Obesity Surgery最新文献

{"title":"Preoperative Patient Attrition in Metabolic Bariatric Surgery: A Retrospective Monocentric Study.","authors":"Umberto Albert, Serena Macchi, Alessia Leschiutta, Elide Francesca De Caro, Lisa Di Blas, Oriana Moro, Manuela Mastronardi, Biagio Casagranda, Nicolò de Manzini, Silvia Palmisano","doi":"10.1007/s11695-025-07730-x","DOIUrl":"10.1007/s11695-025-07730-x","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a major public health issue. Although metabolic bariatric surgery is recommended for patients with obesity and related comorbidities, several patients drop out after receiving surgical eligibility. This study aims to assess dropout rate and identify predictors of attrition before surgery.</p><p><strong>Methods: </strong>This retrospective monocentric study included patients enrolled between June 2007 and December 2019 at a metabolic bariatric surgery center. Sociodemographic, clinical, and psychopathological data were collected. Patients were divided into operated group and attrition group. Univariate analysis and multivariate binary logistic regression were performed to identify independent predictors of attrition.</p><p><strong>Results: </strong>Of the 447 patients, the dropout rate was 22.25%. Depressed mood, binge eating disorder, and impulsivity traits at the time of psychiatric evaluation were correlated with dropout from the bariatric pathway (p < 0.05), but these variables lost significance at multivariate analyses. Significant predictors of attrition included male gender (OR = 3.723, p = 0.001), active smoking (OR = 2.852, p = 0.009), and ex-smoker status (OR = 2.860, p = 0.044). Protective factors were socio-familial support (OR = 0.194, p = 0.003) and the metabolic syndrome (OR = 0.078, p = 0.047). The average waiting time for surgery was 11.57 ± 9.36 months.</p><p><strong>Conclusions: </strong>The study identifies key factors influencing patients' dropout in the surgical pathway, emphasizing the need for targeted interventions to improve retention. Although the presence of depressed mood, binge eating disorder, and impulsivity traits lost statistical significance at the multivariate analyses, their potential clinical relevance should be considered. The findings offer valuable insights for developing strategies to reduce attrition, enhance health care resource to support patients in achieving better health outcomes.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"674-684"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399751","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":"Patients with Severe Obesity Undergoing Roux-En-Y Gastric Bypass Versus Sleeve Gastrectomy: A Systematic Review and an Updated Meta-Analysis.","authors":"Pedro Bicudo Bregion, André Milani Reis, Rafaela Hamada Jucá, Josélio Rodrigues de Oliveira-Filho, Giulia Almiron da Rocha Soares, Everton Cazzo, Victor Kenzo Ivano","doi":"10.1007/s11695-025-07743-6","DOIUrl":"10.1007/s11695-025-07743-6","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic Roux-En-Y Gastric Bypass (LRYGB) contributes significantly to higher weight loss at 6 to 12 months when compared to Laparoscopic Sleeve Gastrectomy (LSG) in patients with severe obesity (SO-body mass index (BMI) ≥ 50 kg/m²). However, there is still no consensus regarding the best procedure in terms of mortality and complication rates. We performed a systematic review and meta-analysis to compare the complication rates between these two surgical procedures.</p><p><strong>Methods: </strong>PubMed, EMBASE, and Cochrane Central were searched for studies that compared LRYGB and LSG in SO patients. We pooled outcomes for mortality and complications, defined as bleeding, cardiovascular events, conversion to open procedure, and a composite endpoint of leak, abscess, fistulas, and reoperation. Length of stay and operative time were also pooled. A random-effects model was used, and statistical analyses were performed using R version 4.4.0.</p><p><strong>Results: </strong>A total of 156,767 patients from 28 observational studies were included, of whom 79,324 (50.6%) underwent LRYGB and 77,443 (49.4%) LSG. Length of stay (MD 0.45; 95% CI 0.42-0.48; P < 0.01) and operative time (MD 58.88; 95% CI 37.88-79.87; P < 0.01) were lower in the LSG group. Overall, there was no difference in mortality (OR 1.28; 95% CI 0.80-2.04; P = 0.311) and in complication rates (OR 1.22; 95% CI 0.85-1.76; P = 0.287). A subgroup analysis showed lower conversion to open procedure for patients who underwent LSG (OR 2.75; 95% CI 1.90-3.98; P < 0.001), and no difference was noted in bleeding (OR 0.98; 95% CI 0.47-2.07; P = 0.965), cardiovascular events (OR 0.99; 95% CI 0.43-2.29; P = 0.983), and a composite endpoint of leak, abscess, and fistulas (OR 0.82; 95% CI 0.67-1.01; P = 0.066).</p><p><strong>Conclusion: </strong>Our meta-analysis suggests that there is no difference in mortality and complication rates between the two groups. However, length of stay and operative time were lower in SO patients who underwent LSG.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"1146-1159"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441640","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":"Integrating Predictive Analytics and Digital Health Innovations to Reduce Postoperative Emergency Department Admissions in Bariatric Surgery.","authors":"Qiuwen Mi, Chunlan Huang","doi":"10.1007/s11695-025-07745-4","DOIUrl":"10.1007/s11695-025-07745-4","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"1193-1194"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441634","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":"Nutritional Concerns in the Meta-Analysis Comparing SADI and OAGB as Revisional Procedures Following Sleeve Gastrectomy.","authors":"Hassan El-Masry, Mohamed H Zidan, Mohamed Hany, Ahmed Abokhozima","doi":"10.1007/s11695-025-07684-0","DOIUrl":"10.1007/s11695-025-07684-0","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"1178-1181"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441636","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":"Outpatient Single Anastomosis Duodeno-ileal Bypass: Is It a Safe Option? A MBSAQIP Database Analysis.","authors":"Emiliano G Manueli Laos, Alvaro Ducas, Carson Potts, Francisco Schlottmann, Mario A Masrur","doi":"10.1007/s11695-025-07691-1","DOIUrl":"10.1007/s11695-025-07691-1","url":null,"abstract":"<p><strong>Background: </strong>Single anastomosis duodeno-ileal bypass (SADI) has emerged as a safe and effective bariatric procedure. Its simplicity and robust weight loss outcomes have contributed to its increasing popularity. While traditionally performed as an inpatient procedure, recent trends towards ambulatory surgery have prompted interest in outpatient SADI.</p><p><strong>Objective: </strong>This study aims to assess the safety profile of outpatient SADI cases reported in the MBSAQIP database, providing valuable insights into the feasibility and potential benefits of this approach.</p><p><strong>Methods: </strong>This retrospective study analyzed data from the MBSAQIP database. Patients who underwent SADI and were discharged on the same day of surgery were included. Demographic, medical history, and postoperative outcomes, including readmission, complication, and reoperation rates, were analyzed.</p><p><strong>Results: </strong>A total of 192 patients who underwent SADI and were discharged on the same day of surgery were included. The majority of patients were female, with a mean age of 44.3 years. Thirty-day readmission and reoperation rates were 4.69% and 2.6%, respectively.</p><p><strong>Conclusion: </strong>Outpatient SADI can be a safe and effective option for appropriately selected patients, with similar complication and readmission rates to inpatient SADI and other outpatient bariatric procedures.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"784-789"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033754","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":"Comparison of Complications and Mortality in Patients Undergoing Laparoscopic Sleeve Gastrectomy With and Without Omentopexy.","authors":"Jamal Akhavan Moghaddam, Hamed Gholizadeh, Mehdi Raei, Fateme Khajat","doi":"10.1007/s11695-025-07695-x","DOIUrl":"10.1007/s11695-025-07695-x","url":null,"abstract":"<p><strong>Background: </strong>Among bariatric surgeries, laparoscopic sleeve gastrostomy (LSG) has gained good global acceptance, but this surgery, like any other invasive procedure, has side effects. Various techniques have been tested to reduce these complications, which are used under the title of stapler line reinforcement (SLR). The purpose of this research is to compare the bleeding, leakage, mortality, food intolerance, re-hospitalization, and post-operative invasive therapeutic interventions in LSG surgery in two groups with and without omentopexy method.</p><p><strong>Methods: </strong>In this retrospective cohort study, the patients who underwent LSG were included in the study and were compared in two groups with omentopexy and without omentopexy in terms of complications. The patients were followed up during the first year after the operation, and the patients were examined in terms of complications, including bleeding, leakage, mortality, food intolerance, re-hospitalization, and post-operative invasive therapeutic interventions.</p><p><strong>Results: </strong>In terms of bleeding (p = 0.263) and the frequency of leak cases (p = 0.286), no significant difference was observed between the two groups, but the treatment measures performed to control the leak had a significant difference between the two groups (p = 0.013). The need for re-admission was significantly higher (p = 0.017) in the group without omentopexy, and the need for re-surgery was also significantly different (p = 0.001) between the two groups. The frequency of food intolerance was significantly higher (p = 0.001) in the group without omentopexy, and the frequency of mortality was no statistically significant difference with the group with omentopexy (p = 0.304).</p><p><strong>Conclusions: </strong>The results of this study showed that the need for more aggressive interventions (laparotomy) to control bleeding and leak is less in the group with omentopexy, also the chance of re-hospitalization and re-surgery after omentopexy is reduced, and food intolerance disorder is less in this group. Therefore, the findings of this study show that LSG with omentopexy has fewer side effects than without omentopexy.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"1018-1025"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067068","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":"New Insights into Ruling Out Internal Herniations After Laparoscopic Gastric Bypass on the Abdominal CT Scan: The OPERATE study.","authors":"Marjolein R A Vink, Barbara A Hutten, Nienke van Olst, Sterre C P de Vet, Max Nieuwdorp, Arnold W van de Laar, Jeroen A W Tielbeek, Victor E A Gerdes","doi":"10.1007/s11695-025-07715-w","DOIUrl":"10.1007/s11695-025-07715-w","url":null,"abstract":"<p><strong>Background: </strong>Internal herniation (IH) is a potentially life-threatening complication after gastric bypass. Accurate diagnosis of IH remains challenging. This study aims to validate the Eindhoven2020 (EHV20) scoring system for ruling out IH and seeks to improve its diagnostic accuracy through additional radiologic parameters.</p><p><strong>Methods: </strong>Patients participating in a prospective study on abdominal pain after gastric bypass surgery were selected if a CT scan was performed. CT scans were scored following the EHV20 scoring system containing ten signs of IH to confirm the individual and collective accuracy of these signs. Also, we evaluated the diagnostic value of additional radiologic parameters: delayed passage of contrast, dilated intestinal loops, and free fluid.</p><p><strong>Results: </strong>A total of 375 patients with abdominal pain were included. IH was confirmed during laparoscopy in 27 patients. On CT, the highest sensitivity was achieved by the swirl sign (66.7%) and the highest specificity by a small bowel behind the superior mesenteric artery (99.7%). The area under the receiver operating characteristic curve (AUC) based on the EHV20 scoring system for ruling out IH was 0.845 (95% CI 0.730-0.959). The AUC could be improved to 0.905 (95% CI 0.825-0.985) (p = 0.088) through the incorporation of several additional signs. Overall, this new scoring system included swirl sign, small bowel obstruction, enlarged nodes, venous congestion, mesenteric edema, dilated alimentary or biliary loop, free fluid, and backward flow in the biliary loop with possible backflow in the residual stomach.</p><p><strong>Conclusions: </strong>Incorporation of additional CT signs into an existing scoring system can help clinicians to safely rule out IH in patients with abdominal pain after bariatric surgery.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"715-724"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189915","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}

{"title":"The Relationship and Mechanisms Between Body Mass Index and Autoimmune Hypothyroidism: Insights from Mendelian Randomization.","authors":"Yanjiang Yang, Renpeng Li, Wenwen Yang","doi":"10.1007/s11695-025-07681-3","DOIUrl":"10.1007/s11695-025-07681-3","url":null,"abstract":"<p><strong>Background: </strong>Obesity is increasingly prevalent worldwide and has been linked to various health conditions, including hypothyroidism.</p><p><strong>Methods: </strong>Summary-level GWAS data from the UK Biobank and the FinnGen Biobank were used for Mendelian randomization analysis. The impact of BMI on autoimmune hypothyroidism through putative mediators was assessed through a four-step analytical process. Statistical analyses, including the inverse-variance-weighted (IVW) method, weighted median (WM), and MR-Egger methods, were employed to evaluate causal relationships and detect horizontal pleiotropy. Mediation analysis was performed using a two-step method to assess the causal relationships between BMI, putative mediators, and autoimmune hypothyroidism.</p><p><strong>Results: </strong>Higher BMI was associated with an increased risk of autoimmune hypothyroidism. Mean corpuscular volume, eosinophil count, and cystatin C levels were found to mediate this association.</p><p><strong>Conclusions: </strong>BMI positively correlates with autoimmune hypothyroidism, with mean corpuscular volume, eosinophil count, and cystatin C levels mediating this relationship. Further research is needed to confirm these findings and explore causal relationships across diverse populations.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"902-914"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189939","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":"Priority Index for Bariatric Surgery Based on a New Classification of Severity in Obesity.","authors":"José Gilvan Rodrigues Maia, Fernando Antonio de Carvalho Gomes, Luiz Gonzaga Porto Pinheiro, Leonardo Adolpho de Sá Sales, João Odilo Gonçalves Pinto, Fernando Antonio Siqueira Pinheiro","doi":"10.1007/s11695-025-07716-9","DOIUrl":"10.1007/s11695-025-07716-9","url":null,"abstract":"<p><p>This study aimed to propose and evaluate a severity rating in obesity (SERO) based on a new priority index for bariatric surgery (PIBS). We compared the waiting time for surgery (WTS) in a simulated list of 200 patients diagnosed, classified, and hypothetically submitted to bariatric surgery using two prioritization criteria: date of inclusion in the list and PIBS. Our simulations show that patients spent an average of 350.44 days waiting for surgery while in the first case, when PIBS was adopted as the prioritization criterion, the WTS varied according to the severity of each patient's condition so more severe cases waited an average of 82.56 days, i.e., up to 75.55% less time considering statistical significance in the differences (p < 0.05). Therefore, the proposed prioritization model proved effective, fair, and reproducible and can be used to manage waiting lists for bariatric surgery.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"1169-1177"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365312","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":"How Long Can an Intragastric Balloon Remain in the Stomach Safely? A Rare Case Report on 5.5 Years of Asymptomatic Retention.","authors":"Mehmet Gencturk, Muhammed Said Dalkılıç, Hasan Erdem, Abdullah Sisik","doi":"10.1007/s11695-025-07744-5","DOIUrl":"10.1007/s11695-025-07744-5","url":null,"abstract":"<p><p>Intragastric balloons (IGBs) are widely used as a minimally invasive weight loss intervention for patients with obesity. While the recommended implantation period for most IGBs is 6 to 12 months, exceeding this duration is associated with an increased risk of complications such as deflation, migration, obstruction, and gastric perforation. However, the long-term safety of retained IGBs remains inadequately studied. We report a rare case of an asymptomatic 5.5-year retention of a Spatz3 IGB in a 29-year-old male patient. Initially implanted for obesity management with a body mass index (BMI) of 38 kg/m², the patient experienced an initial 15 kg weight loss, followed by partial weight regain. Despite multiple attempts to schedule removal, the patient postponed the procedure due to personal reasons and was lost to follow-up. Upon returning 5.5 years later, he remained asymptomatic with a BMI of 37.3 kg/m². Endoscopic examination revealed an intact gastric mucosa and a fully inflated balloon without evidence of degradation or leakage. The balloon was successfully removed endoscopically under sedation, and the postoperative course was uneventful. This case highlights that, under certain conditions, IGBs may remain intact beyond their recommended duration without causing immediate complications. However, this should not be interpreted as evidence of safety, as prolonged retention poses significant risks. Regular patient education, adherence to follow-up schedules, and improved tracking systems are crucial to prevent unintended long-term IGB retention and its associated complications.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"1190-1192"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391389","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}