Obesity Surgery最新文献

{"title":"The Impact of Bias and Stigma on Patient Referral for Metabolic/Bariatric Surgery: An Algerian Experience.","authors":"Heykel Mebarek, Hind Toumi, Abdelrahman Nimeri","doi":"10.1007/s11695-025-07882-w","DOIUrl":"10.1007/s11695-025-07882-w","url":null,"abstract":"<p><p>Obesity is a chronic disease causing a major public health challenge, particularly in Algeria, yet in patient referrals for metabolic/bariatric surgery (MBS), the most effective treatment remain low. This study aims to analyze the factors influencing referrals for MBS, focusing on the impact of obesity bias and stigma among primary care physicians. A survey questionnaire was sent electronically to 250 physicians across four regions in Algeria. The questionnaire evaluated their knowledge, attitudes, perceptions, and practices regarding MBS including questions on indications for MBS, operative techniques, physicians' attitudes toward patients with obesity, and factors influencing patient referrals for MBS. Survey response rate was 37.2% (93/250 physicians), most physicians (89%) recognized obesity as a chronic disease, and majority (60%) of physicians were aware that hunger regulation centers are involuntary and located in the hypothalamus; 34.4% believed that lifestyle changes were sufficient to treat severe obesity. Significant knowledge gaps were observed regarding MBS indications, 83% expressed a willingness to help their patients achieve ideal weight, but only 10% of physicians referred patients for MBS. Many physicians showed negative attitudes toward patients with obesity, and 68% held stereotypes about obesity, attributing it to a lack of personal willpower. These stigmas may have contributed to the low referral rates for MBS. Additional barriers were economic barriers, such as the high cost of MBS and limited or absent insurance coverage. A lack of knowledge about metabolic/bariatric surgery, coupled with stigmatizing attitudes and economic constraints, hinders patient referrals for MBS, which is the most effective treatment for severe obesity. The study highlights the need for more education of primary care physicians, promoting an empathetic and interprofessional approach and implementing health policies that improve financial accessibility to MBS in Algeria.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2342-2351"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973013","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 Venice Declaration: Obesity as a Disease-A Call to Action for Diagnosis, Multimodal Treatment, and Policy Change.","authors":"Maurizio De Luca, Amanda Belluzzi, Giuseppe Navarra, Tarissa B Z Petry, Scott Shikora, Nicola Di Lorenzo, Ricardo V Cohen","doi":"10.1007/s11695-025-07869-7","DOIUrl":"10.1007/s11695-025-07869-7","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"1999-2003"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992438","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":"Post-Metabolic Bariatric Surgery Cirrhosis and the Role of Liver Transplantation: A Report from a Referral Transplant Center.","authors":"Hamed Nikoupour, Erfan Sheikhbahaei, Alireza Shamsaeefar, Kourosh Kazemi, Mohammad Eslamian, Hamidreza Zefreh, Seyed Ali Malek-Hosseini, Saman Nikeghbalian","doi":"10.1007/s11695-025-07852-2","DOIUrl":"10.1007/s11695-025-07852-2","url":null,"abstract":"<p><strong>Background: </strong>Despite their benefits, metabolic bariatric surgery (MBS) has been associated with rare but severe complications, including liver failure (LF) and the need for orthotopic liver transplantation (OLT). The exact mechanisms underlying MBS-related cirrhosis remain unclear, and comprehensive data on this topic are scarce.</p><p><strong>Method: </strong>This retrospective study analyzed 10 patients who underwent OLT after MBS due to decompensated LF. Demographic, clinical, and laboratory data were collected and analyzed, including pre- and post-MBS body mass indexes (BMI), liver function tests, and MELD scores.</p><p><strong>Results: </strong>Mean age was 42.9 years with the female percentage of 40%. Except for two patients who had 110 and 120 months between the MBS and OLT, remaining eight cases had a mean 19.6 months interval between the MBS and OLT. Roux-en-Y gastric bypass (RYGB) being the most common procedures, two of them reported consumption of alcohol, one died afterwards. Four patients died due to different reasons through the study (Two sleeve (SG), and one for each RYGB and one-anastomosis gastric bypass). There were significant correlations between overall survival (OS) and age (Spearman's rank correlation coefficient (r) = 0.85, p = 0.002), bilirubin (r = - 0.74, p = 0.013), and MELD score (r = - 0.69, p = 0.026). Survival with log rank test was only significant for MBS types (p = 0.035). COX regression was significant when compare RYGB vs. SG (Exp(B) = 0.069, p = 0.048).</p><p><strong>Conclusion: </strong>MBS-related cirrhosis is rare but potentially life-threatening and OLT is the final step with a noticeable risk of mortality. Comprehensive preoperative liver assessment, careful selection of MBS procedures, and close postoperative monitoring are crucial for mitigating risks.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2111-2120"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003309","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":"Obesity Surgery Response to Letter to the Editor.","authors":"Jon Schram, John Morton","doi":"10.1007/s11695-025-07718-7","DOIUrl":"10.1007/s11695-025-07718-7","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2399"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029436","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 Preoperative Attrition from a Large, Racially and Ethnically Representative Bariatric Program in the USA: A Single-Center Retrospective, Cohort Study.","authors":"Safraz A Hamid, Samuel D Butensky, Elena Graetz, Miriam Olivares, Jennifer S Schwartz, Eric B Schneider, Saber Ghiassi, Karen E Gibbs","doi":"10.1007/s11695-025-07884-8","DOIUrl":"10.1007/s11695-025-07884-8","url":null,"abstract":"<p><strong>Background: </strong>Preoperative attrition from metabolic and bariatric surgery (MBS) programs remains a barrier for a subset of patients seeking surgical treatment of obesity. Prior analyses examining factors associated with attrition have been limited by study samples that are small in number and predominantly non-Hispanic, White. We aimed to assess factors associated with preoperative attrition using a large, racially and ethnically representative study sample.</p><p><strong>Methods: </strong>We reviewed the electronic health record of an urban, academic health system from 2021 to 2024. Our outcome was preoperative attrition, defined as not completing surgery within the study period. We compared individual- and regional-level factors between patients who experienced attrition with those who did not. We accounted for confounding effects using multivariable logistic regression.</p><p><strong>Results: </strong>Of a total 3043 patients, 28.0% were Black and 31.1% were Hispanic. Compared to patients who completed surgery, those who experienced attrition were older (mean age (SD): 43.9 (12.7) years vs. 41.8 (12.1) years, p < 0.001), were proportionally more likely to have obesity-related diseases (1-3 diseases: 59.3% vs. 55.9%; 3 diseases: 13.1% vs. 9.1%, p < 0.001), and more likely to be insured by Medicare (5.2% vs 2.2%, p < 0.001). Census tract social vulnerability, as measured by the social vulnerability index (SVI), was not associated with attrition (median (IQR) SVI percentile: 0.67 (0.59) vs. 0.59 (0.59), p = 0.071). In adjusted analysis, patients with more than three obesity-related diseases and those insured by Medicare had 53% (aOR 1.53, 95% CI 1.10-2.13) and 94% (aOR 1.94, 95% CI 1.14-3.30) increased odds of experiencing attrition, respectively. Hispanic ethnicity was associated with decreased odds of experiencing attrition (aOR 0.80, 95% CI 0.66-0.97).</p><p><strong>Conclusions: </strong>Among a large sample of patients racially and ethnically representative of the US population, the presence of more than three obesity-related diseases and Medicare insurance were associated with increased odds of preoperative attrition from an MBS program while Hispanic ethnicity was associated with decreased odds. Future studies should elucidate reasons for attrition and develop strategies to address the factors associated with attrition.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2390-2394"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035019","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":"From Panacea to Problem: Why Bariatric Surgery Demands Relentless and Complete Long-Term Follow-Up.","authors":"Francesco Saverio Papadia, Gian Franco Adami, Ottavio De Cian","doi":"10.1007/s11695-025-07914-5","DOIUrl":"10.1007/s11695-025-07914-5","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2024-2025"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045400","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 Intraperitoneal Dexmedetomidine in Comparison with Ropivacaine in Postoperative Pain After Laparoscopic Sleeve Gastrectomy: A Double-Blind, Randomized, Placebo-Controlled, Clinical Trial.","authors":"Mohamadreza Neishaboury, Samira Shokri, Parisa Kianpour, Kousha Farhadi, Khosrow Najjari, Hamidreza Sharifnia, Rana MohammadYousef, Mohammadreza Khajavi","doi":"10.1007/s11695-025-07871-z","DOIUrl":"10.1007/s11695-025-07871-z","url":null,"abstract":"<p><strong>Background: </strong>Studies have shown that non-opioid analgesic drugs can reduce the pain of patients after bariatric surgery. Ropivacaine and dexmedetomidine are associated with high efficacy and safety in managing postoperative complications. We evaluated the effectiveness of ropivacaine alone and in combination with dexmedetomidine in improving outcomes after sleeve gastrectomy surgery.</p><p><strong>Methods: </strong>This double-blind, randomized clinical trial, included patients undergoing bariatric surgery in 2022 and 2023. The participants were randomly divided into three groups: treated with ropivacaine alone (group A), ropivacaine and dexmedetomidine combination (group B), or normal saline (group C). Pain scores, morphine consumption, and postoperative nausea and vomiting (PONV) were assessed over 24 h.</p><p><strong>Results: </strong>All groups showed reduced pain, but group B had significantly lower VAS scores than groups A and C at 4-24 h postoperatively, with the highest difference achieved by group B compared to control at 12-h time point (β =  - 2.5, P < 0.001). Morphine use was lowest in group B (4.38 ± 1.24 mg vs. 6.04 ± 2.07 mg in group A and 7.50 ± 2.55 mg in group C; P < 0.001). PONV incidence was also lower in group B (8.3% vs. 29.2% in group A and 50% in group C; P = 0.008).</p><p><strong>Conclusions: </strong>The ropivacaine and dexmedetomidine combination therapy was associated with a greater pain relief effect after sleeve gastrectomy, a greater reduction in the need to take opioids, and a lower frequency of PONV compared to the ropivacaine alone or placebo.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2150-2159"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045442","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 Regarding \"Predictors of Anemia Recovery in Patients with Pre‑existing Anemia Undergoing Metabolic Bariatric Surgery: A Retrospective Cohort Study\".","authors":"Keli Xu, Chuanlong Zhou","doi":"10.1007/s11695-025-07902-9","DOIUrl":"10.1007/s11695-025-07902-9","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2017-2018"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047956","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":"Comparing Endoscopic Sleeve Gastroplasty (ESG) and Laparoscopic Sleeve Gastrectomy (LSG) 30-Day Outcomes and Healthcare Utilization: A Multi-Centered Retrospective Cohort Study of 506,597 Patients.","authors":"Valentin Mocanu, Emily Jordan, Jerry Dang, Thomas Shin","doi":"10.1007/s11695-025-07893-7","DOIUrl":"10.1007/s11695-025-07893-7","url":null,"abstract":"<p><strong>Background: </strong>While the safety and short-term weight-loss outcomes of endoscopic sleeve gastroplasty (ESG) are now well accepted, the modern uptake and its impact on healthcare utilization continue to remain poorly characterized, particularly in contrast to laparoscopic sleeve gastrectomy (LSG).</p><p><strong>Methods: </strong>After identifying ESG and LSG cases using a combination of CPT and procedural code variables, non-parsimonious multivariable logistic regression models were conducted to identify predictors of serious complications and outpatient emergency department (ED) visits.</p><p><strong>Results: </strong>A total of 506,597 patients met inclusion criteria (2285 ESG and 504,312 LSG). ESG patients were younger (42.6 ± 11.8 years versus 45.1 ± 10.7 years, p < 0.0001), had a lower BMI (39.5 ± 7.5 kg/m² versus 44.9 ± 7.7 kg/m², p < 0.0001), and were primarily female (86.2% versus 81.5%, p < 0.0001). Multivariable regression modeling revealed no differences in serious complications between ESG and LSG. ESG was protective against ED visits (OR 0.66; 95% 0.54-0.80; p < 0.0001). There were no other differences with respect to mortality or other healthcare metrics, such as outpatient rehydration, between procedures.</p><p><strong>Conclusions: </strong>Multivariable logistic regression modeling of prospectively collected 30-day outcomes in a large multi-institutional database demonstrates that ESG does not confer additional risk of 30-day serious complications compared to LSG and has lower odds off post-procedural ED utilization in the same comparison.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2059-2066"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991450","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":"Gastro-Oesophageal Reflux Disease Outcomes Following Roux-en-Y Gastric Bypass Surgery in Patients with Obesity: A Systematic Review and Meta-analysis.","authors":"Narek Sargsyan, Iihan Ali, Christopher Namgoong, Bibek Das, Matyas Fehervari, Michael G Fadel","doi":"10.1007/s11695-025-07865-x","DOIUrl":"10.1007/s11695-025-07865-x","url":null,"abstract":"<p><p>We aimed to investigate the effect of primary Roux-en-Y gastric bypass (RYGB) on gastro-oesophageal reflux disease (GORD) in patients with obesity. A systematic review was performed using MEDLINE, Embase, Emcare, and CINAHL databases for studies that reported on GORD outcomes following RYGB for obesity (January 2000-November 2023). Fourteen studies with 28,027 patients underwent RYGB, with pooled analysis demonstrating a 47% (95% CI 34.0-59.0; p ≤ 0.005) improvement in GORD symptoms and 4.5% (95% CI 1.7-7.2; p ≤ 0.005) with worsening/new onset GORD. Postoperative DeMeester score improved by 16.49 points (95% CI 0.2-32.7; p ≤ 0.005) and 79.4% (95% CI 68.7-90.1; p = 0.01) completely discontinued proton-pump inhibitor therapy during the follow-up period. RYGB surgery may potentially improve GORD symptoms in patients with obesity, with an overall low incidence of de novo GORD.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2321-2332"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006623","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}