Obesity Surgery最新文献

{"title":"Total Alimentary Limb Length Is Not Associated with Weight Loss Following Proximal Roux-en-Y Gastric Bypass.","authors":"Vance L Albaugh, Jacob L Weinberg, Danxia Yu, Matthew D Spann, D Brandon Williams, Jason M Samuels, Charles Robb Flynn, Wayne J English","doi":"10.1007/s11695-025-07817-5","DOIUrl":"https://doi.org/10.1007/s11695-025-07817-5","url":null,"abstract":"<p><strong>Background: </strong>Standard Roux-en-Y gastric bypass (RYGB) typically manipulates the proximal portion of the small intestine, leaving a variable and unknown common channel and total alimentary limb length (TALL). Despite high variability in postoperative weight loss, the factors contributing to this variability remain unknown. Given the known variability in small intestinal length, this unmeasured variability in TALL may be associated with weight loss responses.</p><p><strong>Objective: </strong>To test the hypothesis that TALL is associated with postoperative weight loss following primary laparoscopic Roux-en-Y gastric bypass (RYGB).</p><p><strong>Setting: </strong>Vanderbilt University Medical Center; Nashville, Tennessee, USA.</p><p><strong>Methods: </strong>A total of 329 patients were recruited for this observational study and consented to laparoscopic measurement of the entire small intestinal length at the time of primary RYGB. Of these patients, 208 had successful measurement of the small bowel length (SBL) and underwent RYGB with a fixed biliopancreatic limb length (BPL, 50 cm). Common channel length (CCL) was allowed to vary normally to test the association between TALL and postoperative weight loss.</p><p><strong>Results: </strong>Follow-up rates were 77% at 6 months and 41% at 24 months. Average SBL was 592 cm (min = 390 cm, max = 910 cm), with a standard deviation of 107 cm that led to significant variation in CCL (shortest 190 cm, longest 730 cm). Regression was used to model weight loss and body mass index, as well as percent change from baseline, for each patient given the measured TALL and CCL. Despite significant variation in TALL, there were no clinically significant effects of TALL or CCL on weight loss up to 24 months.</p><p><strong>Conclusions: </strong>With a fixed BPL, normal variation in TALL does not significantly contribute to weight loss variability following RYGB. Future studies are needed to better understand the importance of intestinal limb lengths in primary and revisional RYGB surgery.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720814","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":"Antireflux Surgery in Patients with Moderate Obesity - Fundoplication or Roux-en-Y Gastric Bypass?","authors":"Johanna Betzler, Nina Wiegand, Alexandra Kantorez, Alida Finze, Sebastian Schölch, Christoph Reißfelder, Mirko Otto, Susanne Blank","doi":"10.1007/s11695-025-07829-1","DOIUrl":"https://doi.org/10.1007/s11695-025-07829-1","url":null,"abstract":"<p><strong>Background: </strong>Gastroesophageal reflux disease (GERD), often associated with obesity, impairs quality of life and can lead to complications. This study compared Fundoplication and Roux-en-Y Gastric Bypass (RYGB) in patients with WHO (World Health Organization) class I and II obesity and refractory GERD.</p><p><strong>Material and methods: </strong>A single-center, retrospective study analyzed 93 patients (55 Fundoplication, 38 RYGB) with BMI < 40 kg/m² who underwent surgery between January 2018 and September 2021. Preoperative characteristics, surgical outcomes, and postoperative results after three months and after one year were analyzed. Quality of life was assessed using Bariatric Quality of Life (BQL) and Quality of Life in Reflux and Dispepsia (QOLRAD) questionnaires. Propensity-score matching (PSM) was performed using the parameters age, BMI and gender.</p><p><strong>Results: </strong>Patients who underwent RYGB had higher preoperative BMI (35.9 vs. 27.5 kg/m², p < 0.0001) and more metabolic comorbidities. Patients who underwent Fundoplication experienced longer anesthesia (192.5 vs. 112 min, p < 0.0001), operation times (134 vs. 79 min, p < 0.0001), and hospital stays (4 vs. 3 days, p = 0.0003). Complication rates in general (p = 0.0154, after three months) and dysphagia rates in particular (p = 0.0036, after three months and p = 0.0147, after one year) were higher in the Fundoplication group. Preoperatively, patients undergoing RYGB reported poorer quality of life in BQL questionnaires (p = 0.0008). PSM showed less reflux regression in the Fundoplication group after three months (p = 0.0223).</p><p><strong>Conclusion: </strong>Despite higher preoperative BMI and comorbidities, patients undergoing RYGB had shorter operative times and hospital stays. The results suggest RYGB may be preferable for patients with refractory GERD and class I and II obesity, but further research on long-term outcomes is needed.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Frailty Index as a Predictor of Operative Safety and Efficacy in Patients Undergoing Laparoscopic Sleeve Gastrectomy.","authors":"Eliahu Yonathan Bekhor, Boris Kirshtein, Noam Peleg, Nayyera Tibi, Hila Shmilovich, Lisa Cooper, Alex Tatarov, Nidal Issa","doi":"10.1007/s11695-025-07819-3","DOIUrl":"https://doi.org/10.1007/s11695-025-07819-3","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710706","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 SADI-S Versus SG in Chinese with Diabetes and BMI < 35 kg/m2:a Retrospective Study with Medium-Term Outcomes.","authors":"Zhiqiang Wei, Subo Ma, Zheng Zhang, Tao Jiang, Lifu Hu","doi":"10.1007/s11695-025-07809-5","DOIUrl":"https://doi.org/10.1007/s11695-025-07809-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;As a modification of the duodenal switch (DS), the single-anastomotic ileo-ileal bypass combined with sleeve gastrectomy (SADI-S) has recently gained popularity and has been successfully employed for weight loss and the remission of type 2 diabetes mellitus (T2DM). However, current studies predominantly focus on patients with severe obesity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;In this study, we present the first comparison of single-anastomotic duodenoileal bypass combined with sleeve gastrectomy (SADI-S) and sleeve gastrectomy (SG) for the mid-term treatment of Chinese diabetic patients with a BMI &lt; 35 kg/m2. This research provides comparative reports on the efficacy of these two surgical approaches.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients and methods: &lt;/strong&gt;We included 53 diabetic patients with BMI &lt; 35 kg/m&lt;sup&gt;2&lt;/sup&gt; who underwent either SADI-S or SG and were followed for 2 years postoperatively. Demographic characteristics, weight loss, and nutritional and metabolic outcomes were analyzed at 3-month, 6-month, 1-year, and 2-year follow-up intervals. All surgeries were performed by the same surgeon at a single weight loss center in China between July 2015 and November 2022.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 24 patients who underwent Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy (SADI-S) and 29 patients who underwent Sleeve Gastrectomy (SG) were included in our analysis. Comparative analysis of the baseline indicators between the two groups revealed no statistically significant differences (P &gt; 0.05).Both patient groups completed a 2-year follow-up. In terms of weight loss, the SADI-S group demonstrated superior outcomes compared to the SG group, with better results in weight, BMI, and total weight loss percentage (%TWL) at the 2-year follow-up, and these differences were statistically significant (66.9 ± 7.9 vs. 61.2 ± 6.6, p = 0.007; 23.8 ± 2.0 vs. 21.7 ± 1.6, p = 0.000; 31.1% ± 6.3% vs. 24.4% ± 6.4%, p = 0.000). Regarding diabetes remission, the SADI-S group also outperformed the SG group (p = 0.000). Specifically, 91.8% of patients in the SADI-S group achieved complete remission of T2DM, compared to 41.4% in the SG group (p = 0.000). Furthermore, the SADI-S group showed significantly better results in the remission of hyperlipidemia compared to the SG group.However, there was no significant difference in hypertension relief between the SADI-S group and the SG group. Additionally, the incidence of postoperative hypozincemia was significantly higher in the SADI-S group compared to the SG group (p = 0.038). No significant differences were observed in other postoperative nutritional outcomes between the two groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In Chinese diabetic patients with a BMI &lt; 35 kg/m&lt;sup&gt;2&lt;/sup&gt;, both SADI-S and SG were effective in treating obese T2DM.However, compared with SG, primary SADI-S can achieve better weight loss and remission of obesity-related metabolic diseases.Additiona","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710703","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":"Management of Gastric Leak after Sleeve Gastrectomy: A 13-year Experience in a Tertiary Referral Center.","authors":"Eloise Papet, Rachid Chati, Jean Pinson, Paul Rozenbaum, Edouard Roussel, Emmanuel Huet","doi":"10.1007/s11695-025-07811-x","DOIUrl":"https://doi.org/10.1007/s11695-025-07811-x","url":null,"abstract":"<p><strong>Introduction: </strong>The main complication of sleeve gastrectomy remains fistula formation. Studies have mainly focused on the endoscopic management of fistulas, and surgery is reserved for cases of hemodynamic instability or treatment failure. The aim of this study was to evaluate the management of gastric leak after sleeve gastrectomy.</p><p><strong>Methods: </strong>We retrospectively analyzed the characteristics, treatments, and outcomes of patients managed for gastric leaks after sleeve gastrectomy in our center. Healing was defined as resumed oral intake without inflammatory syndrome or the presence of drainage material.</p><p><strong>Results: </strong>From 2009 to 2022, 43 patients were managed in our center for gastric leak after sleeve gastrectomy. Among them, 21 patients were referred from other centers. In 86% of cases, the gastric leak developed within the first 15 days. It was located at the proximal staple line in 84% of cases. Associated stenosis or twisting was observed in 18% of cases. Surgical treatment alone was used in 32% of patients, while 59% received combined management. Only 3 patients (6.8%) were managed exclusively by endoscopy. The overall healing rate was 91%, with a median healing time of 89 days.</p><p><strong>Conclusion: </strong>The management of gastric leaks after sleeve gastrectomy depends on their location and clinical presentation and should not be limited to a solely endoscopic or surgical approach. Our study demonstrates that surgical intervention alone may be sufficient in 30% of cases. However, for most patients, a multidisciplinary approach in a referral center is recommended.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710708","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":"Glucose Homeostasis Improvement After Single Anastomosis Duodenojejunal Bypass with Sleeve Gastrectomy in Goto-Kakizaki Rats.","authors":"Sirio Melone, Jose Maria Fernandez-Cebrian, Mario Amores, Yolanda Lopez-Tofiño, Elia Perez-Fernandez, Elena Garcia-Garcia, Juan Manuel Acedo, Carlos Guijarro, Sagrario Martinez Cortijo, Raquel Abalo, Maria Ruth Pazos","doi":"10.1007/s11695-025-07799-4","DOIUrl":"https://doi.org/10.1007/s11695-025-07799-4","url":null,"abstract":"<p><strong>Background: </strong>The incidence of type 2 diabetes mellitus (T2DM) is raising with significant associated medical complications and mortality. Bariatric surgery has shown to have beneficial metabolic effects. A model of single anastomosis duodenojejunal bypass with sleeve gastrectomy (SADJB-SG) was developed in a T2DM animal model without obesity, Goto-Kakizaki (GK) rats, to evaluate the effect of the procedure on glucose homeostasis.</p><p><strong>Methods: </strong>Fourteen 12-week old GK rats underwent SADJB-SG, while 11 underwent simulated surgery (Sham). Weight and food intake were recorded comprehensively until sacrifice. Fasting blood glucose data, as well as insulin, fructosamine, and albumin levels were measured both pre-surgically and just before sacrifice. Glucose homeostasis was also monitored by oral glucose tolerance test (OGTT) at different time points. A radiographic study was performed to assess the effect of surgery on gastric emptying.</p><p><strong>Results: </strong>Mortality rate was 24% in the SADJB-SG and 4% in Sham rats. Despite similar food intake, the SADJB-SG showed significant weight loss coupled to a decrease in albumin levels. Glucose homeostasis improved in SADJB-SG rats after surgery, reflected in decreased blood glucose, fructosamine levels, and homeostasis model assessment of insulin resistance index (HOMA-IR). OGTT tests, conducted both post-surgery and at follow-up, demonstrated an improvement in glucose metabolism 120 min after glucose administration. However, a peak in glycemia was observed at 30 min, which negatively affected the expected AUC results. Gastric emptying was accelerated in the SADJB-SG, which could contribute to explain the observed glycemia increment, through fast glucose jejunal uptake.</p><p><strong>Conclusion: </strong>SADJB-SG surgery improved glucose homeostasis in GK rats.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701097","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":"Perioperative Screening for Metabolic Dysfunction Associated Steatotic Liver Disease in People Undergoing Bariatric Surgery: A Pilot Study.","authors":"David M Williams, Thinzar Min, Andrew Beamish, Jeffrey W Stephens","doi":"10.1007/s11695-025-07810-y","DOIUrl":"https://doi.org/10.1007/s11695-025-07810-y","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710711","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":"Cardiac Remodeling after Bariatric Surgery Beyond Weight Loss: A Dose-Response Analysis.","authors":"Valentin Rozandal, Ricardo Mishima, Manuel Garcia, Nadia Berdeja, Pablo Nicolas Martinez Vambakianos, Mayra Valdez, Veronica Catellanos, Fernando Martinez Lascano, Carlos Martin Esquivel","doi":"10.1007/s11695-025-07801-z","DOIUrl":"https://doi.org/10.1007/s11695-025-07801-z","url":null,"abstract":"<p><strong>Background: </strong>Obesity is associated with deleterious metabolic and hemodynamic changes resulting in cardiac remodeling. Bariatric surgery is highly effective for both weight reduction and reverse cardiac remodeling. However, whether these changes depend on the magnitude of weight loss is unknown. This study aims to compare cardiac structure and diastolic function before and after bariatric surgery and examine its association with body mass index (BMI) variation.</p><p><strong>Methods: </strong>Consecutive bariatric patients operated between June 2023 and June 2024 were screened for inclusion. Patients with a) previous bariatric surgery, b) moderate to severe valvular disease, c) those without follow-up 1 year after the intervention, or c) those who declined to participate were excluded. Cardiac structure and diastolic function were assessed preoperatively and 12 months after the surgery.</p><p><strong>Results: </strong>A sample of 70 patients was analyzed. After 12 months, the left atrial (LA) volume index went from 25.0 ± 6.1 ml/m² to 29 ± 7 (p < 0.001) whereas diastolic and systolic left ventricular (LV) diameters decreased from 4.98 ± 0.43 cm to 4.53 ± 0.41 cm (p < 0.001) and from 3.17 ± 0.33 cm to 2.88 ± 0.28 cm (p < 0.001), respectively. LV mass index declined from 75 ± 15 to 65 ± 14 g/m² (p < 0.001). In univariate linear regression analysis, LA volume index, diastolic and systolic LV diameters, and LV mass index were not associated with BMI reduction. These results were similar after adjustment for age and sex. The prevalence of grade I and grade II diastolic dysfunction decreased to 1 (1.4%) and 14 (20%), respectively (p = 0.2) with no association with BMI change.</p><p><strong>Conclusion: </strong>Significant reverse cardiac remodeling occurs after bariatric surgery with no association with BMI reduction. Further research is warranted to clarify the beneficial cardiovascular effects of bariatric surgery beyond weight loss.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701078","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":"Letter to the Editor: Weight Maintenance as an Indication for Metabolic and Bariatric Surgery.","authors":"Sonja Chiappetta, Roxanna Zakeri","doi":"10.1007/s11695-025-07785-w","DOIUrl":"https://doi.org/10.1007/s11695-025-07785-w","url":null,"abstract":"<p><p>Obesity is recognised as a chronic, relapsing and progressive disease, and long-term weight maintenance remains one of the greatest challenges in obesity management. When treatment gets interrupted, recurrent weight gain might be expected. Funding structures for MBS in numerous health systems globally do not currently permit metabolic and bariatric surgery (MBS) to prevent recurrent weight gain in patients who are normal weight or overweight. Gastric band removal is frequently required due to long-term complications such as slippage, which raises an important question: should revisional MBS be considered for weight maintenance in patients who have successfully lost weight after gastric banding? With the increasing use of obesity management medications and the associated successful weight loss, we anticipate that more patients will discontinue pharmacological treatment after reaching a normal weight or overweight range. However, many of these patients may still seek MBS for long-term weight maintenance. We question whether weight maintenance should be considered an indication for MBS in patients who are currently normal weight or overweight but have a history of severe obesity and must discontinue their current obesity treatment.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Determining the Importance of Lifestyle Risk Factors in Predicting Binge Eating Disorder After Bariatric Surgery Using Machine Learning Models and Lifestyle Scores.","authors":"Maryam Mousavi, Mastaneh Rajabian Tabesh, Seyyedeh Mahila Moghadami, Atoosa Saidpour, Soodeh Razeghi Jahromi","doi":"10.1007/s11695-025-07808-6","DOIUrl":"https://doi.org/10.1007/s11695-025-07808-6","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664089","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}