Obesity Surgery最新文献

{"title":"Impact of Bariatric Surgery on Reproductive Hormones and Menstrual Regularity in Women with Obesity.","authors":"Khaled Mosleh Torfa, George A Nashed, Stavro Paulo, Soha Hamed Ammar, Mohammed Elshwadfy Nageeb, Mohamed Yacoub","doi":"10.1007/s11695-026-08903-y","DOIUrl":"https://doi.org/10.1007/s11695-026-08903-y","url":null,"abstract":"<p><strong>Background: </strong>Obesity affects 2.5 billion adults, disrupting the hypothalamic-pituitary-ovarian (HPO) axis through adipokine imbalance and aromatase activity. This causes hormonal dysregulation, infertility, and pregnancy risks. Bariatric surgery can restore hormonal balance and improve menstrual regularity. This study evaluates post-bariatric surgery changes in reproductive hormones and cycle regularity over six months in Egyptian women with obesity.</p><p><strong>Methods: </strong>This prospective cohort study included women aged 18-45 (BMI ≥ 35 kg/m²) undergoing laparoscopic bariatric surgery. Serum FSH, LH, estradiol, Progesterone, and AMH levels were measured at baseline, 3, and 6 months postoperatively. Secondary outcomes included menstrual regularity and hormonal correlations with weight loss.</p><p><strong>Results: </strong>Bariatric surgery resulted in a highly significant reduction in body weight and BMI over the six-month follow-up period (p < 0.001). Significant hormonal shifts were observed, including increased levels of FSH (p < 0.001) and LH (p = 0.001), a decreased LH/FSH ratio (p = 0.005), and marked reductions in estrogen and progesterone concentrations (p < 0.001). While AMH levels remained stable (p = 0.6), menstrual regularity improved significantly from 20% at baseline to 53.3% post-surgery (p = 0.001). Furthermore, the degree of weight loss was significantly and positively correlated with postoperative FSH and LH levels. The interventions were generally well-tolerated, with 82.4% of participants reporting no postoperative complications. No significant differences in the improvement of weight or hormonal profiles were noted between patients with and without PCOS.</p><p><strong>Conclusion: </strong>Bariatric surgery induces weight loss and restores reproductive hormonal balance in women with obesity by improving HPO axis regulation. Increased FSH and LH levels, resulting from reduced adiposity, might contribute to improved menstrual regularity.</p><p><strong>Key points: </strong>• Bariatric surgery resulted in a significant and progressive reduction in body weight and BMI over the six-month follow-up period (p < 0.001). • There was a significant postoperative increase in FSH and LH levels. Estrogen and progesterone concentrations demonstrated significant and sustained reductions post-surgery, whereas AMH levels remained stable throughout the study. • Menstrual regularity improved significantly, increasing from 20% of participants at baseline to 53.3% six months after surgery (p = 0.001). • The degree of weight loss was significantly and positively correlated with postoperative FSH and LH levels.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127683","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":"Metabolic Bariatric Surgery for Cancer Prevention and Risk Reduction in Patients with Obesity: A GRADE-Based International Federation for the Surgery and Other Therapies for Obesity (IFSO) Position Statement.","authors":"Amanda Belluzzi, Maurizio De Luca, Antonio Vitiello, Ricardo Cohen, Ali Aminian, Paulina Salminen, Abdelrahman Nimeri, Nicola Di Lorenzo, Luigi Angrisani, Catalin Copaescu, Tarissa Petry, Jamie Ponce, Ashraf Haddad, Lilian Kow, Matteo Monami","doi":"10.1007/s11695-026-08966-x","DOIUrl":"https://doi.org/10.1007/s11695-026-08966-x","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a major increasing driver of cancer burden worldwide, and intentional weight loss has emerged as a potential strategy for cancer risk reduction. Metabolic bariatric surgery (MBS) achieves sustained weight loss, but its role in cancer prevention remains uncertain. This GRADE-based International Federation for the Surgery and Other Therapies for Obesity (IFSO) position statement aimed to synthesize contemporary evidence on MBS and cancer outcomes and translate it into clinically actionable recommendations.</p><p><strong>Methods: </strong>A systematic review according to PRISMA guidelines was performed searching MEDLINE and EMBASE up to 8th March 2026. Two questions were formulated addressing MBS versus non-surgical weight-loss interventions and comparative effectiveness of MBS procedures for reducing cancer incidence. Evidence was appraised using GRADE principles.</p><p><strong>Results: </strong>There were no RCTs enrolling adults with obesity reporting cancer incidence after MBS. The search identified 191 records, of which 26 were included in the qualitative synthesis and a maximum of seven contributed to any single quantitative pooled estimate. Across retrospective matched cohorts, MBS was generally associated with lower incidence of several obesity-related malignancies, with point estimates favoring MBS for most cancer sites. Pooled random-effects estimates included breast cancer (IRR 0.85, 95% CI 0.80-0.91), endometrial cancer (IRR 0.38, 95% CI 0.23-0.61) and colorectal cancer (IRR 0.72, 95% CI 0.59-0.88); certainty of evidence was low to very low for all outcomes. Reported reductions were most consistent for hormone-sensitive cancers but also observed across multiple gastrointestinal and other sites with variable heterogeneity. Sensitivity analyses incorporating modern obesity management medications (OMMs) also suggested cancer incidence reductions across several sites, supporting sustained weight loss as a mediator of cancer risk reduction.</p><p><strong>Conclusions: </strong>Current evidence suggests that MBS is associated with reduced incidence of several obesity related cancers. However, the certainty of the evidence is limited by residual selection bias, and heterogeneity.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112202","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":"Long-Term Effects of Biliopancreatic Diversion (BPD), Biliopancreatic Diversion with Duodenal Switch (BPD-DS), and Single Anastomosis Duodeno‑Ileal Bypass with Sleeve Gastrectomy (SADI‑S) in Patients with Obesity: A Meta-Analysis.","authors":"Shahriar Azizi, Mohammad Mehdi Zare, Sherko Abbas Nadir, Hengameh Anari Moghadam, Ali Esparham","doi":"10.1007/s11695-026-08977-8","DOIUrl":"https://doi.org/10.1007/s11695-026-08977-8","url":null,"abstract":"<p><strong>Introduction: </strong>The long-term outcomes of biliopancreatic diversion (BPD), BPD with duodenal switch (BPD-DS), and single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) in patients with obesity are not well established.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, Scopus, and Web of Science was conducted until October 11, 2025, following PRISMA guidelines. Studies reporting outcomes at ≥ 10 years following the specified procedures were included.</p><p><strong>Results: </strong>A total of 22 studies with 2156 patients were included. BPD and BPD-DS were associated with a mean BMI reduction of 19.02 kg/m². BPD-DS achieved total weight loss (TWL) of 36.34% and an excess weight loss (EWL) of 75.22%. Resolution rates for diabetes, hypertension, hyperlipidemia, and obstructive sleep apnea were 78%, 63%, 83%, and 89%, respectively. Major long-term complications included revision surgery (3%), anemia (19%), iron deficiency (34%), and bone disorders (25%). Compared with RYGB, BPD and BPD-DS achieved greater BMI reduction (mean difference 6.31 kg/m², 95% CI: 3.16, 9.47) and higher diabetes resolution (OR 3.49, 95% CI: 1.11, 10.91), but with a higher rate of cholecystectomy. Diabetes relapse after BPD and BPD-DS occurred in 15% of patients, with significant reductions in fasting blood sugar and HbA1c. Limited data from two studies on SADI-S showed sustained weight loss (TWL 34.4%, EWL 80.4%) but notable rates of reoperation due to nutritional complications.</p><p><strong>Conclusion: </strong>Overall, BPD and BPD-DS provide lasting weight loss and metabolic benefits, but careful patient selection and ongoing multidisciplinary care are important because of the risk of malnutrition. Long-term data on SADI-S appear promising but remain limited.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112096","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":"Surgeons and Experts' Perspectives in Concomitant Bariatric Surgery with Cholecystectomy: Bari-Chole Egypt Survey.","authors":"Mohamed ElKaseer, Mahmoud ElSafty, Hassan El-Masry, Waleed A Anber, Mohamed S Elgendy, Hamdy Khaled Sabra, Mohammed Ibrahim El Sayed Henish, Mohamed Tolba, Abd-Elfattah Kalmoush, Mahmoud Ashraf Hussein, Ahmed Abo Elmagd, Khaled Gawdat, Ahmed Abokhozima","doi":"10.1007/s11695-026-08907-8","DOIUrl":"https://doi.org/10.1007/s11695-026-08907-8","url":null,"abstract":"<p><strong>Introduction: </strong>The management of gallbladder disease during metabolic and bariatric surgery (MBS) remains controversial. Cholelithiasis is common in patients with obesity, yet the approach to concomitant or prophylactic cholecystectomy varies, with limited data from Egypt. This study aimed to assess Egyptian bariatric surgeons' practices, attitudes, and decision-making regarding cholecystectomy during MBS.</p><p><strong>Methods: </strong>A national cross-sectional survey was distributed to bariatric surgeons in Egypt, collecting information on demographics, surgical experience, preoperative screening, intraoperative decision-making, postoperative management, and prophylactic practices. The questionnaire included structured, closed-ended questions. Data were analyzed descriptively and compared between IFSO members and non-members using chi-square or Fisher's exact tests, with p < 0.05 considered significant.</p><p><strong>Results: </strong>A total of 117 surgeons participated, predominantly male (99%), with 16.2% IFSO members. Bariatric surgery was concentrated in Cairo (42%) and Alexandria (26%). Most surgeons (97%) screened gallstones preoperatively using abdominal ultrasound. Concomitant cholecystectomy was preferred for documented gallstones by 78%, while 82% never performed prophylactic cholecystectomy in patients with normal gallbladders. The majority performed the bariatric procedure first (82%) in reverse Trendelenburg position (88%), minimizing additional ports. Routine intraoperative cholangiography was rare (1.7%). Postoperative management largely mirrored isolated bariatric surgery, although antibiotic and drain practices differed between groups. Surgeons generally perceived combined procedures as safe, with 76% reporting no increase in complications and 89% reporting similar length of stay.</p><p><strong>Conclusion: </strong>Egyptian bariatric surgeons consistently screen for gallstones and favor concomitant cholecystectomy for documented stones, while largely avoiding prophylactic removal of normal gallbladders. Variation exists in intraoperative management and postoperative care. These findings highlight areas for standardization and support the development of a national pathway and multicenter registry to optimize gallbladder management in MBS.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112467","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":"Magnetic Duodeno-Ileostomy as a Conversion Procedure After Sleeve Gastrectomy: First Single-Centre Experience in Colombia.","authors":"Ricardo Nassar, Felipe Giron, Mateo Visbal-Zuluaga, Juan David Hernandez, Alberto Ricaurte, Mary Sandoval, Laura Tatiana Casadiego, Daniela Ayala, Jose Gabriel Rodriguez, Natan Zundel, Michel Gagner","doi":"10.1007/s11695-026-08973-y","DOIUrl":"https://doi.org/10.1007/s11695-026-08973-y","url":null,"abstract":"<p><strong>Background: </strong>Magnetic duodeno-ileostomy (MAGDI) uses magnetic compression to create a side-to-side duodeno-ileal anastomosis without sutures or staples at the anastomotic site. Outcomes differ between primary and revisional settings. We describe our initial experience with MAGDI as a conversion procedure after sleeve gastrectomy.</p><p><strong>Methods: </strong>Three consecutive patients underwent MAGDI after laparoscopic sleeve gastrectomy for insufficient clinical response or recurrent weight gain, following multidisciplinary evaluation. Procedures were laparoscopic, with magnetic docking 300 cm proximal to the ileocecal valve. Patients were reviewed monthly, with contrast study and endoscopy at three to four months. Outcomes are reported per patient at six months.</p><p><strong>Results: </strong>Deployment was successful in all three patients. Operative times were 113, 72 and 70 min, and anastomosis creation times 17, 14 and 13.6 min; the longest procedure required an enterotomy for distal magnet positioning. All patients were discharged on the day of surgery, without emergency attendance, readmission or reintervention through six months. No anastomotic leak, bleeding or other surgical complication occurred. At six months, total weight loss was 7.6%, 5.3% and 20.2%, and body mass index fell by 3.1, 1.8 and 6.5 kg/m². One patient developed meal-related gastrointestinal symptoms compatible with early dumping, persisting at six months under dietary management. Contrast study and endoscopy confirmed a patent anastomosis in all patients, without stricture or retained device material.</p><p><strong>Conclusion: </strong>MAGDI was technically feasible in three selected patients undergoing conversion after sleeve gastrectomy. The sample size and follow-up do not permit conclusions regarding safety or efficacy; larger prospective cohorts are required.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112161","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 Impact of Bariatric Surgery on Obesity-Associated NETosis, Immune Modulation, and Cardiovascular Risk Reduction.","authors":"Farshad Taherpour, Mahsa Najafi Kandovan, Sepideh Soleymani, Sara Najafi Pazooki, Afshin Hasanvand, Seyed Mehdi Marashi, Seyed Eisa Salehi Dehno","doi":"10.1007/s11695-026-08970-1","DOIUrl":"https://doi.org/10.1007/s11695-026-08970-1","url":null,"abstract":"<p><strong>Background: </strong>Obesity drives chronic inflammation and a prothrombotic state, contributing to metabolic dysfunction and cardiovascular disease (CVD). Neutrophil extracellular traps (NETs), web-like DNA-protein structures released by neutrophils, trap pathogens through a specialized cellular process called NETosis, which involves chromatin decondensation and cell death. While NETs protect against infection, excessive NET formation promotes tissue damage, insulin resistance, endothelial dysfunction, and thrombosis in obesity. Elevated NETosis fuels systemic inflammation, disrupts insulin signaling, and amplifies platelet aggregation, significantly raising the risk of atherothrombosis and metabolic decline. Given its critical role in obesity-related complications, NETosis presents a promising therapeutic target.</p><p><strong>Objectives: </strong>This review explores the mechanistic role of NETosis in obesity-driven thromboinflammation, evaluates the impact of bariatric surgery on NET formation and immune modulation, and discusses therapeutic strategies targeting NETs as potential adjuncts or alternatives to surgery.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted using PubMed, Scopus, and Web of Science to identify preclinical and clinical studies examining NETosis, obesity, bariatric surgery, and metabolic inflammation.</p><p><strong>Results: </strong>Obesity induces neutrophil hyperactivation and excessive NET formation, driving insulin resistance, vascular injury, and hypercoagulability. Elevated plasma NET markers (MPO-DNA, cfDNA, H3Cit) correlate with metabolic dysfunction and cardiovascular risk. Bariatric surgery significantly reduces systemic inflammation, suppresses neutrophil activation, and downregulates NET formation, leading to improved insulin sensitivity, endothelial function, and lower thrombotic risk. These findings suggest bariatric surgery exerts profound immunomodulatory effects beyond weight loss.</p><p><strong>Conclusions: </strong>NETosis is a key driver of obesity-associated metabolic and cardiovascular complications. Bariatric surgery effectively reverses NET-driven thromboinflammation, but further research is needed to elucidate its molecular mechanisms and develop NET-targeted therapies as non-surgical alternatives.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112791","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":"Remodeling of Oncogene-Related Molecular Networks Following Bariatric Surgery: a Multi-Omics Study.","authors":"Mohammed Salhi, Sarah Al-Shahabi, Summaiya Khatoon, Aaiza Asif, Marwa Naeem, Muhammad Enamul Hoque Chowdhury, Shona Pedersen, Fakhar Shahid, Muhammad Jawad Khan, Zumin Shi, Aisha Naeem","doi":"10.1007/s11695-026-08959-w","DOIUrl":"https://doi.org/10.1007/s11695-026-08959-w","url":null,"abstract":"<p><p>Obesity is a well-established risk factor for multiple cancers, and Metabolic Bariatric Surgery (MBS) has been associated with reduced cancer incidence and mortality. However, the molecular mechanisms underlying this risk reduction remain incompletely understood. Many recent transcriptomic, proteomic, and metabolomic studies have enabled system-wide molecular profiling following MBS. We performed a systematic analysis of publicly available MBS-related omics datasets, including transcriptomic (n = 22), proteomic (n = 6), and metabolomic studies (n = 5), with pre- and post-operative comparisons. Comparative molecular analyses across all omics datasets were performed using Ingenuity Pathway Analysis (IPA). Sustained suppression of key oncogenic pathways, including Molecular Mechanisms of Cancer, Role of Tissue Factor in Cancer, and metastasis-associated signaling, was observed in tissue transcriptomic datasets (adipose, skeletal muscle, and gastrointestinal tract). In contrast, transcriptomic datasets predominantly showed immune remodeling, characterized by activation of innate immune pathways. Key molecular markers, including CCL2, EGFL6, and S100A8, were identified as consistently regulated across multiple datasets. Proteomic analyses revealed early postoperative suppression of inflammatory and acute-phase proteins, progressive downregulation of complement and coagulation cascades, and sustained upregulation of endocrine regulators such as sex hormone-binding globulin and extracellular matrix-stabilizing factors. Metabolomic profiling demonstrated significant alterations in amino acid, bile acid, and lipid metabolism following MBS. These molecular changes collectively reflect a shift toward a less inflammatory, hormonally balanced, and metabolically favorable systemic environment. These findings highlight the impact of MBS in inhibiting cancer-promoting biological processes and identify candidate molecular biomarkers for future translational and oncologic research.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112137","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 ERAS Era in Bariatric Surgery: A Decade of Transformation.","authors":"Talha Zargar, Misbah Jabeen, Mohsin Aijaz Syed, Mubashir A Shah","doi":"10.1007/s11695-026-08969-8","DOIUrl":"https://doi.org/10.1007/s11695-026-08969-8","url":null,"abstract":"<p><strong>Background: </strong>Enhanced Recovery After Surgery (ERAS) protocols have transformed perioperative care in bariatric surgery over the past decade. This prospective, single-center study evaluates the implementation, evolution, and impact of ERAS protocols across a 10-year period from 2016 to 2025.</p><p><strong>Methods: </strong>An observational before-after cohort study using prospectively collected registry data enrolled 250 consecutive patients undergoing laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass. ERAS protocol elements were progressively implemented and refined. Outcomes included length of stay (LOS), 30-day readmission, opioid consumption, complications, and patient satisfaction (unvalidated VAS). The cohort was divided into two 5-year epochs (2016-2020 and 2021-2025).</p><p><strong>Results: </strong>Mean LOS decreased by 57%, from 2.8 ± 1.2 days to 1.2 ± 0.6 days (p < 0.001). Same-day discharge increased from 12% to 64% (p < 0.001). ERAS compliance improved from 58% to 89% (p < 0.001). Opioid consumption decreased by 72% (p < 0.001). Major complications decreased from 5 events (4.0%) to 2 events (1.6%) (p = 0.04). Thirty-day readmission rates were 3.2% in Epoch 1 versus 2.4% in Epoch 2 (p = 0.68). Patient satisfaction improved from 7.8 to 9.4 (p < 0.001) (unvalidated VAS).</p><p><strong>Conclusion: </strong>ERAS protocol maturation was associated with significant reductions in LOS and opioid consumption, improved recovery, and numerically lower major complications. The study was underpowered for uncommon safety outcomes; therefore, findings support feasibility rather than definitive safety claims.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112734","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":"Early Intraocular Pressure Changes After Laparoscopic Sleeve Gastrectomy: A Prospective Comparative Study.","authors":"İgbal Osmanov, Baris Hazir, Yesim Altay, Ugur Ekici","doi":"10.1007/s11695-026-08975-w","DOIUrl":"https://doi.org/10.1007/s11695-026-08975-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Obesity is a serious health problem worldwide and is associated with several ocular conditions, including glaucoma, cataract, and age-related macular degeneration. Elevated intraocular pressure (IOP) is a well-established and modifiable risk factor for glaucomatous optic neuropathy. This study aimed to evaluate early changes in IOP following laparoscopic sleeve gastrectomy and to examine their relationship with weight loss. A secondary exploratory aim was to describe whether postoperative improvement in hypertension or diabetes mellitus was accompanied by additional changes in IOP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This prospective comparative study included 82 patients who underwent laparoscopic sleeve gastrectomy between 2024 and 2025 and completed the predefined 6-month follow-up, together with 82 prospectively enrolled age- and sex-comparable non-obese control participants serving as a reference cohort. The control cohort was used to contextualize IOP values in non-obese individuals and was not designed to isolate the independent effects of surgical stress, weight loss, or metabolic improvement. Ophthalmologic evaluations, including IOP measurement, were performed at baseline and at 6 months according to the study protocol, whereas systemic comorbidity outcomes were ascertained from routine clinical follow-up records at 6 months. For correlation analyses, right- and left-eye IOP values were evaluated separately, whereas mean IOP values were used for patient-level analyses. Changes in IOP were assessed before and after surgery, and correlations between changes in body mass index (BMI) and IOP were examined. Subgroup observations according to postoperative improvement in hypertension and diabetes mellitus were considered exploratory.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean age was 37.4 ± 9.2 years in the sleeve gastrectomy group and 39.6 ± 9.6 years in the control group. The surgical group included 36 men and 46 women, and the control group included 43 men and 39 women. No significant differences were observed between the groups in age or sex distribution. Six months after surgery, BMI and body weight decreased significantly (both p &lt; 0.001). Mean IOP decreased significantly after sleeve gastrectomy, with a mean change of approximately - 3.0 mmHg (p &lt; 0.001). Baseline mean IOP was significantly higher in the sleeve gastrectomy group than in controls (p = 0.012). At 6 months, mean IOP in the sleeve gastrectomy group had decreased to 12.8 ± 2.2 mmHg compared with 13.3 ± 3.5 mmHg in controls (p = 0.038). Significant positive correlations were observed between reductions in BMI and decreases in IOP in both the right eye (r = 0.545, p &lt; 0.001) and left eye (r = 0.489, p &lt; 0.001). Exploratory subgroup observations suggested a greater IOP reduction in patients with postoperative improvement in hypertension, whereas improvement in diabetes mellitus did not appear to confer an additional short-term effect.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Concl","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112841","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":"Factors Associated with Postoperative Hemorrhage in Primary Metabolic Bariatric Surgery: Nationwide Analysis of Patient Characteristics, Surgical and Stapling Techniques.","authors":"Anne J Brouwer, Mabel M A Kwakkelstein, Jan A Apers, Floris F E Bruinsma, Martin Dunkelgrün, Bo J Noordman, Guusje Vugts, Simon W Nienhuijs, Ronald S L Liem, Dutch Audit For Treatment Of Obesity Research Group","doi":"10.1007/s11695-026-08930-9","DOIUrl":"https://doi.org/10.1007/s11695-026-08930-9","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative hemorrhage is the most common severe complication following metabolic bariatric surgery (MBS). Evidence on associations with surgical and stapling techniques, tranexamic acid (TXA) use, and thromboprophylaxis regimens remains scarce. The aim of this study is to evaluate patient characteristics, surgical and stapling techniques, thromboprophylaxis regimens, and TXA use as factors associated with postoperative hemorrhage following primary MBS.</p><p><strong>Methods: </strong>Patients undergoing primary MBS between 2015 and 2024 were selected from the Dutch Audit for Treatment of Obesity (DATO). Surgical details, including surgical and stapling techniques, stapler brand, thromboprophylaxis regimens, and TXA protocols, were retrospectively collected via nationwide questionnaires. The primary outcome was postoperative hemorrhage (Clavien Dindo (CD) grade ≥ 2) within 30 days of the procedure. Secondary outcomes included reinterventions, intensive care unit admission, mortality, and length of hospital stay. Multilevel logistic regression analysis was performed to identify factors associated with postoperative hemorrhage of CD grade ≥ 2.</p><p><strong>Results: </strong>A total of 83,580 patients were included, with 18,701 sleeve gastrectomies (SG) and 64,879 bypass procedures. Postoperative hemorrhage of CD grade ≥ 2 occurred in 1.2% (n = 1021). The following factors were independently associated with postoperative hemorrhage: BMI (kg/m2) (adjusted odds ratio [aOR] = 0.974; 95% confidence interval [CI]: 0.957-0.991), stroke or transient ischemic attack in medical history (aOR = 1.751; 95% CI: 1.097-2.796), hypertension (aOR = 1.341; 95% CI: 1.080-1.665), and liver disease (aOR = 1.838; 95% CI: 1.038-3.253).</p><p><strong>Conclusion: </strong>Despite limitations inherent in its retrospective, questionnaire-based design, the findings indicate that patient-related factors are associated with postoperative hemorrhage risk in MBS.</p><p><strong>Key points: </strong>• Postoperative hemorrhage is the most common severe short term complication following MBS. • Most postoperative hemorrhages require surgical reintervention. • There is no association between surgical techniques and postoperative hemorrhage.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112869","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}