Obesity Surgery最新文献

{"title":"Weighed Down by Paperwork: Identifying Barriers to Metabolic and Bariatric Surgery Evaluation in the United States.","authors":"Rylee Barber, Stephen Moorhead, Kalina Siehl, Ronit Pathak, Mary K Bryant","doi":"10.1007/s11695-026-08888-8","DOIUrl":"10.1007/s11695-026-08888-8","url":null,"abstract":"<p><strong>Background: </strong>Obesity affects over 42% of U.S. adults, yet access to metabolic and bariatric surgery (MBS) remains limited despite its proven efficacy. While use of GLP-1 receptor agonists has risen in the past three years, MBS volume has declined over 25% during the same period. Reported barriers to MBS include long wait times, societal sigma, fear of surgery, and insurance restrictions. This study investigated appointment accessibility and program requirements for patients seeking MBS.</p><p><strong>Methods: </strong>We conducted a secret shopper study of bariatric surgery centers in North Carolina (n=18) and South Carolina (n=17) June - August 2025. Trained callers contacted each program twice, once posing as a patient with Medicaid and once as a patient with private insurance, to request an initial consultation appointment. Data collected included appointment wait times, required documentation, pre-surgical prerequisites, and administrative barriers.</p><p><strong>Results: </strong>Of the 24 centers successfully contacted, all accepted private insurance and 94.3% accepted Medicaid. Median wait time to appointment was 20 days, with no difference by insurance type. On average, programs required 1.7 calls before reaching a scheduler. Most centers (77.1%,n=27) required pre-appointment steps such as an online application, seminar, or PCP referral. Eleven centers could not be reached due to incorrect contact information, and two offered only online intake forms.</p><p><strong>Conclusions: </strong>Rather than insurance-related disparities, we found that administrative barriers such as repeated call attempts, inaccurate contact information, and variable prerequisites were the main obstacles to MBS access. The lack of standardization across programs highlights the need to streamline the evaluation process.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5074-5077"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857489","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":"Correction: Individuals With Food Addiction After Metabolic And Bariatric Surgery Show Higher Consumption of Ultra-Processed Foods, Sedentary Lifestyle, Anxiety, and Sub-Optimal Body Weight Trajectories.","authors":"Maria Clara Tavares Farias da Silva, Jennifer Mikaella Ferreira Melo, Natália Gomes da Silva Lopes, André Eduardo da Silva Júnior, Mateus de Lima Macena, Nassib Bezerra Bueno","doi":"10.1007/s11695-026-08967-w","DOIUrl":"https://doi.org/10.1007/s11695-026-08967-w","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Simple Scoring Model for Mid-term Remission of Type 2 Diabetes Mellitus After Sleeve Gastrectomy in Chinese Patients.","authors":"Shun Lu, Mengcheng He, Qiyuan Yao, Rong Hua, Bo Xu, Qiwei Shen, Xiaojian Fu, Chongwen Zhan, Jie Gu, Yikai Shao","doi":"10.1007/s11695-026-08925-6","DOIUrl":"10.1007/s11695-026-08925-6","url":null,"abstract":"<p><strong>Background: </strong>Metabolic bariatric surgery is the most effective treatment for obesity and related type 2 diabetes mellitus (T2DM), but T2DM remission post-surgery is heterogeneous. Existing prediction models were developed largely in Western populations, often for gastric bypass and short-term outcomes, limiting applicability to Chinese patients undergoing laparoscopic sleeve gastrectomy (LSG). We aimed to develop a preoperative model for predicting mid-term T2DM remission after LSG.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of Chinese patients with obesity and T2DM who underwent primary LSG between 2017 and 2023. Mid-term remission was assessed over 2-7 years of follow-up. Candidate preoperative variables were screened by univariate analysis and LASSO regression, followed by multivariable logistic regression and 2,000-bootstrap internal validation. The final model was simplified into a scoring system.</p><p><strong>Results: </strong>Among 221 patients included (median baseline HbA1c 7.20%), 81.4% achieved T2DM remission at a mean follow-up of 3.60 ± 1.49 years, with median HbA1c decreasing to 5.60%. The final model retained three predictors: number of hypoglycemic agents, insulin use, and 2-hour plasma C-peptide, and showed strong discrimination (AUC 0.876). Bootstrap validation confirmed robust performance (mean AUC 0.878, 95% CI 0.809-0.935). The simplified score (2-hour plasma C-peptide-5 × number of hypoglycemic agents - insulin use score [11/0]) showed the same AUC, and higher scores indicated greater remission probability.</p><p><strong>Conclusions: </strong>We developed and internally validated a preoperative model for predicting mid-term T2DM remission after LSG in Chinese patients with obesity and T2DM. The model was translated into a simple scoring system that may support individualized management and decision-making.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5202-5212"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956319","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":"Revisional Laparoscopic One Anastomosis Gastric Bypass for Weight Loss Failure after Restrictive Procedures.","authors":"Hossam S Abdelrahim, Ahmed Elnabil-Mortada, Wadie Boshra Gerges, Haitham M Elmaleh","doi":"10.1007/s11695-026-08821-z","DOIUrl":"10.1007/s11695-026-08821-z","url":null,"abstract":"<p><strong>Introduction: </strong>Patients undergoing primary restrictive bariatric metabolic surgery procedures (BMS) are at risk of having suboptimal initial response (SIR) and late postoperative clinical deterioration (LPCD), which can be an indication for conversion. Roux-en-Y gastric bypass (RYGB) is currently the most common conversion procedure. Still, one anastomosis gastric bypass (OAGB) has emerged as a viable alternative conversion procedure to RYGB, due to its relative technical simplicity and easy reversibility. We aim to assess the safety and effectiveness of laparoscopic OAGB as a conversion procedure for managing SIR or LPCD after primary restrictive BMS procedures.</p><p><strong>Methods: </strong>A retrospective observational study was conducted at our university hospital between July 2017 and December 2024. It included patients with failed primary restrictive bariatric procedures. All patients underwent conversion to OAGB and were followed for a minimum of 5 years.</p><p><strong>Results: </strong>115 patients completed the 5-year follow-up. The early postoperative complication rate was 7.6%, and the reoperation rate was 1.6%. After 5 years, late postoperative complications occurred in 11.3% of patients. The mean body mass index loss (BMIL%) was 28.59% and 17.4% of patients had SIR during the study period. Significant improvement in obesity-associated medical problems was observed after 5 years, with remission rates of 70.8% for type 2 diabetes mellitus, 82.4% for dyslipidemia, 64.1% for sleep apnea, and 61.3% for hypertension.</p><p><strong>Conclusion: </strong>OAGB is a safe and effective conversion procedure for the management of SIR and LPCD after restrictive procedures, achieving favorable mid-term outcomes.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5109-5118"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391414","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":"Benign Anorectal Disease Following Weight Loss Interventions Including Bariatric Surgery: A Retrospective Cohort Study.","authors":"Ahmed Alkhamis, Dalia Albloushi, Mohsen Alhashemi, Omar Alkandari, Salman Alsafran, Omar Al Qabandi, Hala AlDabbous, Ameera AlHasan, Mohammad H Jamal","doi":"10.1007/s11695-026-08938-1","DOIUrl":"10.1007/s11695-026-08938-1","url":null,"abstract":"<p><strong>Background: </strong>Bariatric and metabolic surgery (MBS) and intra-gastric balloons (IGBs) are effective interventions for the treatment of obesity, resulting in substantial weight reduction and improvement in associated comorbidities. Nonetheless, the postoperative period can be complicated by new onset of benign anorectal disorders (NBADs). This study aims to examine the incidence and risk factors associated with NBADs following these weight loss interventions.</p><p><strong>Methods: </strong>We conducted a retrospective review of patients who underwent MBS and IGBs in a si ngle center between 2019 and 2024. Data were collected through electronic medical records and follow-up telephone interviews, assessing demographics, comorbidities, bowel habit changes and anorectal symptoms.</p><p><strong>Results: </strong>A total of 371 patients were included, with a mean age of 34.7 ± 11.6 years; 62.3% were female. Laparoscopic sleeve gastrectomy was the most common intervention (64.7%), followed by malabsorptive procedures (9.1%). The rate of NBADs was 10.78% (n=40). Multivariate analysis identified age (OR 1.03, 95% CI: 1.001-1.06, p<0.05) and diabetes mellitus (OR: 4.1, 95% CI: 1.2-14.2, p<0.05) as independent risk factors for developing post operative changes in bowel habits. Importantly, constipation demonstrated the strongest association with NBADs (OR 10.4 CI: 4.7-23.1, p<0.001).</p><p><strong>Conclusion: </strong>NBADs occur in over 10% of patients following weight loss interventions with constipation being the strongest predictor. These findings highlight the need for proactive monitoring and personalized dietary strategies to manage bowel habit changes and reduce the risk of anorectal complications.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5265-5274"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977635","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 Improvements and Weight Trajectories After Metabolic-Bariatric Surgery in Women with Polyendocrine Metabolic Ovarian Syndrome.","authors":"Lei Zhang, Xihan Li, Shiyan Zhang, Bojun Zhou, Boyi Hu, YiLin Gai, Chaojun Wang, Guoqing Yang, Hua Meng","doi":"10.1007/s11695-026-08916-7","DOIUrl":"10.1007/s11695-026-08916-7","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity in women with Polyendocrine Metabolic Ovarian Syndrome (PMOS) is associated with substantial metabolic and reproductive burden. metabolic-bariatric surgery (MBS) is effective for weight loss, yet postoperative responses vary considerably. Identifying distinct weight loss trajectories and their associated metabolic outcomes may enable individualized postoperative management.</p><p><strong>Methods: </strong>In this prospective study, women with obesity and PMOS who underwent sleeve gastrectomy were followed at 1, 3, 6, and 12 months postoperatively. Group-based trajectory modeling (GBTM) based on percentage total weight loss (%TWL) was used to identify distinct patterns of weight loss. Longitudinal changes in anthropometric and metabolic parameters were compared between the identified trajectory groups.</p><p><strong>Results: </strong>A total of 111 women were included. Significant improvements in anthropometric and metabolic parameters were observed over 12 months, with the most pronounced changes occurring within the first three months. Median BMI decreased from 38.5 kg/m. ² preoperatively to 26.7 kg/m² at 12 months (median %TWL 30.1%; %EWL 83.9%), and HbA1c improved from 5.8% to 5.2%. GBTM identified two distinct %TWL trajectories: an accelerated-decline group (57.7% of patients) and a normal-decline group (42.3%). Despite comparable baseline characteristics between the two groups, patients in the accelerated-decline group demonstrated consistently superior metabolic outcomes, including lower fasting insulin, C-peptide, and LDL-cholesterol at various postoperative time points.</p><p><strong>Conclusion: </strong>MBS yields substantial metabolic improvements in women with obesity and PMOS, with two distinct weight loss trajectories. Greater weight loss after MBS is associated with more pronounced metabolic benefits, yet preoperative characteristics do not distinguish between trajectory groups, underscoring the heterogeneity in surgical response and the need for further research into the determinants of differential outcomes.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5339-5348"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897546","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":"Publisher Correction: Chronodisruption as an Emerging Determinant of Weight Loss Trajectories After Metabolic Bariatric Surgery: A Scoping Review.","authors":"Athanasios G Pantelis, Zoe Pafili, Vasiliki Tseliou, Evangelia Dimitrakopoulou, Moysis Moysidis, Dimitris P Lapatsanis","doi":"10.1007/s11695-026-08931-8","DOIUrl":"10.1007/s11695-026-08931-8","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5543"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956342","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":"Behavioral Determinants of Lifestyle Modifications Following Metabolic Bariatric Surgery in a Culturally Specific Population: A Qualitative Study.","authors":"Haya Subhi, Rana Hijazi, Mahmoud Abu Gazala, Husam Mahajna, Ram Elazary, Tair Ben-Porat","doi":"10.1007/s11695-026-08941-6","DOIUrl":"10.1007/s11695-026-08941-6","url":null,"abstract":"<p><strong>Introduction: </strong>Sustained healthy behaviors are critical for long-term success after metabolic bariatric surgery (MBS); however, patients from culturally distinct communities may face unique sociocultural and structural barriers to postoperative behavior change. We explored behavioral determinants of lifestyle modifications among women from the Arab society in Israel post-MBS.</p><p><strong>Methods: </strong>Semi-structured, in-depth interviews were conducted with 20 women who underwent MBS at a public university-affiliated medical center. Interviews explored participants' experiences of postoperative lifestyle adjustments, including dietary and physical activity patterns. Data were analyzed using inductive thematic analysis followed by deductive mapping to the COM-B model and the Theoretical Domains Framework (TDF).</p><p><strong>Results: </strong>Seventeen themes were identified across all COM-B components and 12 TDF domains. Key facilitators included knowledge of dietary recommendations; improved physical functioning and stamina; and social support as an enabler of behavior change. Motivation was reinforced by health-related consequences and concerns of relapse; and visible progress and external feedback. Major barriers included limited postoperative follow-up and healthcare access; time, resource, and infrastructure constraints to physical activity. Additional challenges included variability in physical activity guidance; social norms, pressure, and expectations; and postoperative emotional distress and adjustment. Participants also described self-directed learning and information seeking, including the use of AI and digital tools.</p><p><strong>Conclusion: </strong>Postoperative lifestyle adherence following MBS is shaped by interacting individual, social, and environmental factors. Findings highlight the need for culturally tailored, theory-informed interventions integrating structured guidance, continuous follow-up, social support, and potentially digitally supported strategies to address real-world and culturally embedded barriers and support long-term outcomes following MBS.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5294-5306"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977572","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":"Triglyceride-to-HDL Cholesterol Ratio is Associated with Hepatic Steatosis but not Fibrosis in Patients with Severe Obesity: A Cross-Sectional Study.","authors":"Carolina de Oliveira Bernardes, Esdras Marques Lins, Fernanda Appolonio Rocha, Flavio Kreimer, Roberta Bessa Veloso Silva, Nataly Regina Fonseca Carvalho de Medeiros, Karolyna Maria Lima de Medeiros Ferreira, Alvaro Antonio Bandeira Ferraz","doi":"10.1007/s11695-026-08891-z","DOIUrl":"10.1007/s11695-026-08891-z","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent among individuals with severe obesity. The triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-C) is an accessible surrogate marker of insulin resistance, but its association with hepatic steatosis and fibrosis in candidates for metabolic and bariatric surgery remains incompletely defined.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 99 patients undergoing preoperative evaluation for metabolic and bariatric surgery between 2020 and 2024. Hepatic steatosis was assessed by ultrasonography and liver fibrosis by elastography. Associations with TG/HDL-C were examined using categorical analyses and multivariable logistic regression. Because diabetes perfectly predicted hepatic steatosis, Firth penalized logistic regression was used for the primary adjusted analysis.</p><p><strong>Results: </strong>The cohort included 61 women (61.6%), with a mean age of 37.0 ± 9.8 years and body mass index of 40.4 ± 4.2 kg/m². Hepatic steatosis was present in 81 of 99 patients (81.8%), whereas fibrosis was identified in 35 of 98 patients with evaluable elastography (35.7%). Higher TG/HDL-C categories were associated with hepatic steatosis (p = 0.0016). After adjustment, each unit increase in TG/HDL-C was associated with higher odds of steatosis (adjusted odds ratio, 2.23; 95% CI, 1.22-4.08; p = 0.0090). TG/HDL-C showed moderate discrimination for steatosis (area under the curve, 0.763; 95% confidence interval, 0.632-0.868), with an exploratory optimal threshold of 2.17 (79.0% sensitivity and 66.7% specificity). In contrast, TG/HDL-C was not associated with fibrosis after adjustment (adjusted odds ratio, 0.84; 95% confidence interval, 0.63-1.10; p = 0.209) and showed no discriminatory ability for fibrosis (area under the curve, 0.494).</p><p><strong>Conclusions: </strong>TG/HDL-C was independently associated with ultrasonographically detected hepatic steatosis and showed moderate discriminatory performance in patients with severe obesity undergoing evaluation for metabolic and bariatric surgery. However, it was not associated with fibrosis assessed by elastography. These findings support TG/HDL-C as a potential low-cost adjunct for identifying steatosis, but not as a substitute for fibrosis-specific assessment.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5164-5172"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796224","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":"Simultaneous Versus Interval Sleeve Gastrectomy on Patients Requiring Left Ventricular Assist Devices for End-stage Heart Failure: A Retrospective, Single-Center Cohort Study.","authors":"Oscar Olavarria, Syed Naqvi, Luke Crawford, Melissa Felinski, Shinil Shah, Peter Walker, Marwan Jumean, Manish Patel, Ismael Salas, Jayeshkumar Patel, Kha Dinh, Sriram Nathan, Bindu Akkanti, Biswajit Kar, Igor Gregoric, Kulvinder Bajwa","doi":"10.1007/s11695-026-08936-3","DOIUrl":"10.1007/s11695-026-08936-3","url":null,"abstract":"<p><strong>Background: </strong>Durable Left ventricular assist devices (LVADs) are commonly employed as therapy in end-stage heart failure (ESHF). However, individuals with class II obesity (Body Mass Index (BMI) > 35 kg/m²) are often ineligible for heart transplant and have limited options. Laparoscopic sleeve gastrectomy (LSG) is increasingly utilized to facilitate weight loss and improve transplant candidacy. This study evaluates the safety of performing LSG in patients undergoing LVAD implantation who are otherwise ineligible for heart transplantation due to morbid obesity.</p><p><strong>Methods: </strong>A retrospective, single-center cohort study was conducted on congestive heart failure (CHF) patients who underwent either simultaneous LVAD and LSG or staged LSG following LVAD placement. The primary outcome was LSG-related complications within 90 days, including gastrointestinal (GI) bleeding, staple line leaks, and mortality. Secondary outcomes included reoperation rates, acute kidney injury (AKI), transfusion requirements, length of stay (LOS), readmissions, transplant rates, and percent excess body weight loss (%EBWL) at follow-up.</p><p><strong>Results: </strong>Among 77 patients (54 simultaneous, 23 interval), LSG-related complications were lower in the simultaneous group (7.4% vs. 17.4%; p = 0.23). Transfusion rates were significantly lower in this group (38.9% vs. 69.6%; p = 0.02), though AKI was more frequent (72.2% vs. 56.6%; p = 0.19). One mortality occurred in the simultaneous cohort. No significant differences were observed in reoperations, LOS, readmissions, transplant rates, or %EBWL.</p><p><strong>Conclusion: </strong>Simultaneous LVAD/LSG was associated with comparable sleeve-related complication rates relative to interval LSG. Although limited by small sample size and potential temporal confounding, these findings hypothesize that simultaneous LVAD/LSG may potentially be a feasible strategy in select patients with obesity and ESHF. Larger prospective studies are needed to better define safety, patient selection, and long-term outcomes.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5430-5436"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025640","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}