Obesity Surgery最新文献

{"title":"The Role of Pre-surgery Clinical Communication on Metabolic and Bariatric Surgery Outcomes: A Prospective Study.","authors":"Ana João Ferreira, Irene P Carvalho","doi":"10.1007/s11695-025-07772-1","DOIUrl":"10.1007/s11695-025-07772-1","url":null,"abstract":"<p><strong>Background: </strong>Research shows that a positive doctor-patient relationship plays an important role in patient outcomes. However, the influence of their communication during the pre-surgery preparatory consultation (PC) for metabolic and bariatric surgery (MBS) remains unclear. The goal of this study was to inspect the association between patients' perceptions of doctor-patient communication (DPC) in the PC for MBS and the results of the MBS.</p><p><strong>Methods: </strong>This prospective cross-sectional study included 89 adult patients undergoing MBS at a hospital. Before the surgery, patients' perspectives regarding DPC were assessed with the Communication Assessment Tool (CAT). One month after the surgery, participants' levels of well-being were assessed through the 36-Item Short Form Survey (SF-36). Other clinical data were obtained through patients' electronic records. Data were analyzed with regression models.</p><p><strong>Results: </strong>In the adjusted models, associations with the quality of doctor-patient communication (p < 0.05) were found for the following outcomes: weight loss, body mass index decrease, and patient well-being regarding bodily pain and social functioning. Significant differences (p < 0.05) were also found for digestive complaints and for patient perception of physician post-surgery support.</p><p><strong>Conclusions: </strong>DPC in the preparatory consultation has a positive effect on the clinical results of MBS. More studies are necessary for inspection of the generalizability of these findings.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"1223-1233"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616114","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":"Response to \"Integrating Predictive Analytics and Digital Health Innovations to Reduce Postoperative Emergency Department Admissions in Bariatric Surgery\".","authors":"Şükrü Salih Toprak, Hatice Toprak","doi":"10.1007/s11695-025-07790-z","DOIUrl":"10.1007/s11695-025-07790-z","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"1568"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605809","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 Pandora's Box of Bariatric Surgery: Unveiling the Association with Kidney Stone Risk-A Cross-Sectional Study.","authors":"Jinlong Wang, Liguo Tian, Ping Xiao, Yan Jiao","doi":"10.1007/s11695-025-07795-8","DOIUrl":"10.1007/s11695-025-07795-8","url":null,"abstract":"<p><strong>Background: </strong>Metabolic and bariatric surgery is an effective intervention for severe obesity, known for improving comorbidities such as type 2 diabetes, hypertension, and hyperlipidemia. However, its association with kidney stone formation remains uncertain. This study investigates the relationship between bariatric surgery and kidney stone prevalence using data from NHANES 2015-2018.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of 8,087 participants from NHANES (2015-2018). Bariatric surgery and kidney stone history were self-reported. Logistic regression models adjusted for demographic, clinical, and lifestyle factors were used to evaluate associations. Stratified analyses explored effect modification by subgroups.</p><p><strong>Results: </strong>Kidney stones were more prevalent among participants with bariatric surgery (26.57%) compared to those without (10.92%, P < 0.001). Bariatric surgery was associated with increased odds of kidney stones in the crude model (OR: 2.95, 95% CI: 1.57-5.55) and adjusted models (OR: 2.69, 95% CI: 1.27-5.70). Subgroup analyses highlighted stronger associations among females and participants with moderate physical activity.</p><p><strong>Conclusion: </strong>Metabolic and bariatric surgery is linked to an elevated risk of kidney stones, influenced by demographic and clinical factors. Personalized counseling on hydration and dietary modifications is essential for mitigating this risk.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"1476-1483"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630632","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":"Alcohol and Other Substance Screening in Bariatric Surgery Candidates: Utility of Self-Report and Toxicology Tests, Including Ethyl-Glucoronide.","authors":"Silvia Cañizares, Laura Nuño, Pablo Barrio, Mireia Forner-Puntonet, Carolina Gavotti, Miquel Monràs, Patricia Gavín, Ricard Navinés, Lilliam Flores, Maite Barrios, Alba Andreu, Judit Molero, Amanda Jimenez, Josep Vidal, Anna Lligoña","doi":"10.1007/s11695-025-07774-z","DOIUrl":"10.1007/s11695-025-07774-z","url":null,"abstract":"<p><p>Following bariatric surgery (BS) patients have an increased risk of alcohol misuse.</p><p><strong>Purpose: </strong>This 1-year cross-sectional study in potential BS candidates had several objectives: (a) assess the prevalence of risky drinking, alcohol use disorder (AUD), and other substance use/disorder; (b) compare the prevalence of these behaviors to that of the general Spanish population; (c) determine the proportion of patients with positive results in toxicology tests; and (d) study the predictive factors of risky drinking.</p><p><strong>Setting: </strong>tertiary university hospital.</p><p><strong>Materials and methods: </strong>Alcohol and other substance use were evaluated with the AUDIT-C and ASSIST questionnaires. Urine tests analyzed several markers (ethyl-glucoronide [EtG] ≥ 500 ng/ml, amphetamine, benzodiazepine, cannabinoid, cocaine, and opioid). The Mini-International-Neuropsychiatric-Interview (5.0.0) was employed to assess psychiatric diagnoses.</p><p><strong>Results: </strong>Among 308 candidates for BS, 196 were accepted to participate (69% women; mean age 46.7 ± 10.9 years; mean body mass index 45.6 ± 5.9). AUDIT-C and ASSIST identified 7% and 5% of risky drinkers, respectively. Men were more frequently risky drinkers compared to women (18% vs. 2%) and compared to the general population (18% vs. 8%). Six percent of individuals had AUD, being men the most affected, and 2% met criteria for other substance disorder. Fifteen percent of the sample presented risky tobacco use. Cannabis was self-reported only by males (3%). EtG ≥ 500 ng/ml was present in 15% of the sample, being a risk factor for risky drinking together with the male sex.</p><p><strong>Conclusion: </strong>Identification of candidates at risk for risky drinking can help to prevent any alcohol misuse after BS. The combination of subjective and objective measures improves the validity of the assessment of substance use.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"1242-1250"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615080","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":"Geographical Disparities in Outcomes After Metabolic and Bariatric Surgery in Chicago: Insights from Four Major Academic Institutions.","authors":"Mario A Masrur, Emiliano G Manueli Laos, Ezra Teitelbaum, Yalini Vigneswaran, Vanessa Buie, Nicholas J Skertich, Amber Pirzada, Francisco Schlottmann","doi":"10.1007/s11695-025-07787-8","DOIUrl":"10.1007/s11695-025-07787-8","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"1563-1565"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615979","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 Effects of Metabolic and Bariatric Surgery on the Anterior Segment Parameters of the Eye.","authors":"Muslum Toptan, Hasan Elkan, Hamza Erdogdu, Omer Goc, Omer Faruk Yilmaz","doi":"10.1007/s11695-025-07773-0","DOIUrl":"10.1007/s11695-025-07773-0","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the effects of metabolic and bariatric surgery (MBS) on the corneal and anterior segment parameters of the eye.</p><p><strong>Materials and methods: </strong>In this study, the anterior chamber depth, volume, angle and central corneal thickness of obese patients who underwent laparoscopic sleeve gastrectomy surgery were prospectively examined using Pentacam topography before and six months after surgery.</p><p><strong>Results: </strong>A total of 112 eyes of 56 individuals, including 26 males with a mean age of 38.88 ± 7.00 years and 30 females with a mean age of 40.94 ± 7.76 years, were evaluated (p = 0.310). Six months following MBS, the average body mass index (BMI) in men decreased from 45.5 kg/m² to 34 kg/m² (p < 0.001), and the BMI decreased from 47 kg/m² to 33 kg/m² (p < 0.001) in women. Central corneal thickness and intraocular pressure decreased significantly in both men and women. The anterior chamber depth, volume and angle ​​significantly increased six months after surgery (p < 0.001 for all parameters). A statistically significant negative correlation was observed between postoperative BMI and anterior chamber depth, volume and angle in both sexes (p < 0.001 for all).</p><p><strong>Conclusion: </strong>This study revealed that anterior segment values, intraocular pressure, and corneal thickness may change after MBS. Caution should be exercised when evaluating for cataracts and refractive surgery after MBS.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"1234-1241"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630515","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 Surgery and Remission of Metabolic Syndrome: A Meta-analysis of Randomised Controlled Trials and Prospective Studies.","authors":"Yomna E Dean, Mohamed I Mohamed, Abdulrahman Shokri, Moussa Nassar, Abu Omayer, Maryam Shahid, Arsalan Sharif, Zakaria Soliman, Yasser Almadani, Abdelrahman Yakout, Asim Eren Guvem, Urvij Jaiswal, Adham Hamza, Mohamed Zein, Mohamed M Elnemr, Shabab Shahabi, Mohammad Kermansaravi, Wah Yang, Tamer N Abdelbaki","doi":"10.1007/s11695-025-07750-7","DOIUrl":"10.1007/s11695-025-07750-7","url":null,"abstract":"<p><strong>Background: </strong>Studies have discussed the efficacy of bariatric surgery (BS) in remission of individual components of metabolic syndrome (MS). We aimed to analyse the prevalence of MS following BS.</p><p><strong>Methods: </strong>On October 5, 2023, we conducted a literature search on PubMed, Scopus, Web of Science, and Cochrane. RevManv5.4 was used for the analysis.</p><p><strong>Results: </strong>MS patients who underwent BS had lower odds of MS within the first year post-BS (OR 0.14, 95%CI 0.12-0.17); patients who had a preoperative BMI < 50 showed a higher reduction in MS post-BS compared with patients who suffered from super obesity (OR 0.12 versus OR 0.17). Older patients (age > 42) had lower odds of MS post-BS compared with younger patients (OR 0.05 versus OR 0.17). There was not a difference in MS prevalence between 1 and 2 years postoperatively (OR 1.07, 95%CI 0.72-1.58). Asians reported the highest reduction in MS post-BS (OR 0.08). MS patients who received medical treatment had three times the odds of having MS compared with patients who underwent BS. Patients who had BS reported a decline in their anti-hypertensives and oral anti-diabetic drugs (OR 0.26, 95%CI 0.15-0.46, OR 0.11, 95%CI 0.07-0.16, respectively). There was not a significant difference in MS prevalence between patients who underwent RYGB and those who had SG (OR 2.16, 95%CI 0.74-6.26).</p><p><strong>Conclusions: </strong>BS is superior to medical treatment in the remission of MS. Age, preoperative BMI, and country of origin affect the rates of MS remission. BS results in a sustainable resolution of MS across 1, 2, and 5 years post-surgery. A tailored approach is warranted to achieve the best outcomes.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"1337-1349"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143503074","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":"Mobilization of the Left Liver for Optimal Hiatal Exposure During Bariatric Surgery Procedures.","authors":"Alejandro Gandsas, John Marr, Adam Weltz, Miljana Vladimirov","doi":"10.1007/s11695-025-07782-z","DOIUrl":"10.1007/s11695-025-07782-z","url":null,"abstract":"<p><p>Hepatomegaly, particularly an enlarged left liver lobe, is a well-recognized challenge in bariatric surgery, contributing significantly to staged procedures, conversions to open surgery, and aborted operations. Impaired intraoperative visualization hinders safe access to the hiatus and gastroesophageal junction, increasing the risk of complications. This report focuses on the laparoscopic mobilization of the left liver lobe as a reliable technique to address these challenges, offering improved exposure and facilitating precise surgical dissection. This technique should be considered a last resort to provide proper visualization of the hiatus when other retraction methods have failed. In our experience, this approach was applied in seven patients (six sleeve gastrectomies and one gastric bypass) with good outcomes. All patients tolerated the procedures well, and no intra- or post-operatively complications directly attributable to the mobilization technique were observed. These findings underscore the safety and efficacy of this method, making it a valuable tool for both primary and revisional bariatric surgeries.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"1547-1550"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649868","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 Postoperative Lidocaine and Ketamine Effects on Morphine Requirement in Bariatric Surgery.","authors":"Gregory Contreras Pérez, Carolina Frederico Avendaño, Luis Ignacio Cortínez, José Giménez Crouseilles, Alex Carví Mallo","doi":"10.1007/s11695-025-07689-9","DOIUrl":"10.1007/s11695-025-07689-9","url":null,"abstract":"<p><strong>Background: </strong>Effective postoperative pain management in patients with obesity undergoing metabolic bariatric surgery is challenging due to the adverse effects associated with opioid use. Multimodal analgesic approaches during the intraoperative period have been shown to effectively reduce postoperative opioid consumption. This study evaluated the impact of prolonged postoperative lidocaine and ketamine infusion for 90 min on postoperative morphine consumption as a complementary multimodal analgesic approach.</p><p><strong>Methods: </strong>This retrospective cohort study included 64 patients who underwent elective sleeve gastrectomy and Roux-en-Y gastric bypass (RYGB). Thirty-two patients who received lidocaine and ketamine infusions postoperatively (group A) were compared with 32 patients who received standard postoperative analgesia (group B). The primary outcome measured was total morphine consumption within the first 48 h post-surgery. Pain was assessed using the visual analog scale (VAS) at 1, 2, 4, 24, and 48 h post-surgery.</p><p><strong>Results: </strong>Mean cumulative morphine consumption at 48 h was 0.82 ± 1.55 mg in group A versus 2.03 ± 2.61 mg in group B (p = 0.0696). In total, 62.5% of patients did not require morphine during the first 48 postoperative hours. VAS scores were significantly lower in group A at four postoperative hours (1.03 ± 1.36) compared to group B (2.16 ± 1.65) (p = 0.0024).</p><p><strong>Conclusions: </strong>Postoperative morphine consumption and pain scores were low in the current multimodal analgesic approach. Prolonging lidocaine and ketamine infusion for 90 min postoperatively was not justified based on the current results.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"1265-1272"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649872","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":"Enhanced Total Weight Loss 2 Years Post-Roux-en-Y Gastric Bypass with Longer Biliopancreatic Limb.","authors":"Miya C Yoshida, Diana Luong, Sally Tan, Jennifer Pan, Jonathan Luu, Owen Pyke, Venkata Kella, Collin E M Brathwaite, Jun Levine","doi":"10.1007/s11695-025-07797-6","DOIUrl":"10.1007/s11695-025-07797-6","url":null,"abstract":"<p><strong>Background: </strong>Despite widespread use of Roux-en-Y gastric bypass (RYGB), there are no standardized limb lengths in the United States.</p><p><strong>Methods: </strong>A multi-center retrospective cohort study was conducted from 2020 to 2023. Eligible patients who had undergone RYGB were divided into subgroups based on BP limb lengths: short (50-75 cm), intermediate (80-125 cm), and long (150-175 cm). Primary outcomes were total weight loss (TWL) and % TWL at 1 and 2 years. Secondary outcomes were post-operative BMI and % BMI change at 1 and 2 years, micronutrient deficiencies, hypothyroidism, acute kidney injury (AKI) requiring treatment, and remission in associated medical problems. Subgroups were compared using multivariate analysis.</p><p><strong>Results: </strong>Two hundred twenty-eight patients received a long BP limb, 194 patients received an intermediate BP limb, while 152 patients received a short BP limb. Primary outcomes TWL and % TWL were significantly different between the groups at 1 year: TWL and % TWL were greater in patients with long BP limbs. The difference between the long and short BP limb groups increased at the 2-year mark. Patients who had long BP limbs had higher rates of DM remission (12.3% vs 11.9% 6.6%), HTN (8.8% vs 5.7% vs 7.9%), GERD symptoms (14.5% vs 9.8% vs 5.3%), and OSA (8.8% vs 7.7% vs 5.3%). Vitamin A deficiency rates were higher in the long BP limb group.</p><p><strong>Conclusions: </strong>The results suggest that longer BP limb lengths are conducive to TWL and overall treatment of obesity-related problems without severe rates of complications. Additional longer longitudinal studies are needed to assess the impact of long BP limbs on nutrition and weight loss in the long term.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"1493-1503"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658062","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}