Obesity Surgery最新文献

{"title":"Predictive Factors for Pulmonary Embolism in Patients Undergoing Metabolic and Bariatric Surgery: Insights from the Latest MBSAQIP Data.","authors":"Emiliano G Manueli Laos, Andres Fontaine-Nicola, Lily Zhang, Reed Berger, Khaled Abdelhady, Francisco Schlottmann, Mario A Masrur","doi":"10.1007/s11695-025-08190-z","DOIUrl":"10.1007/s11695-025-08190-z","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity is a major risk factor for many diseases, including cardiovascular disease and cancer, among others. While metabolic and bariatric surgery (MBS) is an effective treatment, pulmonary embolism (PE) remains a concern due to factors like Virchow's triad exacerbated by excess adipose tissue. This study aims to identify perioperative risk factors for PE in patients undergoing MBS to help reduce its incidence.</p><p><strong>Methods: </strong>This study retrospectively analyzed the MBSAQIP PUF database of the year 2023 to identify risk factors for PE within 30 days of sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB).</p><p><strong>Results: </strong>A total of 200865 MBS patients (133,620 SG, 67,245 RYGB) were included in the study; the incidence of 30-day postoperative PE was 0.1% for SG and 0.12% for RYGB. For SG, significant PE risk factors included age, BMI, Black/African American race, history of PE, immunosuppressive therapy, and heart failure. For RYGB, risk factors were age, Black/African American race, history of PE/VTE, dialysis, need for surgical conversion, and mechanical-only VTE prophylaxis.</p><p><strong>Conclusion: </strong>PE is a rare but potentially fatal post-bariatric surgery complication. The most important risk factor was previous history of thromboembolic events in both cohorts. Individualized risk assessment requires further prospective studies.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"4264-4269"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963534","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":"Not Just Skin Deep: A Hidden Complication of Tirzepatide Therapy.","authors":"Liam N Phelan, Sairah Fatima Tariq, Rishi Singhal, Tom Wiggins","doi":"10.1007/s11695-025-08214-8","DOIUrl":"10.1007/s11695-025-08214-8","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"4019-4020"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993140","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":"Predictive Factors for Acute Kidney Injury After Primary Bariatric Surgery in Patients With or Without Preoperative Chronic Kidney Disease and Postoperative Complications: An Analysis of MBSAQIP Database.","authors":"Ali Esparham, Rachel Black, Maryam Khalil, Hengameh Anari Moghadam, Gabriel Bolender, Prany Kathuria, Zhamak Khorgami","doi":"10.1007/s11695-025-08195-8","DOIUrl":"10.1007/s11695-025-08195-8","url":null,"abstract":"<p><strong>Introduction: </strong>Patients who underwent bariatric surgery are at risk of dehydration and postoperative acute kidney injury (AKI). This study aimed to investigate the predictive factors of AKI after sleeve gastrectomy and gastric bypass, considering preoperative chronic kidney disease and postoperative complications as predisposing factors for AKI.</p><p><strong>Methods: </strong>The MBSAQIP database was analyzed to assess patients who had AKI after gastric bypass or sleeve gastrectomy between 2015 and 2020. Patients were categorized based on postoperative AKI. Multivariate logistic regression was used to identify independent predictive factors of AKI in all the patients who underwent laparoscopic primary bariatric surgery. The analysis was repeated in patients without postoperative major complications, with subgroups with or without preoperative chronic kidney disease.</p><p><strong>Results: </strong>Patients were divided into AKI (N = 1376) and non-AKI (N = 1,137,775) groups. The AKI group consists of a significantly older, more male, and black race, compared to the non-AKI group. The factors most predictive of AKI in all the patients consist of readmission within 30 days (OR = 10.10), ICU admission (OR = 7.90), septic shock (OR = 6.72), preoperative chronic kidney disease (OR = 5.95), myocardial infarction (OR = 3.9), cardiac arrest (OR = 3.5), using hypertension medication (OR = 3.3), previous organ transplant (OR = 3.2) and reintubation (OR = 3.08).</p><p><strong>Conclusion: </strong>Various factors have been identified as independent predictors of AKI in patients who have undergone bariatric surgery. Recognizing these risk factors enables surgeons and clinicians to categorize patients more effectively and prioritize attention toward those at high risk, thus aiding in the prevention of AKI and its associated consequences.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"4277-4285"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086659","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 SGLT-2 Inhibitors Use and Incidence of Anemia in Female Patients Undergoing Metabolic and Bariatric Surgery: A Retrospective Study.","authors":"Kuo-Chuan Hung, Li-Chen Chang, Chun-Ning Ho, Chia-Hung Yu, Yi-Chen Lai, I-Wen Chen","doi":"10.1007/s11695-025-08262-0","DOIUrl":"10.1007/s11695-025-08262-0","url":null,"abstract":"<p><strong>Background: </strong>While emerging evidence suggests that sodium-glucose cotransporter 2 (SGLT-2) inhibitors may increase hemoglobin levels through erythropoiesis stimulation and iron metabolism modulation, their relationship with anemia risk in patients undergoing metabolic and bariatric surgery (MBS) remains poorly characterized.</p><p><strong>Methods: </strong>This retrospective cohort study utilized the TriNetX database to identify adult female patients with type 2 diabetes who underwent MBS and subsequently initiated SGLT-2 inhibitors or DPP-4 inhibitors (active comparator). The primary outcome was the risk of anemia (hemoglobin level < 12 g/dL) at one-year follow-up, with additional assessments at six months and three years. Secondary outcomes included the risk of pneumonia and urinary tract infection at the same follow-up intervals.</p><p><strong>Results: </strong>After matching, 389 patients were analyzed per group. SGLT-2 inhibitor use demonstrated significant protective effects against anemia development across all follow-up periods compared to DPP-4 inhibitors: six months (hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.42-0.80, p < 0.001), one year (HR 0.58, 95% CI 0.44-0.75, p < 0.001), and three years (HR 0.64, 95% CI 0.51-0.81, p < 0.001). Secondary outcomes showed no significant differences between the groups, with comparable rates of pneumonia (3.3% vs. 3.9% at one year, p = 0.758) and urinary tract infection (8.0% vs. 7.5% at one year, p = 0.658).</p><p><strong>Conclusions: </strong>SGLT-2 inhibitors were associated with reduced anemia risk in female patients after MBS, with effects observed from six months through three-year follow-up. However, given the relatively small sample size, potential unmeasured confounding factors, and observational study design, prospective randomized controlled trials are required to establish causality before informing clinical practice recommendations.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"4402-4410"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075820","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":"Ring Augmentation and Pouch Resizing for the Treatment of Dumping Syndrome After Roux-en-Y Gastric Bypass: A Prospective Single-Center Trial.","authors":"Jodok Matthias Fink, Mareike Luehn, Maximilian Meyer-Steenbuck, Gabriel Seifert, Sephan Herrmann, Stefan Fichtner-Feigl, Jochen Seufert, Goran Marjanovic, Katharina Laubner","doi":"10.1007/s11695-025-08245-1","DOIUrl":"10.1007/s11695-025-08245-1","url":null,"abstract":"<p><strong>Background: </strong>Early dumping syndrome (DS) and postbariatric surgery hypoglycemia (PBH) are common side effects after Roux-en-Y gastric bypass (RYGB) and may substantially impact patients' quality of life. Established management options provide limited response in many patients. This trial tested the effect of pouch resizing and silicone ring implantation (trial intervention) in patients with dumping symptoms after RYGB.</p><p><strong>Methods: </strong>The trial intervention was assessed in a prospective single-arm trial including 16 patients. The primary endpoint was the change in Sigstad score 12 months after surgery. Secondary endpoints included Arts dumping score, insulin secretion, and glucose uptake assessed by a mixed meal tolerance test (MMTT), weight loss, quality of life, and safety evaluated by gastroscopy and contrast swallow.</p><p><strong>Results: </strong>The trial intervention led to a significant improvement in Sigstad (preOP: 20.4 (95% CI 17.8-23.1); 12 months: 10.4 (6.7-14.1); P = 0.0002) and Arts dumping score (preOP: 20.3 (16.7-23.9); 12 months: 10 (6.5-13.5); P = 0.0001). Glucose uptake and insulin secretion during MMTT remained largely unchanged (AUC glucose: 21,526 (19,654-23,398) mg/dl*min vs. 12 months 22,294 (20,511-24077) mg/dl*min), P = 0.21; AUC insulin: (preOP 62897 (33,531-92,263) pmol/l*min vs. 12 months 68,974 (40,691-97257) pmol/l*min, P = 0.19). Following the trial intervention, mean weight loss was 5.1% (1.4-8.9%). No ring migration or misplacement occurred during follow-up.</p><p><strong>Conclusions: </strong>Pouch resizing and silicone ring implantation led to a clinically relevant improvement in symptoms associated with DS and PBH. This was not related to an apparent impact on glycemic regulation.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"4062-4070"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125356","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":"Comment on \"Surgical Outcomes in Patients with Preoperative GLP-1 Therapy: A Retrospective Analysis\".","authors":"Dalyal Nader Alosaimi","doi":"10.1007/s11695-025-08202-y","DOIUrl":"10.1007/s11695-025-08202-y","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"4547-4548"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963268","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":"Distinguishing Sleeve Gastrectomy with Jejunal Bypass (SG-JB) from Sleeve Gastrectomy with Jejunoileal Bypass (SG-JIB): An Urgent Call for Terminological Clarity.","authors":"Kuo-Feng Hsu, Hsin-Mei Pan","doi":"10.1007/s11695-025-08183-y","DOIUrl":"10.1007/s11695-025-08183-y","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"4040-4043"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963293","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 Prediction Model for Obstructive Sleep Apnea in Bariatric Surgery Candidates with Obesity.","authors":"Xiaoxiao Zhu, Bei Xu, Chengcan Yang, Shuai Ma, Guihua Hao, Fen Gu, Bing Wang, Ying Yao","doi":"10.1007/s11695-025-08093-z","DOIUrl":"10.1007/s11695-025-08093-z","url":null,"abstract":"<p><strong>Background: </strong>Our study aimed to develop a predictive model for the risk of obstructive sleep apnea (OSA) in bariatric surgery candidates for utilization during the preoperative evaluation.</p><p><strong>Methods: </strong>Relevant clinical data were retrospectively collected for 453 patients who met the inclusion criteria and did not meet the exclusion criteria; the patients were randomized into training and test cohorts. Univariate analysis was performed on the training set. Multiple risk factors associated with OSA were identified using multivariate analysis. These factors were incorporated into a regression model and used to construct a nomogram to predict the risk of OSA. The model was validated with a calibration curve and an operating characteristic curve. The models were verified for discrimination, consistency, and accuracy by calibration and subject operating characteristic curves. Finally, decision curve analysis was used to determine the model's utility.</p><p><strong>Results: </strong>In this study, non-alcoholic fatty liver disease (NAFLD), age, chest circumference (CC), and average SpO₂ were found to be independent risk factors for developing OSA in bariatric surgery candidates. The AUC for the training cohort was 0.88 with a sensitivity and specificity of 0.93 (95% CI: 0.84-1.00) and 0.70 (95% CI: 0.64-0.75). The Hosmer-Lemeshow test of the calibration curves for the training and validation sets revealed a P > 0.05 (training cohort: P = 0.955; test cohort: P = 0.440).</p><p><strong>Conclusions: </strong>We constructed a prediction model that included NAFLD, age, CC, and mean SpO₂, which showed superior predictive performance compared to existing models. This model offers a convenient, cost-effective alternative to PSG, particularly useful in preoperative screening of bariatric surgery patients. In the future, the relationship between NAFLD and OSA needs to be further explored, and the prediction model needs to be externally validated. Key Points 1. OSA increases the risk of postoperative complications in bariatric surgery patients, but there is a lack of tools to effectively predict the risk of OSA in bariatric surgery. 2. NAFLD, age, CC, and average SpO2 were found to be independent risk factors for developing OSA in bariatric surgery candidates. 3. A nomogram was constructed to predict the risk of incidence of OSA in patients undergoing bariatric surgery, offering a practical alternative to PSG.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"4205-4215"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023871","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":"Effects of Endoscopic Sleeve Gastroplasty on Body Composition and Metabolism: An InBody Analysis.","authors":"Ali Lahooti, Zane Gouda, Sean Rangwani, Kate E Johnson, Qusai Al Zureikat, Chino Aneke-Nash, Adeyinka Adejumo, Muhammad Usman Baig, Dominque Gay, Adam Buckholz, Robert E Schwartz, Carolyn Newberry, Kartik Sampath, David Carr-Locke, SriHari Mahadev, Sonal Kumar, Reem Z Sharaiha","doi":"10.1007/s11695-025-08194-9","DOIUrl":"10.1007/s11695-025-08194-9","url":null,"abstract":"<p><strong>Introduction and aim: </strong>Despite ESG's efficacy in promoting weight loss, data on its impact on body composition is limited. This study evaluated ESG's effectiveness in improving body composition and metabolic parameters over 6 and 12 months using InBody analysis.</p><p><strong>Methods: </strong>We prospectively analyzed patients with obesity (BMI > 30 kg/m² or > 27 with comorbidities) who underwent ESG between August 2021 and May 2024. Body composition was assessed via bioelectrical impedance analysis (InBody 770™).</p><p><strong>Results: </strong>Thirty-six patients (81% female, mean age 47.9 ± 13.4 years, BMI 35.3 ± 5.6 kg/m²) completed baseline assessment. Follow-up rates were 67% at 6 months and 61% at 12 months. ESG produced significant reductions in BMI (4.6 and 4.8 kg/m²) and total body weight loss (13.4% and 13.5%) at both timepoints (p < 0.001). Body fat percentage decreased by 4.7% at 6 months, with truncal fat loss of 4.0 kg comprising 32% of total weight loss. These improvements persisted at 12 months (p < 0.01). While skeletal muscle mass also declined, muscle loss represented only 13-17% of total weight loss.</p><p><strong>Discussion: </strong>ESG achieves substantial weight loss with preferential fat reduction and favorable preservation of lean body mass over 12 months, supporting its role in improving metabolic health.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"4071-4078"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023913","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":"Exploratory Assessment of Preoperative GLP-1 Receptor Agonists Before Sleeve Gastrectomy: A Retrospective Matched Analysis.","authors":"Guillaume Luc, Arnaud Dedieu, Guillaume Canard, Amélie Cesard, Amandine Brunet, Camille Furois, Angèle Leterrier, Barbara Daridon, Lea Mendes, Emilie Brighen, Lucie Fournet, Anaelle David, Ludivine Muzard","doi":"10.1007/s11695-025-08258-w","DOIUrl":"10.1007/s11695-025-08258-w","url":null,"abstract":"<p><strong>Background: </strong>Preoperative treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) before bariatric surgery has not been studied. Therefore, we investigated the impact of neoadjuvant treatment with GLP-1 RAs on weight loss and postoperative outcomes in patients who underwent sleeve gastrectomy for severe obesity.</p><p><strong>Method: </strong>A retrospective single-center study was conducted between January 2022 and December 2023. Patients with morbid obesity who were treated preoperatively with a GLP-1 RA (GLP-1 group) were matched with patients who were not preoperatively treated with a GLP-1 RA (No GLP-1 group) using propensity scores calculated according to age and body mass index (BMI). Between-group differences in demographics, comorbidities, surgical parameters, complications, weight loss, and comorbidity outcomes were analyzed.</p><p><strong>Results: </strong>Fourteen patients were included in the GLP-1 group and matched with 28 controls (1:2 ratio). Preoperative weight loss was significantly greater in the GLP-1 group (7.8 ± 6.8 kg) than in the control group (0.2 ± 4.5 kg), with a mean difference of + 7.54 kg (95% CI: [3.47;11.6], p = 0.001, Cohen's d = 1.41). Mixed-effects ANOVA revealed a significant effect of time, with progressive BMI reduction in both groups (p = 0.019), no main effect of group (p = 0.080), and no group-time interaction (p = 0.972), indicating similar BMI trajectories throughout the perioperative period and no between-group difference at 12 months. Postoperative vomiting occurred in 21.4% of patients in the GLP-1 group versus 0% in the No GLP-1 group (p = 0.031). No significant differences in surgical parameters or the comorbidity resolution rate at one year were found.</p><p><strong>Conclusion: </strong>Neoadjuvant GLP-1 RA treatment increased preoperative weight loss before sleeve gastrectomy, but the benefit was not sustained postoperatively. Preoperative GLP-1 RA use could be considered to optimize surgical preparation, but further data regarding postoperative outcomes and long-term weight benefits are needed.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"4383-4392"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033871","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}