNB group (same protocol plus PGNB, n=50). The primary outcome was pain intensity (Numeric rating scale [NRS] score 0-10) within 48 hours post-surgery. Secondary outcomes included time to first analgesic use, cumulative analgesic doses, nausea/vomiting incidence, and hemodynamic changes.</p><p><strong>Results: </strong>NRS scores were significantly lower in the PGNB group within 8 hours postoperatively (p<0.001). The time to first rescue analgesic use was prolonged (1084.08±902.78 minutes vs. 260.60±482.25 minutes; p<0.001) and the cumulative frequency of analgesic use on the day of surgery was also lower in the PGNB group (0.46 times vs. 1.34 times; p<0.001). No significant differences in the incidence of postoperative nausea and vomiting (PONV) were observed on postoperative days (PODs) 0 and 2, although POD 1 showed higher nausea in the PGNB group (p=0.002). The operative time was significantly longer in the PGNB group (113.90±14.54 minutes vs. 97.86±20.78 minutes; p<0.001). There was one case of localized hematoma at the injection site, which was controlled with local compression and resolved within a few minutes. No other complications were observed.</p><p><strong>Conclusion: </strong>PGNB effectively reduces VP and the need for rescue analgesics during the early postoperative period following LSG, without any major complications.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310252","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}