Obesity Surgery最新文献

{"title":"Five year outcomes of primary and secondary Single-Anastomosis Duodeno-Ileal bypass with Sleeve gastrectomy (SADI-S).","authors":"Mitchell J R Harker, Laura Heusschen, Valerie M Monpellier, Ronald S L Liem, Magaly J J Van Himbeeck, Simon W Nienhuijs, May Al Nawas, Rene J Wiezer, Guusje Vugts, Eric J Hazebroek","doi":"10.1007/s11695-025-07888-4","DOIUrl":"10.1007/s11695-025-07888-4","url":null,"abstract":"<p><strong>Background: </strong>The single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) can be performed as a primary or (planned) secondary metabolic bariatric procedure. The aims of this study were to compare mid-term outcomes up to 5 years after primary vs secondary SADI-S and between different common channel (CC) lengths.</p><p><strong>Methods: </strong>Multicenter retrospective cohort study including 103 patients who underwent SADI-S between 06-2015 and 02-2019. Outcomes on weight loss, nutrient status, health-related quality of life (HRQoL) and gastro-intestinal symptoms until 5 years postoperatively were evaluated and compared between primary (n = 19) vs secondary SADI-S (n = 84), and CC length ≤ 250 cm (n = 66,) vs > 250 cm (n = 33).</p><p><strong>Results: </strong>Mean total weight loss (TWL) at 5 years of follow-up was higher for patients who underwent primary SADI-S compared to secondary SADI-S (34.8 (29.8-39.9)% vs 15.9 (13.0-18.9)%, p < 0.001) and for CC length ≤ 250 cm compared to > 250 cm (25.3 (21.8-28.9)% vs 21.3 (17.2-25.4)%, p = 0.12). Patients who underwent primary SADI-S also had significantly higher scores on the domains of the BODY-Q HRQoL questionnaire (p < 0.05 for all), with the exception of sexual well-being. Nutrient status and gastro-intestinal symptoms were comparable between the indication groups, but CC length ≤ 250 cm tended to result in more nutrient deficiencies and higher defecation frequency.</p><p><strong>Conclusion: </strong>Both primary and secondary SADI-S result in durable weight loss outcomes up to 5 years postoperatively. It is imperative that CC length should be at least 250 cm to prevent malnutrition and gastro-intestinal complaints. Furthermore, focus on HRQoL is essential in future research into SADI-S.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2160-2173"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013150","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":"Is Bariatric Surgery Safe to Perform in Patients with Chronic Liver Disease? A National Cross-Sectional Study.","authors":"Alexandra Z Agathis, Jeanne Wu, Damien J Lazar, Jordan Gipe, Edward H Chin, Linda P Zhang, Scott Q Nguyen","doi":"10.1007/s11695-025-07926-1","DOIUrl":"10.1007/s11695-025-07926-1","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a worldwide epidemic and is pervasive in the liver disease community. Given that liver disease is both caused and worsened by obesity, our study assesses the risks of bariatric surgery in patients with chronic liver disease.</p><p><strong>Methods: </strong>This retrospective study using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program 2023 database includes adult patients who underwent minimally invasive sleeve gastrectomy, Roux-en-Y gastric bypass, or gastric band placement procedures. Liver disease (LD) includes a spectrum of severity (borderline to moderate) and etiologies (including steatosis). LD and non-liver disease (non-LD) cohorts were compared using Chi-square and t-tests. Univariate and multivariate analyses were performed using logistic regression.</p><p><strong>Results: </strong>Our sample of 201,605 patients included 22,476 (11.2%) LD and 179,129 (88.9%) non-LD patients. Overall mean body mass index was 44.68 kg/m² (SD 7.86). The mortality rates were no different between groups (0.07% and 0.07%, p = 0.85). While multivariate subset analyses of each procedure showed a statistically slightly elevated risk of bleeding, infection, bowel obstruction, Clavien-Dindo I-III complications, and ICU admission for the liver group patients (odds ratios ranged from 1.42-1.76), rates of complications were clinically very low (3.1% and 0.8% for Clavien-Dindo I-III and IV).</p><p><strong>Conclusion: </strong>Given the low 30-day complication rate, our study shows that in the appropriate candidates with mild-to-moderate chronic liver disease, minimally invasive bariatric surgery is safe in the short-term, and the documented benefits of weight loss likely outweigh the slightly elevated risk. Bariatric surgeons can feel more comfortable and informed operating in this context.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2264-2273"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085810","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":"Gastroduodenal Intussusception After Conversion Of Gastric Plication To Roux-En-Y Gastric Bypass: A Case Report With Intraoperative Video.","authors":"Asyadée Jacob, Uto Randone, Ibrahim Dagher, Hadrien Tranchart","doi":"10.1007/s11695-025-07883-9","DOIUrl":"10.1007/s11695-025-07883-9","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2387-2389"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023398","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":"Medication Use Before and After Different Bariatric Surgery Procedures: Results from a Population-Based Cohort Study.","authors":"Federico Rea, Emanuele Muraca, Gabriella Morabito, Alice Oltolini, Alessia Bongo, Gianluca Perseghin, Giovanni Corrao, Stefano Ciardullo","doi":"10.1007/s11695-025-07911-8","DOIUrl":"10.1007/s11695-025-07911-8","url":null,"abstract":"<p><strong>Background: </strong>Metabolic and bariatric surgery improves most obesity-related comorbidities. Here, we evaluate the effect of different metabolic and bariatric surgery interventions on the use of medications to treat chronic conditions.</p><p><strong>Materials and methods: </strong>This was an observational population-based cohort study performed in Lombardy, Italy. Healthcare utilization databases were used to identify all residents who underwent a metabolic and bariatric surgery procedure between 2010 and 2020 with available follow-up data for at least three years after surgery. We included patients undergoing laparoscopic sleeve gastrectomy (LSG), gastric bypass (GB), laparoscopic adjustable gastric banding (LAGB), and biliopancreatic diversion (BPD).</p><p><strong>Results: </strong>During the period 2010 to 2020, 19,450 patients (22.5% males, 13.5% with diabetes) underwent a metabolic and bariatric surgery procedure. LSG was the most commonly performed procedure (65%), followed by LAGB (19%), GB (15%), and BPD (1%). There was a significant reduction in the use of glucose-lowering and antihypertensive drugs after the procedure in all groups. Compared to LSG, the reduction in the use of glucose-lowering drugs was greater following GB (reduction at 3 years: 59 vs 65%, p-interaction < 0.001) and lower following LAGB (59 vs 25%, p-interaction < 0.001). There was a significant reduction in lipid-lowering drug use following LSG and GB (3-year reduction: 21 and 50%, p-interaction < 0.001), and in psychiatric drug use following LSG, GB, and LAGB (with no difference between groups). In all groups, proton pump inhibitor use increased during the first 6 months, followed by a decrease from 1 year afterward.</p><p><strong>Conclusion: </strong>The present study including a large number of patients undergoing metabolic and bariatric surgery procedures shows robust reductions in the use of glucose, blood pressure and lipid-lowering drugs at 3 years follow-up, suggesting benefits of surgery on both quality of life and healthcare costs.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2240-2248"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079336","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":"Association Between Bariatric Surgery and Kidney Stone Risk: Addressing Limitations and Future Research Directions.","authors":"Junrou Zhu, Wenhua Yu","doi":"10.1007/s11695-025-07913-6","DOIUrl":"10.1007/s11695-025-07913-6","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2023"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003241","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":"Association Between Preoperative COVID-19 Infection and Postoperative Outcomes in Patients with Obstructive Sleep Apnea Undergoing Metabolic Surgery: A Retrospective Analysis.","authors":"I-Wen Chen, Li-Chen Chang, Jheng-Yan Wu, Yi-Chen Lai, Ying-Jen Chang, Wan-Jung Cheng, Kuo-Chuan Hung","doi":"10.1007/s11695-025-07900-x","DOIUrl":"10.1007/s11695-025-07900-x","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is highly prevalent in patients undergoing metabolic surgery and can complicate recovery. While OSA and COVID-19 share common pathophysiological mechanisms involving systemic inflammation and respiratory dysfunction, their combined impact on surgical outcomes remains poorly understood.</p><p><strong>Methods: </strong>Using TriNetX data from June 2022 to December 2024, we retrospectively analyzed adult patients with OSA undergoing metabolic surgery. Patients were divided into two groups: those with COVID-19 infection within 4 weeks before surgery and controls without infection in the preceding 8 weeks. After propensity score matching, 8,733 pairs were analyzed. The primary outcomes included postoperative pneumonia and respiratory failure within 30 days. The secondary outcomes included acute kidney injury (AKI), intensive care unit (ICU) admission, mortality, surgical site infection (SSI), emergency department (ED) visit, and deep vein thrombosis (DVT).</p><p><strong>Results: </strong>No significant differences were found between the COVID-19 and control groups in postoperative pneumonia (0.28% vs. 0.32%, p = 0.5785) or respiratory failure (0.30% vs. 0.38%, p = 0.3613). Secondary outcomes, including the incidence of AKI, ICU admission, mortality, SSI, ED visit, and DVT, showed no significant differences. Chronic obstructive pulmonary disease (COPD) emerged as the strongest risk factor for both pneumonia (odds ratio 6.06, p = 0.002) and respiratory failure (odds ratio 4.22, p = 0.013).</p><p><strong>Conclusion: </strong>Recent preoperative COVID-19 infection did not significantly impact postoperative outcomes in patients with OSA undergoing metabolic surgery. However, the presence of COPD substantially increases the risk of respiratory complications, suggesting the need for additional preoperative optimization in these patients.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2218-2226"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003244","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":"ChatGPT vs. Standard Medical Resources for Endoscopic Sleeve Gastroplasty Education: Correspondence.","authors":"Hineptch Daungsupawong, Viroj Wiwanitkit","doi":"10.1007/s11695-024-07373-4","DOIUrl":"10.1007/s11695-024-07373-4","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2401"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013144","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":"Laparoscopic Upper Polar Esophagogastrectomy with Gastroplasty Using Gastric Remnant After Roux-en-Y Gastric Bypass for Recurrent Gastroesophageal Junction Adenocarcinoma.","authors":"Pierre Platevoet, Antoine Mariani, Lionel Rebibo, Gilles Manceau, Mehdi Karoui","doi":"10.1007/s11695-025-07901-w","DOIUrl":"10.1007/s11695-025-07901-w","url":null,"abstract":"<p><p>Roux-en-Y gastric bypass is a commonly performed procedure for the treatment of severe obesity. Oncological surgery for patients who have had a prior Roux-en-Y gastric bypass with esophagogastric cancer poses technical challenges, mainly because of the altered anatomy. We present in this video an upper polar esophagogastrectomy with gastroplasty on a gastric remnant and the reversal of Roux-en-Y gastric bypass performed in a 55-year-old woman with an anastomotic recurrence of an adenocarcinoma of the gastroesophageal junction. As far as we know, there is no report about the surgical management of an anastomotic recurrence of an adenocarcinoma of the gastroesophageal junction in a patient with altered anatomy due to RYGB and upper polar gastrectomy.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2395-2398"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013758","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 Results of Linear Versus Circular Stapled Gastrojejunostomy in Gastric Bypass Surgery: A Propensity Score-Adjusted Analysis of Weight Loss and Morbidity.","authors":"Mathias Schmid, Patrick Folie, Rene Warschkow, Thomas Steffen","doi":"10.1007/s11695-025-07875-9","DOIUrl":"10.1007/s11695-025-07875-9","url":null,"abstract":"<p><strong>Background: </strong>Different techniques are used to create a gastrojejunal anastomosis (GJ) in laparoscopic Roux-en-Y gastric bypass (LRYGB). This study compares long-term weight loss and technique-related morbidity between circular (CSA) GJ and linear (LSA) stapled GJ.</p><p><strong>Methods: </strong>The clinical data of LRYGB patients prospectively registered in a database were retrospectively analyzed. The primary endpoints were long-term excess weight loss (EWL) and excess BMI loss (EBL). The risk factors were adjusted via propensity score matching (PSM), and the long-term morbidity rates of the procedures were compared as time-to-event-data using hazard ratios (HR).</p><p><strong>Results: </strong>Two hundred forty-three patients underwent surgery between 2012 and 2014 (CSA n = 109; LSA n = 134). No significant differences in weight development were shown during 6 years postoperatively between CSA and LSA. A mixed effects regression analysis before and after PSM revealed that CSA performed better than LSA after 6 years (potentially biased by low follow-up rates for this period). CSA was associated with higher overall morbidity (LSA 26.1% vs. CSA 38.8%, HR = 1.58, p = 0.048), incisional hernia (LSA 0.7% vs. CSA 6.4%, HR = 10.0, p = 0.006), and GJ stenosis rates (LSA 0% vs. CSA 17.4%, p < 0.001). LSA was associated with marginal ulcers (LSA 8.2% vs. CSA 0.9%, HR = 5.5, p = 0.012).</p><p><strong>Conclusions: </strong>Marginal ulcers have been linked to LSA, while CSA has been associated with higher rates of overall morbidity, stenosis of the GJ, and incisional hernia. No difference terms of weight loss were observed between the CSA and LSA groups during the initial six postoperative years. After 6 years, CSA may offer benefits in terms of sustained weight loss; however, the clinical relevance of these differences appears minimal.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2132-2141"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014852","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 Home Sleep Polygraphy or Laboratory Polysomnography for the Diagnosis of OSA Before Bariatric Surgery.","authors":"Luc Groshaeny, Emmanuel Gomez, Simon Valentin, Pierre Thore, Marine Fauny, Nicolas Carpentier, Claire Nomine-Criqui, Laurent Brunaud, Didier Quilliot, Francois Chabot, Ari Chaouat, Bruno Ribeiro Baptista","doi":"10.1007/s11695-025-07909-2","DOIUrl":"10.1007/s11695-025-07909-2","url":null,"abstract":"<p><strong>Background: </strong>In-laboratory polysomnography (PSG) is considered the gold standard for diagnosing obstructive sleep apnea (OSA). Our study aimed to compare whether home polygraphy (PG) could provide comparable diagnostic accuracy to PSG before bariatric surgery in a real-life cohort and to determine whether home PG is associated with a higher incidence of complications.</p><p><strong>Methods: </strong>In a retrospective study, we compared 400 patients who performed home PG or laboratory PSG between January 2017 and March 2020. All patients included had to be incident cases and had to have undergone bariatric surgery after the sleep test.</p><p><strong>Results: </strong>Among the participants, 215 underwent PSG, while 185 underwent PG. Demographic characteristics such as age, sex, BMI, and Epworth sleepiness score were similar between groups. The apnea-hypopnea index was significantly lower in the PG group (21 ± 20 events/h) compared to the PSG group (29 ± 28 events/h) (p < 0.001). The proportion of patients treated with positive airway pressure was comparable between the two groups. Following bariatric surgery, the duration of hospitalization and the incidence of postoperative complications did not differ significantly between the two groups.</p><p><strong>Conclusion: </strong>Our findings suggest that before bariatric surgery, home PG could identify patients requiring positive airway pressure as equivalent to in-laboratory PSG, without increasing postoperative complications.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2234-2239"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030904","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}