Obesity Surgery最新文献

{"title":"Impaired Iron-Copper Metabolic Axis in Human Intestinal Mucosa After Roux-en-Y Gastric Bypass: A Prospective Transcriptomic Study Using Double-Balloon Enteroscopy.","authors":"Camila Shimizu, Dan Linetzky Waitzberg, Raquel Susana Torrinhas, Steven B Heymsfield, Mariana Doce Passadore, Priscila Sala","doi":"10.1007/s11695-026-08713-2","DOIUrl":"https://doi.org/10.1007/s11695-026-08713-2","url":null,"abstract":"<p><strong>Background: </strong>Roux-en-Y gastric bypass (RYGB) effectively leads to weight loss in patients with severe obesity but is often accompanied by refractory iron deficiency. The molecular mechanisms governing the human intestinal copper-iron metabolic axis post-surgery remain poorly defined. This study evaluated the longitudinal impact of RYGB on intestinal gene expression related to micronutrient homeostasis.</p><p><strong>Methods: </strong>In a prospective study of 20 women (body mass index, BMI 46.5 ± 5.3 kg/m²), intestinal mucosa biopsies were collected via double-balloon enteroscopy (DBE) pre- and three months post-RYGB from anatomically marked sites in the duodenum, jejunum, and ileum. Gene expression was assessed using Affymetrix microarrays, with Ceruloplasmin (CP) validated by RT-qPCR.</p><p><strong>Results: </strong>Three months post-RYGB, BMI significantly (p < 0.05) decreased to 38.2 ± 4.2 kg/m². Microarray analysis revealed segment-specific adaptations. Divalent metal transporter 1 (DMT1) was significantly (p < 0.05) upregulated in the bypassed duodenum (+ 0.421), indicating a local compensatory response to decreased iron availability. Conversely, CP expression was significantly downregulated across all segments, notably in the jejunum (- 1.017; p < 0.05). This downregulation, confirmed by RT-qPCR, suggests impaired iron oxidation and mobilization. Lysyl oxidase (LOX), a copper-dependent enzyme critical for mucosal structural integrity, was also significantly downregulated in the duodenum (- 0.333; p < 0.05) and jejunum (- 0.450; p < 0.05).</p><p><strong>Conclusion: </strong>RYGB induces early and segment-specific transcriptional adaptations in the intestinal mucosa. The upregulation of DMT1 in the bypassed duodenum suggests a compensatory response, whereas the consistent downregulation of CP and LOX indicates a potential alteration in the copper-iron metabolic axis. These findings provide a biologically plausible framework for postoperative micronutrient disturbances; however, in the absence of functional and biochemical data, causal relationships cannot be established.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856887","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 Erector Spinae Block on Postoperative Outcomes in Bariatric Surgery Patients: A Systematic Review, Meta-Regression, and Trial-Sequential Analysis of Randomized Controlled Trials.","authors":"Vitaliy Voznyy, Salem Abu Al-Burak, Yamini Subramani, Mouad Elganga, Alla Iansavitchene, Lee-Anne Fochesato, Priyanka Singh, Harley Williams, Christopher Harle, Mahesh Nagappa","doi":"10.1007/s11695-026-08716-z","DOIUrl":"https://doi.org/10.1007/s11695-026-08716-z","url":null,"abstract":"<p><strong>Background: </strong>Bariatric surgery is effective for severe obesity, but recovery is often complicated by pain, nausea, and high opioid use. This systematic review and meta-analysis (SRMA) evaluates the role of erector spinae plane block (ESPB) in reducing pain, opioid consumption, and postoperative nausea and vomiting (PONV) after bariatric surgery.</p><p><strong>Methods: </strong>Electronic databases were systematically searched from their inception to March 2025 for randomized controlled trials (RCTs) assessing bilateral ESPB in adults undergoing bariatric surgery. This review included studies which compared ESPB to a control group and reported at least one postoperative outcome. The primary outcome was resting pain at 6 h and 24 h. The mean difference (MD) and 95% confidence interval (CI) were calculated for each study and pooled using a random-effects model. The meta-regression and trial sequential analysis were performed to evaluate the impact of confounding variables and sample size on the pooled estimate. The risk of bias and certainty of evidence were assessed using the Cochrane Risk of Bias 2 (RoB 2) and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) assessment tools.</p><p><strong>Results: </strong>Twelve RCTs (n = 825; ESPB = 412, control = 413) were included. ESPB significantly reduced resting pain at 6 h (MD: 1.79; 95% CI: 0.80 - 2.78; p = 0.0004) and 24 h (MD: 1.09; 95% CI: 0.38-1.79; p = 0.002). Six RCTs (n = 509) reported lower movement-evoked pain at 6 h (MD:1.28; 95% CI: 0.68-1.88; p < 0.0001) and 24 h (MD: 0.79; 95% CI: 0.44-1.14; p < 0.0001). Nine RCTs (n = 673) showed reduced 24-h opioid consumption (MD: 9.0; 95% CI: 2.72 to 15.27, P = 0.005). Five RCTs (n = 448) reported a lower incidence of PONV with ESPB (Risk Ratio: 1.47; 95% CI: 1.08-1.98, p = 0.01). Meta-regression to adjust for baseline confounding factors and trial sequential analysis did not materially alter the results. The risk of bias was low, and the certainty of evidence was rated as moderate to low.</p><p><strong>Conclusion: </strong>This SRMA of RCTs demonstrates that ESPB may significantly reduce postoperative pain, 24-h postoperative opioid consumption, and PONV compared to control in patients undergoing bariatric surgery. However, further RCTs with adequate power, unified protocols, and clearly defined endpoints are warranted.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841223","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":"Retraction Note: Intrathoracic Migration of Gastric Sleeve Affects Weight Loss as well as GERD-an Analysis of Remnant Gastric Morphology for 100 Patients at One Year After Laparoscopic Sleeve Gastrectomy.","authors":"Seung Joon Choi, Seong Min Kim","doi":"10.1007/s11695-026-08718-x","DOIUrl":"https://doi.org/10.1007/s11695-026-08718-x","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841191","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 Role of Total Small Bowel Length and its Measurement in Metabolic Bariatric Surgery. A Systematic Review.","authors":"Niccolo Petrucciani, Chiara Cuzzocrea, Margherita Floris, Marta Zerunian, Nunzio Velotti, Paolo Aurello, Marta Goglia, Maria Vittoria Mascolini, Mirto Foletto, Chiara Giulia Fontanella, Mario Musella, Gianfranco Silecchia","doi":"10.1007/s11695-026-08715-0","DOIUrl":"https://doi.org/10.1007/s11695-026-08715-0","url":null,"abstract":"<p><p>This systematic review evaluated the role and measurement of total small bowel length (TSBL) in metabolic bariatric surgery (MBS) following PRISMA guidelines. Twenty-seven studies involving 6968 adult patients undergoing bariatric surgery with TSBL measurement were included. Outcomes of interest included TSBL, weight loss outcomes, comorbidities improvement/resolution, and the relationship between TSBL and weight loss outcomes. Mean TSBL ranged from 506.5 cm to 795.0 cm. Complications related to TSBL measurement occurred in six patients (0.2%), all small bowel perforations. Nutritional deficiencies ranged from 0.3% to 33.8%. In six studies, tailoring procedures according to TSBL was associated with fewer nutritional deficiencies than in controls. Adoption of standardized TSBL measurement protocol may have a notable impact on surgical outcomes with respect to reducing malabsorptive complications in highly malabsorptive procedures.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841219","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":"A Machine-Learning Assisted Genetic Risk Score Identifies Improved Weight Loss After Endoscopic Sleeve Gastroplasty.","authors":"Thomas Fredrick, Daniel Maselli, Eric Vargas, Chase Wooley, Khushboo Gala, Diego Anazco, Serban Ciotlos, Timothy O'Connor, Barham Abu Dayyeh, Christopher McGowan, Andres Acosta","doi":"10.1007/s11695-026-08642-0","DOIUrl":"https://doi.org/10.1007/s11695-026-08642-0","url":null,"abstract":"<p><strong>Background and aims: </strong>Obesity remains an epidemic associated with significant health consequences. Endoscopic sleeve gastroplasty (ESG) can lead to significant and sustained weight loss, with heterogeneous response. We previously reported a machine-learning (ML) assisted genetic risk score (GRS) for calories to satiation that predicts response to anti-obesity medications. Here, we evaluated the performance of novel GRSs for emotional hunger (EH), and calories to satiation (CTS, also high or low CTS_GRS) to predict weight loss after ESG.</p><p><strong>Methods: </strong>Individuals treated with ESG at two separate endobariatric centers completed genetic testing using MyPhenome^® test (Phenomix Sciences, Menlo Park, CA). This test uses a machine-learning (ML) assisted GRS for high or low CTS_GRS and a GRS score combined with survey responses for EH. The primary outcome was total body weight loss (TBWL) after ESG at 12 and 24 months. Last observation carried forward (LOCF) analysis was used for missing values. Statistical analysis was performed using ANOVA analysis for multiple groups, and Tukey's HSD for pairwise analysis.</p><p><strong>Results: </strong>Forty individuals completed testing. The low CTS_GRS group had a greater TBWL than both other groups at all observed time points (3 to 24 months). TBWL in the low CTS_GRS group was most significant at 12 months using LOCF analysis (21.4% vs. 13.7% in EH; p = 0.0153, and 14.9% in high CTS_GRS; p = 0.0305) and persisted to 24 months.</p><p><strong>Conclusion: </strong>We report that a machine-learning assisted GRS is associated with significantly greater weight loss after ESG. Identifying individuals more likely to have superior weight loss response may improve selection of patient candidates for ESG.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841198","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":"Safety, Efficacy, and Quality of Life Outcomes of Bariatric and Metabolic Surgery in Korea: A Prospective Multicenter Cohort Study.","authors":"Sung Il Choi, Yoonseok Heo, Seung Wan Ryu, Sungsoo Park, Yeongkeun Kwon, Tae Kyung Ha, Yeon-Ji Lee, Sangjun Lee, Kyung Won Seo, Sang Hyun Kim, Ji Yeon Park, Jong-Han Kim","doi":"10.1007/s11695-026-08697-z","DOIUrl":"https://doi.org/10.1007/s11695-026-08697-z","url":null,"abstract":"<p><strong>Introduction: </strong>This prospective multicenter cohort study aimed to assess the effectiveness and safety of bariatric and metabolic surgery (BMS) in Korean patients with class II obesity or higher and those with a body mass index (BMI) ≥ 27.5 kg/m².</p><p><strong>Methods: </strong>Between September 2020 and December 2022, 116 patients undergoing BMS were enrolled from nine centers in Korea. Of these, 37 patients underwent gastric bypass and 79 underwent sleeve gastrectomy. Follow-up evaluations were performed for up to 2 years. Clinical data were collected alongside four quality of life (QOL) surveys (EQ-5D, IWQOL-lite, OP-scale, and BAROS) administered at 12, 24, 48, 72, and 96 weeks postoperatively. Clinical parameters included obesity severity, complications by surgery type, associated medical problems, nutritional status, and their longitudinal changes.</p><p><strong>Results: </strong>The cohort had a mean age of 37.0 ± 11.1 years and a mean BMI of 41.9 ± 7.6 kg/m²; 71.6% of participants were female. Baseline associated medical problems included type 2 diabetes mellitus (T2DM) in 45 patients (38.8%), hypertension in 77 (66.4%), and hyperlipidemia in 77 (66.4%). Total weight loss reached 26.8% at 1 year, 27.5% at 1.5 years, and 24.7% at 2 years. Remission rates for T2DM, hypertension, and hyperlipidemia at 1 year were 80.7%, 50.0%, and 49.0%, respectively, increasing to 85.7%, 50.0%, and 71.4% at 2 years. No significant differences were observed between the procedures in postoperative weight trajectories, nutritional outcomes, or improvements of associated medical problem. All QOL scores showed significant and sustained improvement across all surveys. The overall complication rate was 12.1% (early: 0.9%, late: 11.2%), which was considered acceptable.</p><p><strong>Conclusion: </strong>Gastric bypass and sleeve gastrectomy are effective and safe BMS procedures for Korean patients, providing substantial weight loss, remission of associated medical problems, and improved QOL.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841178","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":"Correction to: Residual Stigma and Internalized Weight Bias following Metabolic Bariatric Surgery.","authors":"Rebecca Puhl, Kyriakos Papasavas, Isabel Michalak, Yin Wu, Tara McLaughlin, Arit Esu, Darren Tishler, Pavlos Papasavas, Dale Bond, Devika Umashanker","doi":"10.1007/s11695-026-08719-w","DOIUrl":"https://doi.org/10.1007/s11695-026-08719-w","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841244","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 Efficacy of Transversus Abdominis Plane Blocks in Roux-en-Y Gastric Bypass - a Systematic Review and Meta-Analysis of Randomised Control Trials.","authors":"Caroline Drumm, Matthew G Davey, Shane Moore, Taya Keating, Noel E Donlon","doi":"10.1007/s11695-026-08711-4","DOIUrl":"https://doi.org/10.1007/s11695-026-08711-4","url":null,"abstract":"<p><strong>Background: </strong>Transversus abdominis plane (TAP) block is commonly used as an element of multimodal analgesia following abdominal surgery; however, its efficacy in Roux-en-Y gastric bypass (RYGB) remains uncertain.</p><p><strong>Aim: </strong>To perform a systematic review and meta-analysis of randomised clinical trials (RCTs) to evaluate the effectiveness of TAP block following RYGB.</p><p><strong>Methods: </strong>A comprehensive search was performed as per PRISMA guidelines. RCTs comparing TAP block with control in adult patients undergoing RYGB were included. Primary outcomes were postoperative pain scores (visual analogues scores (VAS)/numeric rating scale (NRS)) in recovery and at 6, 12, and 24-hours. Data analytics were performed using RevMan v.5.3.</p><p><strong>Results: </strong>Five RCTs comprising 481 patients were included. TAP block did not significantly reduce pain scores in recovery, at 6-hours, or at 12-hours postoperatively. A significant reduction in pain was observed at 24-hours (mean difference (MD) -0.57, 95% CI -0.96- -0.17, p = 0.005, I² = 92%). Patients receiving TAP block were significantly less likely to require breakthrough opioid analgesia (odds ratio (OR) 0.09, 95% confidence interval (CI) 0.02-0.32, p = 0.0003, I² = 51%). TAP block was also associated with earlier ambulation (MD -1.65, 95% CI -2.32- -0.98, p < 0.00001, I² = 0%). No significant differences were observed in PONV or LOS.</p><p><strong>Conclusion: </strong>While TAP block provided limited benefit in early postoperative pain control in patients undergoing RYGB, it was associated with reduced 'breakthrough' opioid requirements, earlier mobilisation, and a significant analgesic effect at 24 h. These findings support the use of TAP blocks as an opioid-sparing adjunct within enhanced recovery after bariatric surgery pathways.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841166","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":"Probiotic Effect on Quality of Life, Bowel Habits and Weight Loss after Different Types of Bariatric Surgeries, a Randomized Controlled Trial.","authors":"Mostafa Mahmoud Abdelfatah, Osama Salah Mohammad, Ismail Ahmed Shafik, Mahmoud Ali Mohammed AbdelMohsen","doi":"10.1007/s11695-026-08706-1","DOIUrl":"https://doi.org/10.1007/s11695-026-08706-1","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity is a complex health condition marked by an excessive accumulation of adipose tissue. Bariatric surgery continues to be the most efficacious intervention for attaining significant and enduring weight loss. This study aimed to assess a 6-month probiotics supplementation effect on quality of life (QoL), bowel habits, excess weight loss (EWL) and changes in stool composition and fecal Calprotectin in severely obese patients undergoing different types of bariatric surgeries.</p><p><strong>Methods: </strong>This prospective randomized controlled trial involved 200 cases underwent standardized bariatric procedures. Cases were randomized into two equal groups: Probiotic group received either Enterogermina^® 6 billion sachets or Lacteol forte^® sachets, one sachet twice daily for 6 months postoperatively and control group: Patients received standard postoperative care without probiotics.</p><p><strong>Results: </strong>At 1 month postoperatively, the probiotics group showed a significantly higher QOL and EWL% (p < 0.001) compared to controls. At 3 months, the probiotics group had a significantly higher QOL and EWL% (p < 0.001). At 6 months, the probiotics group showed a statistically significant improvements across all measured outcomes, including QOL, BHQ, and EWL% compared to the control group(p < 0.001). Probiotic group had a significantly lower fecal calprotectin compared to control group (p < 0.001).</p><p><strong>Conclusion: </strong>The probiotic use post-bariatric surgery offers measurable benefits in QOL, weight loss, and gastrointestinal inflammation, regardless of the surgical type. Although procedures like RYGB and OAGB yield superior weight loss, they may induce higher gut inflammation. Meanwhile, sleeve gastrectomy appears to be the most gut-friendly in terms of inflammatory markers and bowel consistency.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841225","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":"Publisher Correction: Machine Learning Models for Predicting Significant Liver Fibrosis in Patients with Severe Obesity and Nonalcoholic Fatty Liver Disease.","authors":"Chien-Hung Lu, Weu Wang, Yu-Chuan Jack Li, I-Wei Chang, Chi-Long Chen, Chien-Wei Su, Chun-Chao Chang, Wei-Yu Kao","doi":"10.1007/s11695-026-08668-4","DOIUrl":"https://doi.org/10.1007/s11695-026-08668-4","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841216","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}