Obesity Surgery最新文献

{"title":"Gastro-Jejunal Ileal Interposition with Bipartition: A Salvage Procedure for Severe Protein-Energy Malnutrition After Transit Bipartition.","authors":"Tugrul Demirel, Ulku Korkmaz, Surendra Ugale","doi":"10.1007/s11695-025-07825-5","DOIUrl":"https://doi.org/10.1007/s11695-025-07825-5","url":null,"abstract":"<p><strong>Background: </strong>Intractable diarrhea or excess weight loss associated with protein-energy malnutrition (PEM) can occur after Transit Bipartition (TB). This study evaluates the effect of transposing the alimentary limb to the proximal intestines.</p><p><strong>Methods: </strong>Between 2017 and 2024, ten patients with malnutrition and diarrhea underwent Gastro-Jejunal Ileal Interposition (GJIB) surgery after TB. We prospectively monitored protein-energy malnutrition postoperatively and retrospectively analyzed demographic data, laboratory findings, and anthropometric measurements. Gastric transit scintigraphy was performed on symptomatic and asymptomatic patients to evaluate gastric evacuation diversity between the pylorus and the gastro-ileostomy.</p><p><strong>Results: </strong>Ten patients (male/female, 6/4) were operated on. The preoperative mean age was 49.4 ± 9.19 years. The mean body mass index (BMI) was 22.19 ± 1.13 kg/m², the mean excess BMI loss (%EBMIL) percentage was 123.26 ± 14.85%, and the total weight loss percentage (%TWL) was 42.35 ± 0.33. Eighty percent of food passed through the gastroileostomy in all patients. The mean follow-up period was 50.56 ± 57.28 months. Postoperatively, the mean BMI increased to 28.16 ± 2.2 kg/m² (p = 0.001), %EBMIL decreased to 79.88 ± 21.53% (p = 0.001), and %TWL decreased to 27.31 ± 10.1. Albumin levels rose from a median of 2.1 mg/dl to an average of 3.8 ± 0.78 mg/dl (p = 0.001), and stool frequency decreased from 11.56 ± 0.71 to 2.1 ± 2.12 per day (p = 0.001). The excluded bowel length percentage (Exl.B%) decreased significantly from 72.4 ± 3.18% to 12.3 ± 1.99% after conversion (p = 0.005). All patients were diabetic before and had remission after TB. Glycemic control was preserved after the conversion, with a median HbA1c of 5.4% compared to 5.8% before conversion.</p><p><strong>Conclusions: </strong>GJIB may be a viable revision procedure for resolving PEM and related complications without compromising the metabolic benefits of the initial surgery on diabetes resolution by decreasing the Exl.B%.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812057","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":"Assessment of Preoperative Multivitamin Use on the Impact on Micronutrient Deficiencies in Patients with Obesity Prior to Metabolic Bariatric Surgery.","authors":"Johannes Sander, Bart Torensma, Jacqueline Siepe, Torsten Schorp, Thilo Schulte, Christine Schmeer, Hannes Gögele, Inga Böckelmann, Andrea Grabenhorst, Ildiko Ockert-Belz, Frits Berends, Edo Aarts","doi":"10.1007/s11695-025-07853-1","DOIUrl":"https://doi.org/10.1007/s11695-025-07853-1","url":null,"abstract":"<p><strong>Background: </strong>Most patients achieve successful weight loss following metabolic bariatric surgery (MBS), but they face an increased risk of micronutrient deficiencies due to altered gastrointestinal physiology and dietary restrictions. This study evaluated the impact of a specialized multivitamin on blood serum levels before MBS.</p><p><strong>Methods: </strong>A prospective, within-patient comparison trial was conducted between January and July 2023 at a large bariatric clinic. Differences in serum micronutrient levels between baseline and the 3-month follow-up were assessed, along with changes in the prevalence of micronutrient deficiencies.</p><p><strong>Results: </strong>Of 120 patients recruited, 99 (82.5%) completed the 3-month follow-up. Significant changes were observed in 13 of 21 serum parameters (61.9%). Ten parameters, including iron, vitamin K₁, zinc, C-reactive protein, hemoglobin, hematocrit, mean corpuscular volume, calcium, folic acid, and vitamin D, showed significant increases (p < 0.001). Conversely, magnesium, phosphate, and albumin levels significantly decreased (p < 0.001). Among 21 parameters, deficiencies were identified in 17 (80.1%), with prevalence rates ranging from 1.0% (copper) to 88.8% (vitamin D). After 3 months, significant reductions in deficiency prevalence were observed for iron, folic acid, and vitamin D. However, phosphate deficiency increased significantly, from 2.1 to 19.8% (p < 0.001).</p><p><strong>Conclusions: </strong>Micronutrient deficiencies are prevalent in patients with obesity. Preoperative specialized multivitamin supplementation effectively reduces key deficiencies, particularly in iron, folic acid, and vitamin D. Future research should address residual deficiencies and evaluate long-term outcomes of prolonged supplementation.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812053","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 Brief Guide for Endoscopists: Key Points for Upper Gastrointestinal Endoscopy in Patients Undergoing Sleeve Gastrectomy.","authors":"Eduardo Lemos de Souza Bastos, Samuel Azenha Gregorio","doi":"10.1007/s11695-025-07863-z","DOIUrl":"https://doi.org/10.1007/s11695-025-07863-z","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812052","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":"Biography Dr. Ramon Vilallonga Puy.","authors":"Miguel Angel Carbajo, Ramon Vilallonga","doi":"10.1007/s11695-025-07812-w","DOIUrl":"https://doi.org/10.1007/s11695-025-07812-w","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812055","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":"Bariatric Lymphedema One-Stage Operative Management (BLOOM).","authors":"Nadia Hui-Shan Sim, Lester Wei-Lin Ong, Matthew Sze Wei Yeo, Baldwin Po-Man Yeung, Allen Wei-Jiat Wong","doi":"10.1007/s11695-025-07847-z","DOIUrl":"https://doi.org/10.1007/s11695-025-07847-z","url":null,"abstract":"<p><strong>Background: </strong>Obesity and lymphedema pose serious public healthcare problems. Though there are clear links between both chronic conditions, they are rarely treated together.</p><p><strong>Methods: </strong>We describe the successful management of secondary lower limb lymphedema by the combination of obesity and lymphedema treatment in a 44-year-old patient with a body mass index of 35. She underwent simultaneous a vascularized lymph node transfer by repurposing the gastroepiploic lymph nodes from the sleeve gastrectomy.</p><p><strong>Results: </strong>The patient recovered uneventfully with significant improvement in her BMI and lymphedema.</p><p><strong>Conclusion: </strong>We present a novel and effective double-pronged treatment method for patients with both lymphedema and obesity.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812054","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":"Endoscopic Sleeve Gastroplasty for the Treatment of Metabolic Syndrome: A Systematic Review and Meta-analysis.","authors":"Mark Hanscom, Muhammad Usman Baig, Drew Wright, Laith Baqain, Kate Elise Johnson, Vivek Kumbhari, Shelby Sullivan, Barham Abu Dayyeh, SriHari Mahadev, Carolyn Newberry, Kartik Sampath, David Carr-Locke, Christopher Thompson, Reem Sharaiha","doi":"10.1007/s11695-025-07842-4","DOIUrl":"https://doi.org/10.1007/s11695-025-07842-4","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic sleeve gastroplasty (ESG) is an incisionless weight loss procedure that has been demonstrated to be safe and effective for the treatment of obesity; however, the efficacy of ESG for the treatment of comorbid type 2 diabetes mellitus (T2DM) and other components of metabolic syndrome (MetS) has been less well studied. We aimed to conduct a systematic review and meta-analysis of available literature to evaluate the outcomes of ESG on T2DM and MetS.</p><p><strong>Methods: </strong>Bibliographic databases were systematically searched for studies assessing the outcomes of ESG on T2DM and MetS. Studies were included if they reported at least one objective outcome related to T2DM or other components of MetS, including hyperlipidemia (HLD), hypertriglyceridemia, and hypertension (HTN). This study was deemed IRB exempt.</p><p><strong>Results: </strong>Ten studies with 4320 patients were included. At 12 months, ESG was associated with significant improvements in T2DM, HLD, and HTN, with risk difference of - 0.72 [95% CI, - 0.87 to - 0.58, p < 0.00001], - 0.65 [95% CI, - 0.78 to - 0.52, p < 0.00001], and - 0.60 [95% CI, - 0.66 to - 0.53, p < 0.00001], respectively. Disease improvement was defined as patients being able to stop some or all of their related treatment medications. Additionally, there were significant reductions in hemoglobin A1c (HGBA1c), fasting blood glucose, homeostatic model assessment for insulin resistance (HOMA-IR), low-density lipoprotein, and triglycerides.</p><p><strong>Conclusions: </strong>ESG is an effective modality for the treatment of comorbid T2DM and MetS in patients with obesity. Additional studies are needed to establish long-term responses and to compare ESG against established pharmacologic and surgical techniques.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812056","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 Clinical Conundrum: Prophylactic Metabolic Bariatric Surgery for People Without Obesity?","authors":"Francesco Saverio Papadia, Ricardo Vitor Cohen, Nicola Di Lorenzo","doi":"10.1007/s11695-025-07851-3","DOIUrl":"https://doi.org/10.1007/s11695-025-07851-3","url":null,"abstract":"<p><p>Revisional metabolic and bariatric surgery (MBS) in patients with a body mass index (BMI) below the obesity threshold (> 30 kg/m²) presents complex clinical and ethical challenges. Indications for reoperation vary widely, from acute complications like gastric band slippage to chronic metabolic disorders such as persistent hypoglycemia after Roux-en-Y gastric bypass (RYGB). While some revisional procedures, like elongation of the common limb for malabsorption-related complications, are widely accepted, other interventions remain controversial. The introduction of a distinct ICD code could help classify MBS-related complications and support surgical decision-making independent of BMI. Additionally, the role of obesity management medications (OMMs) complicates the landscape, as their discontinuation often leads to weight regain. The prophylactic use of MBS to prevent future weight gain is highly debated and risks expanding surgical indications inappropriately. Establishing clear guidelines for revisional surgery in non-obese patients with complications is crucial to ensure justified and effective interventions.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795983","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":"Intragastric Balloon as a Bridge Before Metabolic and Bariatric Surgery: A Systematic Review and Meta-analysis.","authors":"Mohammad Kermansaravi, Ali Esparham, Chetan Parmar, Farah A Husain, Ali Solouki, Mohammad Mahjoubi, Amir Hossein Davarpanah Jazi, Shahab Shahabi Shahmiri","doi":"10.1007/s11695-025-07838-0","DOIUrl":"https://doi.org/10.1007/s11695-025-07838-0","url":null,"abstract":"<p><p>The intragastric balloon (IGB) acts as a restrictive procedure with acceptable short-term weight loss outcomes and a low incidence of major complications. This systematic review and meta-analysis aimed to assess whether preoperative insertion of an IGB can reduce perioperative complications and improve weight loss outcomes following metabolic bariatric surgery (MBS). PubMed, Embase, Scopus, and Web of Science databases were searched using relevant keywords to include studies on IGB as a bridge before MBS. The main outcome of this study was to compare the weight loss results and complications after MBS between the IGB group and the control group. For the meta-analysis of variables with severe and non-severe heterogeneity, random-effects and fixed-effects meta-analyses were used, respectively. Eleven articles were included. The IGB and control groups included 318 and 501 patients, respectively. The pooled random-effects analysis of six studies showed that preoperative IGB insertion resulted in a body mass index (BMI) loss of 7.45 kg/m² over a mean follow-up of 6.14 months. The major complication rate for IGB was 5%. The mean BMI change after MBS between the IGB and control groups was not significantly different after 15.06 months (mean difference - 4.08, p = 0.07). Additionally, a fixed-effects analysis of ten studies found no significant difference in post-MBS complication rates between the IGB and control groups (OR 0.66, p = 0.12). Even though using IGB as a bridging approach to subsequent MBS can result in significant reductions in preoperative BMI, this weight loss does not appear to positively impact the overall outcomes of MBS in patients in the long term.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803929","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":"Effects of different Metabolic Bariatric Surgeries in Testosterone Levels: A Systematic Review and Meta-Analysis.","authors":"Rodrigo Pinto Diniz, Ítalo Kauan Ribeiro de Carvalho Martins, Welbert Souz Furtado, Layza Hellen Fernandes Menezes, Almir Vieira Dibai Filho, Ed Carlos Rey Moura, Caio Márcio Barros de Oliveira, Plínio da Cunha Leal","doi":"10.1007/s11695-025-07839-z","DOIUrl":"https://doi.org/10.1007/s11695-025-07839-z","url":null,"abstract":"<p><p>Obesity, a globally prevalent condition associated with various comorbidities, has significant impacts on male endocrine health, including alterations in testosterone levels. Metabolic Bariatric Surgery stands out as an effective approach to promoting weight loss and improving hormonal outcomes. This study aims to evaluate and compare the effects of Roux-en-Y gastric bypass (RYGB) and Laparoscopic Sleeve Gastrectomy (LSG) or Laparoscopic adjustable gastric banding (LAGB) on testosterone levels in men. This systematic review and meta-analysis followed the Cochrane Handbook and PRISMA guidelines, registered under Id no. CRD42025633946, approved on Jan 29, 2025, in the Prospective International Registry of Systematic Reviews (PROSPERO). The search was conducted in Medline, Embase, and Web of Science platforms (up to July 2024) focused on studies comparing RYGB and LSG or LAGB and reporting pre- and post-surgery testosterone levels. Data on patients, interventions, and outcomes were extracted, and statistical analyses employed random-effects models and heterogeneity assessment. The combined analysis showed a mean difference of 113.07 ng/dL (95% CI: 1.47 to 224.67) favoring RYGB, with high heterogeneity (I² = 65%). Individual studies suggest a greater increase in testosterone levels in the RYGB group. This review suggests that RYGB may lead to a significant increase in testosterone levels, but the results should be interpreted cautiously due to study limitations and variability, and future studies with larger samples and standardized protocols are needed.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788611","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":"Pathophysiological Insights of Perforated Peptic Ulcer After One Anastomosis Gastric Bypass.","authors":"Eduardo Neubarth Trindade, Manoel Roberto Trindade","doi":"10.1007/s11695-025-07802-y","DOIUrl":"https://doi.org/10.1007/s11695-025-07802-y","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788616","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}