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

{"title":"Longitudinal changes in positive airway pressure device use after metabolic surgery: a 3-year matched cohort study of National Claims Data.","authors":"Michael Kachmar, Elizabeth Wall-Wieler, Yuki Liu, Feibi Zheng, Prachi Singh, Vance L Albaugh","doi":"10.1016/j.soard.2025.01.009","DOIUrl":"https://doi.org/10.1016/j.soard.2025.01.009","url":null,"abstract":"<p><strong>Background: </strong>Metabolic surgery (MS) is the most durable treatment of obesity and can treat obstructive sleep apnea (OSA).</p><p><strong>Objectives: </strong>To compare trajectories of positive airway pressure (PAP) device use between individuals who had MS and similar individuals who did not have MS (non-MS).</p><p><strong>Setting: </strong>Merative MarketScan Research Databases - a US-based commercial claims database.</p><p><strong>Methods: </strong>Those who underwent MS were matched 1:1 with nonoperative controls on baseline demographic and health characteristics. PAP use trajectories were examined in the 3years after the index dates and stratified by baseline PAP use.</p><p><strong>Results: </strong>A total of 8772 adults who had MS were matched with 8772 adults who did not have MS; in both groups, 17.3% had baseline PAP claims. Among individuals who had baseline PAP claims, those who had MS had significantly higher rates of PAP use cessation (58.9% versus 27.1%; P value < .01). Among individuals who were not using a PAP at baseline, PAP initiation was higher among those who did not have MS than those who had MS (10.8% versus 2.6%; P value < .01).</p><p><strong>Conclusions: </strong>MS was associated with discontinuation of PAP use and decreased initiation of PAP use among individuals who were not using these devices, suggesting that MS leads to symptomatic and preventive treatment for OSA.</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":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598678","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":"Evaluation of patients on immunosuppressants undergoing sleeve gastrectomy, Roux-en-Y gastric bypass, and duodenal switch: analysis of 19,414 patients.","authors":"Emily A Grimsley, Melissa A Kendall, Tyler Zander, Paul C Kuo, Salvatore Docimo","doi":"10.1016/j.soard.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.soard.2025.02.001","url":null,"abstract":"<p><strong>Background: </strong>Bariatric surgery is being offered to more medically complex patients, including patients on immunosuppressants, although outcomes after different bariatrics surgeries have not been studied in this population.</p><p><strong>Objectives: </strong>We compared perioperative safety of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and duodenal switch (DS) in patients on immunosuppression.</p><p><strong>Setting: </strong>National sample from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database.</p><p><strong>Methods: </strong>The MBSAQIP database was queried from the years 2015 to 2021 for adult patients on chronic immunosuppression who underwent SG, RYGB, or DS. Revisional, open, endoscopic, or emergency surgeries were excluded, as were patients with an American Society of Anesthesiologists class of 5 and patients without full 30-day follow-up. Propensity-score matching was performed with a 3:3:1 ratio (SG:RYGB:DS) controlling for surgical approach, sex, age, functional status, American Society of Anesthesiologists, body mass index, and comorbidities.</p><p><strong>Results: </strong>There were 19,414 patients on immunosuppression who underwent SG (n = 14,358), RYGB (n = 4864), or DS (n = 192). After propensity-score matching , RYGB and DS had longer LOS (P < .01), greater global 30-day complication (P < .01), and 30-day reoperation rates (P = .048). Compared with SG and RYGB, DS had greater rates of patients requiring mechanical ventilation >48-hour postoperatively (P < .05). Compared with SG, DS had greater rates of renal insufficiency (P = .01), organ space infection (P = .01), unplanned intubation (P < .01), and unplanned intensive care unit admission (P < .01).</p><p><strong>Conclusions: </strong>For patients on immunosuppression, SG carried the lowest complication and reoperation rates, whereas DS had overall complication rates in line with RYGB.</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":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538289","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: Rare gene variants and weight loss at 10 years after sleeve gastrectomy and gastric bypass-A randomized clinical trial.","authors":"Sarah Samreen","doi":"10.1016/j.soard.2025.01.014","DOIUrl":"https://doi.org/10.1016/j.soard.2025.01.014","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":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525676","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":"Impact of high-protein bariatric diet on the prevention of postoperative nausea and vomiting.","authors":"Brigitte Anderson, Amrita Iyer, Martina Rama, Abigail M O'Connell, Anna P Torres, Scott H Koeneman, Renee Tholey, Alec Beekley, Francesco Palazzo, Talar Tatarian","doi":"10.1016/j.soard.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.soard.2025.02.002","url":null,"abstract":"<p><strong>Background: </strong>Postoperative nausea and vomiting (PONV) commonly occurs following metabolic/bariatric surgery, contributing to increased health care utilization and length of stay (LOS). Studies have suggested the benefit of protein-predominant meals in suppressing gastric tachyarrhythmia and PONV.</p><p><strong>Objective: </strong>To investigate the impact of a high-protein postoperative liquid diet on PONV and LOS after primary sleeve gastrectomy (SG).</p><p><strong>Setting: </strong>University Hospital, United States.</p><p><strong>Methods: </strong>This prospective randomized trial included adult patients undergoing primary SG. Exclusion criteria were history of bariatric/foregut surgery, chronic nausea/vomiting, HbA1C ≥9, or therapeutic anticoagulation. Patients were randomized 1:1 to receive a clear liquid (control) or high-protein full-liquid diet (intervention) starting 4 hours postoperatively. The primary endpoint was incidence of PONV. Secondary endpoint was increased LOS due to PONV. Pearson's chi squared test for independence compared outcomes between groups on an intention to treat basis.</p><p><strong>Results: </strong>One-hundred and twelve patients were randomized (56 control, 56 intervention). Most patients were female (80.4%). All underwent laparoscopic (72.3%) or robotic (27.7%) SG and 90.2% received inhalational anesthesia. In the intervention arm, 15 patients had zero protein intake due to PONV, 6 had missing data, and 35 had a mean intake of 24.2 grams. There was no observed treatment effect on PONV (78.6% control versus 89.3% intervention; P = .20). Almost 70% of patients were discharged home on postoperative day (POD) 1. Delay in discharge due to PONV was not significant between groups (32.1% control versus 28.6% intervention; P = .84).</p><p><strong>Conclusions: </strong>Early introduction of liquid protein after SG does not improve PONV or LOS.</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":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639953","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":"Response to Milder et al. \"Letter to the editor regarding multisociety clinical practice guidance- safe use of glucagon-like peptide-1 receptor agonists in perioperative period\".","authors":"Tammy L Kindel, Girish P Joshi, Teresa LaMasters","doi":"10.1016/j.soard.2025.01.012","DOIUrl":"https://doi.org/10.1016/j.soard.2025.01.012","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":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143589137","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":"Payor status differences in 30-day and 1-year outcomes after primary laparoscopic bariatric surgery.","authors":"Arielle Grieco, Clifford Y Ko, Stacy A Brethauer, Anthony T Petrick","doi":"10.1016/j.soard.2025.01.015","DOIUrl":"https://doi.org/10.1016/j.soard.2025.01.015","url":null,"abstract":"<p><strong>Background: </strong>There was a call for research regarding safety and efficacy of bariatric surgery in Medicare beneficiaries. Payor status may be an indicator of both health and socioeconomic status.</p><p><strong>Objectives: </strong>The American College of Surgeons Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) sought to explore the association of insurance type in U.S. patients receiving primary bariatric surgery on both postoperative risks and benefits.</p><p><strong>Setting: </strong>Not-for-profit organization, clinical data registry.</p><p><strong>Methods: </strong>MBSAQIP data from primary laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) cases performed in 2021 along with follow-up records through 18 months postoperatively were included (N = 156,046). All analyses were stratified by age (<65 years, n = 149,949; ≥65 years, n = 6097). Hierarchical logistic regression models for 30-day adverse events, and longitudinal models for percent total weight loss and cox regression models for mortality and comorbidity remission rates through 1 year were performed.</p><p><strong>Results: </strong>Among those <65 years, Medicare patients showed greatest risk for 30-day postoperative complications followed by Medicaid, private insurance, and self-pay patients aligning with preoperative risk profiles. Private insurance holders <65 years lose 1.5% more of their total preoperative weight and show greater rates of comorbidity remission at 12 months than Medicare patients. Across all payor groups <65 years, scenario-based survival probabilities through 1-year are ∼99%, 25% total weight loss or greater is realized, and 33% to over 75% of those with respective comorbidities experience remission. No meaningful payor status differences were noted among those ≥65 years.</p><p><strong>Conclusions: </strong>Payor status may be an indicator of both health and socioeconomic status, where traditional risk adjustment is inappropriate. Results reinforce these complex relationships, but also prove immense benefits of bariatric surgery regardless of payor type.</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":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143589134","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: Risk assessment for esophageal cancer after bariatric surgery: a comparative cohort study between sleeve gastrectomy and gastric bypass.","authors":"Enrico Facchiano, Emanuele Soricelli","doi":"10.1016/j.soard.2025.01.013","DOIUrl":"https://doi.org/10.1016/j.soard.2025.01.013","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":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538287","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 relationship between physical activity, sedentary time, and cognitive function following bariatric surgery.","authors":"Urja Bhatia, Dale Bond, Jeffrey A Ciesla, John Gunstad, Ian Carroll, Ross Crosby, James E Mitchell, Christine M Peat, Kristine Steffen, Leslie Heinberg","doi":"10.1016/j.soard.2025.01.010","DOIUrl":"https://doi.org/10.1016/j.soard.2025.01.010","url":null,"abstract":"<p><strong>Background: </strong>Obesity is associated with cognitive impairment. Metabolic and bariatric surgery (MBS) improves cognitive functioning and weight loss is not a primary mechanism. Physical activity (PA) and sedentary time (ST) may play an important role in cognitive outcomes following MBS, though few studies have examined this possibility.</p><p><strong>Objectives: </strong>Prospectively examine the relationship among PA, ST, and cognitive function following MBS, as well as possible sex differences in these associations.</p><p><strong>Setting: </strong>Data were collected at 2 health centers in the United States.</p><p><strong>Methods: </strong>MBS patients (n = 138, 42.9 ± 10.5 years of age, body mass index of 46.3 ± 7.3 kg/m²) completed the National Institute of Health Toolbox, a computerized neuropsychological battery, and wore an accelerometer for 7 days at preoperative baseline and 1, 6, and 12-month postoperative follow-up to measure ST, light-intensity PA (LPA), and moderate-to-vigorous intensity PA (MVPA).</p><p><strong>Results: </strong>Total attrition rate was 33.3%. Multilevel modeling showed that ST was negatively associated with List Sorting Working Memory (β_0j=-.02,t(379.77)=-3.89,p<.001,95%CI=[-.03,-.01],d=0.26) and Picture Sequence Memory (β_0j=-.02,t(337.93)=-.02,p=.009,95%CI=[-.03,-.004],d=0.47), and positively associated with Flanker Inhibitory Control and Attention (β_0j=.02,t(378.56)=2.89,p=.004,95%CI=[.005,.025],d=0.22). MVPA was positively associated with Card Sort (β_0j=.10,t(139.02)=2.79,p=.006,95%CI=[.03,.17],d=0.58). No significant relationships were found between LPA and cognitive function, and no sex differences were found in any associations.</p><p><strong>Conclusions: </strong>The current study links ST and MVPA to cognitive function, though ST was both positively and negatively associated with test performance. Such findings suggest a role for movement and activity levels in cognitive outcomes following MBS, though further investigation is needed to clarify possible mechanisms.</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":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143589139","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":"Letter to Editor regarding comments by Dr. Axer et al. for manuscript weight loss specific to indication, remission of diabetes, and short-term complications after sleeve gastrectomy conversion to Roux-en-Y gastric bypass: a systematic review and meta-analysis.","authors":"Matyas Fehervari, Bibek Das, Hutan Ashrafian","doi":"10.1016/j.soard.2025.01.011","DOIUrl":"https://doi.org/10.1016/j.soard.2025.01.011","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":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639954","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: Variation in opioid-free discharge after metabolic surgery from 2018 to 2023: a state-wide analysis from the Michigan Bariatric Surgery Collaborative.","authors":"Michael Kachmar, Vance L Albaugh","doi":"10.1016/j.soard.2025.02.003","DOIUrl":"https://doi.org/10.1016/j.soard.2025.02.003","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":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477324","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}