Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery最新文献

{"title":"Postoperative outcomes following revision or conversion surgery after primary sleeve gastrectomy: an analysis of the MBSAQIP database.","authors":"Karanbir Brar, Ranjan Sudan, Dana Portenier, Jacob A Greenberg, Shaina R Eckhouse, Keri A Seymour, James J Jung","doi":"10.1016/j.soard.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.soard.2025.04.003","url":null,"abstract":"<p><strong>Background: </strong>A significant proportion of patients that undergo primary sleeve gastrectomy (SG) require revision or conversion metabolic and bariatric surgery (MBS). Despite various procedures performed in practice, comparative analyses of short-term outcomes remain limited.</p><p><strong>Objectives: </strong>We conducted a retrospective comparative analysis of postoperative outcomes of revision or conversion MBS following primary SG.</p><p><strong>Setting: </strong>The 2020-2022 MBSAQIP database.</p><p><strong>Methods: </strong>We included patients who underwent any one of the following: revision SG (Re-SG), Roux-en-Y gastric bypass (SG-RYGB), biliopancreatic diversion/duodenal switch (SG-BPD/DS), single anastomosis duodenoileal bypass (SG-SADI), or one anastomosis gastric bypass (SG-OAGB). Our primary outcome was 30-day major complications, defined as Clavien-Dindo Grade≥ II.</p><p><strong>Results: </strong>Among 33,348 revision/conversion MBS, SG-RYGB was the most common (n = 27,393, 82.1%). Compared to SG-RYGB, the odds of 30-day major complications were lower in Re-SG (odds ratio [OR] .75, 95%- confidence interval [CI] .61-.90) and SG-SADI (OR .75, 95%-CI .57 - .97). However, both Re-SG and SG-SADI were associated with higher odds of anastomotic or staple line leak (OR 2.74; 95%-CI 1.78-4.12 and OR 2.44; 95%-CI 1.35-4.17, respectively). In addition, both Re-SG (mean difference 1.66 days, 95%-CI .44 - 2.88) and SG-SADI (MD 3.0 days, 95%-CI 1.31- 4.70) resulted in longer hospital stays upon readmission.</p><p><strong>Conclusions: </strong>In our analysis, Re-SG and SG-SADI had lower odds of 30-day major complications compared to SG-RYGB, but had significantly higher odds of anastomotic or staple line leak and had longer hospital stays on readmission. Given its limited indications and significant potential morbidity, Re-SG should not be routinely offered as a revisional procedure for primary SG.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucagon-like peptide-1 receptor agonists in conjunction with bariatric surgery: an alert regarding the less commonly perceived nonarteritic anterior ischemic optic neuropathy (NAION).","authors":"Maria S Varughese, Sushuma Kalidindi","doi":"10.1016/j.soard.2025.03.013","DOIUrl":"https://doi.org/10.1016/j.soard.2025.03.013","url":null,"abstract":"","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"The impact of bariatric surgery on maternal and neonatal health: a systematic review and meta-analysis\".","authors":"Venkata Dileep Kumar Veldi, Rachana Mehta, Ranjana Sah","doi":"10.1016/j.soard.2025.03.012","DOIUrl":"https://doi.org/10.1016/j.soard.2025.03.012","url":null,"abstract":"","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing transparency and accuracy in metabolic disease severity evaluation with assessment of obesity-related metabolic conditions.","authors":"Zheke Yu","doi":"10.1016/j.soard.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.soard.2025.04.005","url":null,"abstract":"","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleeve gastrectomy versus GLP-1 agonist to improve kidney transplant access in end-stage renal disease patients with obesity: a decision analysis.","authors":"Marissa Di Napoli, Armaun D Rouhi, Kristoffel R Dumon, Rose Castle, Noel N Williams, Maria Baimas-George, Peter T Kennealey, Trevor L Nydam, Rashikh A Choudhury","doi":"10.1016/j.soard.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.soard.2025.04.001","url":null,"abstract":"<p><strong>Background: </strong>Obesity can be a barrier to accessing kidney transplantation as there is significant variability in body mass index (BMI) criteria among transplant centers. Effective weight loss strategies are crucial for improving access to kidney transplantation in the end-stage renal disease (ESRD) population with obesity.</p><p><strong>Objectives: </strong>To estimate access to kidney transplantation following diet and exercise, sleeve gastrectomy (SG), and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in this population.</p><p><strong>Setting: </strong>University hospital, United States.</p><p><strong>Methods: </strong>A decision-analytic Markov state transition model was created to simulate the outcomes of ESRD patients with obesity who were ineligible for kidney transplantation unless they achieved a BMI <35 kg/m². Base case patients were defined as a 45-year-old patient with a preintervention BMI of 45 kg/m². Model inputs were obtained from literature review.</p><p><strong>Results: </strong>SG resulted in 14% of patients receiving kidney transplantation at 10 years, compared to 2.5% of patients in the GLP-1 RA group, and <1% of patients with diet and exercise. Upon sensitivity analysis, SG demonstrated a survival advantage over both diet and exercise and GLP-1 RAs above a BMI of 34.4 kg/m² and 37.5 kg/m², respectively, assuming 100% compliance with diet and exercise or medication.</p><p><strong>Conclusions: </strong>SG improves access to kidney transplantation compared to diet and exercise and GLP-1 RAs. As new obesity medications continue to be developed and increase in popularity, the risks and benefits of these therapies should be compared to currently available weight loss therapies in an effort to optimize obesity management in this population.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: evaluation of patients on immunosuppressants undergoing sleeve gastrectomy, Roux-en-Y gastric bypass, and duodenal switch: analysis of 19,414 patients.","authors":"Gabriela Restrepo-Rodas, Luis Muñoz, Alfredo D Guerron","doi":"10.1016/j.soard.2025.03.010","DOIUrl":"https://doi.org/10.1016/j.soard.2025.03.010","url":null,"abstract":"","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in diagnosing gestational diabetes after Roux-en-Y gastric bypass: a comparative analysis of OGTT, SMBG, and CGM.","authors":"Chiara Ferrario, Sara Santini, Nathalie Vionnet, Jerôme Pasquier, Jardena J Puder, Styliani Mantziari, Lucie Favre","doi":"10.1016/j.soard.2025.03.008","DOIUrl":"https://doi.org/10.1016/j.soard.2025.03.008","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) is a common complication of pregnancy, and the oral glucose tolerance test (OGTT) is the standard diagnostic tool. However, in women after Roux-en-Y gastric bypass (RYGB), OGTT is less reliable and potentially unsafe due to the risk of hypoglycemia.</p><p><strong>Objectives: </strong>This study compares 3 methods of GDM diagnosis-OGTT, self-monitoring of blood glucose (SMBG), and continuous glucose monitoring (CGM)-in post-RYGB pregnant women to assess and compare their diagnostic performance.</p><p><strong>Setting: </strong>University Hospital, Switzerland.</p><p><strong>Methods: </strong>A cohort of 15 pregnant women with a history of RYGB was evaluated between 24 and 28 weeks of gestation. Each participant underwent OGTT, SMBG, and CGM. We assessed the sensitivity, specificity, and concordance of OGTT and SMBG against CGM, which served as the reference test. The incidence of hypoglycemia during OGTT was examined.</p><p><strong>Results: </strong>Using OGTT, 7 of the 15 participants were diagnosed with GDM, and 8 participants experienced hypoglycemia (glucose levels below 3.0 mmol/L). SMBG diagnosed GDM in 7 participants and CGM identified GDM in 11 participants. There was no significant concordance among OGTT, SMBG, and CGM (φ .26 (-.26 to .67) between OGTT and CGM (P = .57); φ -.07 (-.58 to .44) between OGTT and SMBG (P = 1), φ .26 (-.21 to .67), and between CGM and SMBG (P = .57). OGTT and SMBG demonstrated similar sensitivity and specificity, when compared to CGM (sensitivity of 54.40% and specificity of 75%) even though the patients diagnosed differed between the methods.</p><p><strong>Conclusions: </strong>In this exploratory study, CGM appears to be a possible approach for diagnosing GDM in post-RYGB patients. SMBG is a commonly available method. OGTT poses risks of severe hypoglycemia. These findings support the need for tailored GDM screening approaches in postbariatric surgery pregnancies and highlight the importance of further research to establish specific guidelines for this population.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-anastomosis duodenal-ileal bypass with sleeve gastrectomy for diabetes: predictors of remission and metabolic outcomes in a multicenter study.","authors":"Jack W Sample, Daniel Cottam, Romulo Lind, Amit Surve, Muhammad Ghanem, Walter S Medlin, Simon Laplante, Karl Hage, Calista Kee, Legrand Belnap, Brian Mooers, Tatum Cottam, Andre F Teixeira, Omar M Ghanem","doi":"10.1016/j.soard.2025.03.007","DOIUrl":"https://doi.org/10.1016/j.soard.2025.03.007","url":null,"abstract":"<p><strong>Background: </strong>The single-anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) combines the restrictive aspects of a sleeve gastrectomy (SG) with the hypoabsorptive advantages of a gastric bypass. SADI-S has demonstrated excellent weight loss outcomes and technical feasibility.</p><p><strong>Objectives: </strong>To evaluate the benefits of SADI-S in patients with obesity and type 2 diabetes mellitus.</p><p><strong>Setting: </strong>Academic and private practice hospitals, United States.</p><p><strong>Methods: </strong>Following the institutional review board (IRB) approval, a multicenter retrospective review was conducted to evaluate adult patients with obesity and type 2 diabetes who underwent SADI-S between January 1, 2013, and April 1, 2023. Type 2 diabetes remission was defined as a hemoglobin A1C (HbA1C) value of <6.5% in the absence of any antidiabetic medication use. Patient demographics and bariatric and metabolic-related parameters were collected.</p><p><strong>Results: </strong>A total of 419 consecutive patients were identified with a median age of 50.0 years (interquartile range [IQR] 17) and a mean body mass index (BMI) of 47.1 ± 8.9 kg/m². The mean percentage of total weight loss (%TWL) was 31.9% with a type 2 diabetes remission rate of 60.1% and a mean follow-up period of 2.0 years. Two hundred twenty-six patients were included in the final analysis. Preoperative insulin use and higher BMI were negative predictors of type 2 diabetes remission, whereas greater %TWL was associated with a higher likelihood of type 2 diabetes remission at the last follow-up. On average, patients maintained reduced HbA1C values.</p><p><strong>Conclusions: </strong>SADI-S is an effective and durable metabolic and bariatric surgery (MBS) for patients with obesity and type 2 diabetes. Patients with higher preoperative BMI and insulin use are less likely to experience type 2 diabetes remission after surgery.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of bariatric surgery on maternal and neonatal health: a systematic review and meta-analysis.","authors":"Alexander Arbis, Abdul Rafay, Christopher Namgoong, Jeong Hyun Yoon, Hutan Ashrafian, Matyas Fehervari, Samer Humadi","doi":"10.1016/j.soard.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.soard.2025.03.005","url":null,"abstract":"<p><strong>Background: </strong>Maternal obesity increases the risk of neonatal and maternal complications. Although the weight-loss benefits of bariatric surgery are well established, the effects on subsequent pregnancies, particularly regarding timing of pregnancy after surgery, are not yet fully understood OBJECTIVES: To evaluate the impact of bariatric surgery on weight-related, maternal, and neonatal outcomes in subsequent pregnancies, focusing on the timing of pregnancy after surgery.</p><p><strong>Setting: </strong>A systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO ID: CRD42024570170).</p><p><strong>Methods: </strong>The systematic review process identified 129 studies eligible for inclusion involving 227,792 women who became pregnant after bariatric surgery. Data were analyzed for body mass index (BMI) changes, gestational age, and neonatal birth weight.</p><p><strong>Results: </strong>Prepregnancy BMI reduced by 13.93 kg/m² (P < .001) compared with presurgery BMI. There was no significant change in BMI throughout the antenatal period against non-bariatric surgery controls. Neonatal birth weight was 257.8 g lower (P < .001) in patients who had previously undergone bariatric surgery. There was no significant difference in neonatal birth weight (-69.41 g, P = .152) or gestational age (-.749 d, P = .826) in patients who became pregnant fewer than 18 months after surgery and those who became pregnant greater than 18 months after surgery.</p><p><strong>Conclusions: </strong>Bariatric surgery successfully reduced maternal BMI before pregnancy but lowered neonatal birth weight, indicating the need for careful fetal monitoring. The timing of pregnancy after surgery appears flexible, with no significant impact on gestational age or birth weight, suggesting that clinical management should focus on individualized nutritional and health monitoring rather than fixed guidelines.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of insurance status with postoperative resource utilization after metabolic/bariatric surgery-A multi-institutional study.","authors":"Florina Corpodean, Michael Kachmar, Jake Doiron, Denise Danos, Michael W Cook, Philip R Schauer, Vance L Albaugh","doi":"10.1016/j.soard.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.soard.2025.03.003","url":null,"abstract":"<p><strong>Background: </strong>Postoperative emergency department (ED) use and readmissions are key quality outcome measures for Metabolic & Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) centers. Given increasing costs, limiting postoperative resource use is of paramount importance.</p><p><strong>Objectives: </strong>This study aimed to investigate disparities in postoperative resource use after metabolic and bariatric surgery (MBS) across primary payor status.</p><p><strong>Settings: </strong>Two MBSAQIP-accredited centers.</p><p><strong>Methods: </strong>Using data from our institutional MBSAQIP dataset (2020-2023), MBS cases were identified and categorized on the basis of primary payor type. Analysis of 30-day readmissions, reinterventions, and reoperations was performed on the basis of case characteristics and stratified by payor status to examine intergroup differences.</p><p><strong>Results: </strong>Medicaid beneficiaries were overall younger (40.4 years versus 46.5 years; P < .05) than patients with private insurance (PI) and more likely to be female. Body mass index was significantly greater for Medicaid compared with PI or Medicare (49.8 versus 47.8 versus 48.2; P < .05). Medicaid recipients had significantly greater rates of ED use (P < .0001) compared with PI and self-pay and longer operative times compared with PI and Self-Pay (144.8 min versus 126.7 versus 108.1 min; P < .05). Patients with Medicaid status also had a longer length of stay than patients with PI (1.68 days versus 1.48 days, P < .05). Despite these differences, Medicaid status was not associated with increased composite complications, composite infection, length of stay >5 days, or readmission.</p><p><strong>Conclusions: </strong>Postoperative ED use and readmission/reoperation rates were notably higher in publicly insured (Medicare or Medicaid) patients compared with those with PI or self-pay. This highlights the importance of implementing targeted quality improvement measures to improve access to care in this population.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}