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

{"title":"Prevalence of gastric intestinal metaplasia and other endoscopic findings and their influence on surgical management for patients seeking bariatric surgery.","authors":"Félix Thibeault, Aghiles Abbad, Alexis Deffain, Pierre Garneau, Ronald Denis, Anne-Sophie Studer, Adam Di Palma, Radu Pescarus","doi":"10.1016/j.soard.2025.05.011","DOIUrl":"10.1016/j.soard.2025.05.011","url":null,"abstract":"<p><strong>Background: </strong>Routine preoperative esophagogastroduodenoscopy (EGD) for patients undergoing bariatric surgery remains controversial. However, anatomopathologic findings during endoscopy can influence the choice of bariatric procedure. Gastric intestinal metaplasia (GIM) is increasingly recognized as a potential risk factor for gastric adenocarcinoma, with a prevalence of 2.7% in patients seeking bariatric surgery.</p><p><strong>Objective: </strong>To establish the prevalence of GIM among patients undergoing bariatric surgery in our population and determine the impact of routine EGD on surgical management.</p><p><strong>Setting: </strong>Canadian academic hospital.</p><p><strong>Methods: </strong>We retrospectively reviewed the charts of 314 consecutive patients who underwent routine EGD with antral/corpus biopsies by a single endoscopist at our institution between March 2021 and November 2022. Data were collected on patient demographic characteristics and EGD and pathology reports.</p><p><strong>Results: </strong>The population consisted of 234 (74.5%) female patients and 80 (25.5%) male patients with average age of 43.6 years and body mass index of 46.5 kg/m². GIM was present in 8.6% of endoscopies, high-risk GIM in 2.9%, and Helicobacter pylori in 16.6%. Esophagitis and Barrett esophagus (BE) were present in 19.4% and 1.6% of patients, respectively. Regression analysis independently associated previous H pylori infection, antral erosive gastritis, BE, and mucosal atrophy with GIM. Preoperative EGD altered surgical management for 14.3% of patients. Reasons for alteration included hiatal anatomy (9.6%), GIM (2.2%), BE (.6%), gastric and esophageal varices (.6%), achalasia (.3%), and gastric adenocarcinoma (.3%).</p><p><strong>Conclusion: </strong>We demonstrated greater GIM and high-risk GIM prevalence than previously published in the literature. GIM is the second most frequent finding altering surgical decision making in our bariatric population.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":"1042-1047"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287695","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":"Paired Editorial: Efficacy of combined sleeve gastrectomy and Nissen fundoplication for weight loss and prevention of postoperative gastroesophageal reflux disease in patients with obesity: a systematic review and meta-analysis.","authors":"Ruth Lopez-Gonzalez, Alyssa Ritchie, Ricard Corcelles","doi":"10.1016/j.soard.2025.05.009","DOIUrl":"10.1016/j.soard.2025.05.009","url":null,"abstract":"","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":"e23-e24"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201230","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":"A call to action: Paired editorial for \"Payor status differences in 30-day and 1-year outcomes after primary laparoscopic bariatric surgery\".","authors":"Matthew Brengman","doi":"10.1016/j.soard.2025.05.010","DOIUrl":"10.1016/j.soard.2025.05.010","url":null,"abstract":"","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":"e21-e22"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218001","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":"Outcomes of reversal of malabsorptive and maldigestive bariatric procedures: a single center experience and a systematic review.","authors":"Pauline Aeschbacher, Angelica Garcia, Joel Frieder, Brett Weiss, Mauricio Sarmiento Cobos, Zoe Garoufalia, Samuel Szomstein, Ana Pena, Emanuele Lo Menzo, Raul J Rosenthal","doi":"10.1016/j.soard.2025.04.470","DOIUrl":"10.1016/j.soard.2025.04.470","url":null,"abstract":"<p><strong>Background: </strong>A small proportion of patients undergoing malabsorptive or maldigestive bariatric interventions experience excessive weight loss and/or side effects. Some patients with recurrent comorbidities or severe metabolic derangements require a reversal to normal anatomy or physiology.</p><p><strong>Objectives: </strong>To analyze indications, surgical techniques, and outcomes of reversal after malabsorptive or maldigestive surgery.</p><p><strong>Setting: </strong>Academic institution, United States.</p><p><strong>Methods: </strong>Single-center retrospective analysis and systematic literature review of reversal after malabsorptive and maldigestive bariatric surgery.</p><p><strong>Results: </strong>From January 2005 until November 2022, 19 patients underwent a reversal of malabsorptive or maldigestive surgery to normal anatomy (15 Roux-en-Y gastric bypass, 4 jejunoileal bypass). The median age was 52 years (21; 74), and 80% of patients were female. Median body mass index (BMI) was 23 kg/m2 (17; 38) before reversal and 28 kg/m2 (17; 39) after reversal. Indication for reversal was often multifactorial but the most common indications were malnutrition (53%) with intractable diarrhea (42%) or hypoglycemia/dumping syndrome (37%). The most common reversal technique was a single anastomosis gastric bypass reversal (SARR procedure). Postoperative morbidity was 53%, with one major complication requiring reoperation (5%). With the exception of 4 patients who were lost during follow-up, all patients had improvement/resolution of symptoms. Weight regain occurred in three patients (16%), and one patient required further weight loss intervention (sleeve gastrectomy [SG]). Median follow-up time was 6 months (1; 206).</p><p><strong>Conclusion: </strong>Reversal of a malabsorptive or maldigestive procedure due to metabolic complications is an effective and safe treatment modality. Because of the surgical complexity and its related postoperative morbidity, careful patient selection is essential to ensure a favorable postoperative outcome.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":"1025-1034"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251601","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":"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":"1087-1088"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","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":"Effect of laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass on esophageal motility and gastroesophageal reflux at more than 5 years in patients with severe obesity.","authors":"Julian Süsstrunk, Anne C Meyer-Gerspach, Ralph Peterli, Suzanne M Edwards, Alissa Jell, Markus Trochsler, Mark Fox, Bettina K Wölnerhanssen, Jennifer C Myers","doi":"10.1016/j.soard.2025.05.015","DOIUrl":"10.1016/j.soard.2025.05.015","url":null,"abstract":"<p><strong>Background: </strong>The effect of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) on postoperative esophageal motility and its clinical significance is poorly understood.</p><p><strong>Objectives: </strong>To investigate the effect of SG and RYGB on esophageal motility and distal esophageal acid exposure time at least 5 years after surgery.</p><p><strong>Setting: </strong>Prospective clinical study conducted in 2 academic hospitals in Switzerland.</p><p><strong>Methods: </strong>Patients who underwent SG and RYGB were invited at least 5 years after surgery to undergo upper endoscopy, high-resolution manometry (HRM) and wireless pH measurement. Primary outcome was presence of esophageal motility disorders. Exploratory outcomes included presence of esophagitis, Barrett's esophagus, esophageal acid exposure, and validated symptom questionnaires.</p><p><strong>Results: </strong>A total of 113 patients (49 SG and 64 RYGB) underwent HRM and pH monitoring 7 ± 1.6 years after bariatric-metabolic surgery. Integrated-relaxation-pressure was 4.3 ± 3.9 mm Hg after SG and 4.2 ± 3.8 mm Hg after RYGB (P = .89). Average distal contractile integral was 2931 ± 2102 mm Hg-cm-s after SG and 3530 ± 3454 mm Hg-cm-s after RYGB (P = .29). After 100-mL rapid drinking challenge, a hypercontractile or spastic contraction was seen in 37.5% after RYGB and 16.3% after SG (P = .01). Mean esophageal acid exposure time was 11.4 ± 7.9% after SG and 1.3 ± 2.1 after RYGB (P < .0001). Esophagitis was present in 67.3% after SG and 28.1% after RYGB (P < .0001).</p><p><strong>Conclusions: </strong>Esophageal motility is similar for patients after SG and RYGB and clinically significant motility disorders of the esophagus are rare at long term follow-up. SG leads to significantly more reflux esophagitis, acid reflux and symptoms than RYGB and therefore, endoscopic surveillance should be considered.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":"1065-1072"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236353","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":"Role of bariatric surgery in patients with advanced heart failure.","authors":"Darae Kim, In-Cheol Kim, Jong-Chan Youn, Jin-Jin Kim, Mi-Hyang Jung, Jin-Oh Choi, Daniel Seong Kyu Kim, Mason Lee, Evan P Kransdorf, David H Chang, Michelle M Kittleson, Michele Hamilton, Jignesh K Patel, Fardad Esmailian, Jon A Kobashigawa","doi":"10.1016/j.soard.2025.05.013","DOIUrl":"10.1016/j.soard.2025.05.013","url":null,"abstract":"<p><strong>Background: </strong>Although bariatric surgery (BaS) is an important treatment option to treat obesity in general, the safety and efficacy of BaS in patients with advanced heart failure (HF) are not well known.</p><p><strong>Objectives: </strong>To describe the trajectory of patients with advanced HF who underwent BaS and cardiac replacement therapy.</p><p><strong>Setting: </strong>Single-tertiary academic hospital.</p><p><strong>Methods: </strong>We conducted a retrospective study of patients with advanced HF with obesity (body mass index [BMI] >35 kg/m²) between January 2010 and August 2022. Among them, 15 patients underwent BaS, and their clinical trajectories were compared with 62 patients with advanced HF who received orthotopic heart transplant (OHT) or durable mechanical circulatory support without BaS (non-BaS group) during the same period. Key outcomes included BMI reduction, OHT eligibility, and post-OHT survival.</p><p><strong>Results: </strong>Among 15 patients who underwent BaS, 12 underwent sleeve gastrectomy and 3 underwent gastric bypass surgery. After a median duration of 11 (6-14) months from BaS, the mean value of BMI was significantly reduced (39.8 [39.0-42.2] kg/m² versus 31.6 [27.7-35.3] kg/m², P < .001) with no BaS related mortality. In subgroup of OHT patients, post-OHT survival was comparable between the 2 groups.</p><p><strong>Conclusions: </strong>BaS is a safe and effective intervention for BMI reduction in patients with advanced HF. BaS may enhance OHT eligibility without compromising posttransplantation outcomes.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":"1056-1064"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251602","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":"Evaluating outcomes after metabolic/bariatric surgery among middle Eastern and North African patients in Michigan.","authors":"Ahmad M Hider, Sarah Petersen, Arthur M Carlin, Jonathan Finks, Oliver A Varban, Nabeel R Obeid","doi":"10.1016/j.soard.2025.05.014","DOIUrl":"10.1016/j.soard.2025.05.014","url":null,"abstract":"<p><strong>Background: </strong>The Middle Eastern and North African (MENA) population of the United States consists of 3.8 million citizens. This study compares health care outcomes for MENA patients undergoing metabolic and bariatric surgery (MBS) in Michigan to those of non-MENA patients statewide.</p><p><strong>Objectives: </strong>To compare outcomes of MBS between MENA and non-MENA patients in Michigan and identify disparities in surgery rates.</p><p><strong>Setting: </strong>Michigan Bariatric Surgery Collaborative (MBSC), Ann Arbor, MI.</p><p><strong>Methods: </strong>This retrospective cohort study used data from the MBSC database from 2017 to 2024. The cohort consisted of self-identified MENA patients (n = 799), approximately 1.5% of the MBSC total patient cohort. Data collected included demographic information, co-morbidities, type of bariatric procedure performed, adverse events at 30 days and at 1-year postoperative, including weight loss and changes in co-morbid status.</p><p><strong>Results: </strong>Compared to non-MENA patients, MENA patients were more likely to be males (25.8% vs. 18.5%; P < .0001), present at younger ages (age < 30 years: 21.8% vs. 11.0%, P < .0001), have lower initial body mass index (BMI) (45.1 vs 47.4, P < .001), be active smokers (12.6% vs 8.5%; P < .0001), and undergo sleeve gastrectomy (84.7% vs 80.1%; P = .0011). There were no differences in 30-day complications (5.9% vs. 5.7%, P = .5056), although MENA patients had lower rates of emergency department visits (6.3% vs 7.1%, P = .0139) and healthcare utilization (8.6% vs 10.0%, P = .0117). Overall, there were no differences in weight loss outcomes or rates of comorbidity improvement at 1 year following MBS among MENA patients undergoing gastric bypass specifically, the percent total weight loss at 1 year was lower than non-MENA patients (30.2% vs 33.4%, P = .0168).</p><p><strong>Conclusion: </strong>MENA individuals tend to pursue MBS at a younger age and with a lower BMI. Bariatric surgery appears equally safe and similarly effective in this patient population.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":"1048-1055"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287694","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":"Revisional bariatric surgery in the elderly: a comprehensive review of the safety and efficacy profile.","authors":"Noura Jawhar, Jack W Sample, Agustina Pontecorvo, Jorge Cornejo, Lorna A Evans, Nour El Ghazal, Simon J Laplante, Enrique F Elli, Omar M Ghanem","doi":"10.1016/j.soard.2025.08.012","DOIUrl":"https://doi.org/10.1016/j.soard.2025.08.012","url":null,"abstract":"<p><strong>Background: </strong>Despite the well-known safety and efficacy of metabolic and bariatric surgery, certain patients require revisional bariatric surgery (RBS) due to weight-related and/or procedure-related complications. Date on long-term RBS outcomes remains limited in the elderly.</p><p><strong>Objectives: </strong>To evaluate the safety and efficacy of RBS in the elderly.</p><p><strong>Setting: </strong>Tertiary referral centers with prospectively maintained metabolic and bariatric surgery databases.</p><p><strong>Methods: </strong>A retrospective review was conducted for patients aged ≥ 60 years who underwent RBS between 2008 and 2023. Patient demographics, type of revisional procedure, postoperative outcomes, weight loss data, and nutritional parameters were collected. All patients had at least a 6-month follow-up and were followed at least 5 years after RBS when possible.</p><p><strong>Results: </strong>201 patients were included. The most common indication for RBS was gastroesophageal reflux (37.8%). Conversion to Roux-en-Y gastric bypass was the most common RBS procedure (65.2%). This subgroup achieved significantly sustained mean percentage of total weight loss throughout follow-up. Conversion to sleeve gastrectomy subgroup only maintained a significant mean percentage of total weight loss at 6 months, 1 year, and 2 years postoperatively. The overall 30-day and late complication rates within the cohort were 17.4% and 26.9%, respectively. A .5% 30-day mortality rate and 0% long-term RBS-related morality rate were reported. For patients indicated for revision, RBS was successful in resolving malnutrition and did not result in recurrence of any nutritional deficiencies.</p><p><strong>Conclusions: </strong>Our study demonstrated that RBS is safe and effective in elderly patients in the long term. Proper RBS procedure selection is integral to address revision indication and decrease the risk of long-term complications.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056496","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":"A prospective assessment of weight bias internalization in patients seeking body contouring after bariatric surgery.","authors":"Ashley Dunford, Abigail Metzler, Valentina Ivezaj, Brian Pittman, Michael Alperovich, Gary Price","doi":"10.1016/j.soard.2025.06.020","DOIUrl":"https://doi.org/10.1016/j.soard.2025.06.020","url":null,"abstract":"<p><strong>Background: </strong>Weight bias internalization (WBI), or the internalization of \"antifat\" attitudes, is associated with greater eating-disorder psychopathology, body image, and mental health concerns in patients following bariatric surgery. Yet, WBI in patients seeking body contouring surgery (BCS) after bariatric surgery remains unstudied.</p><p><strong>Objectives: </strong>This study prospectively examined the relationship between WBI, eating-disorder psychopathology, and depressive symptoms in patients seeking BCS after bariatric surgery.</p><p><strong>Setting: </strong>Yale University School of Medicine, United States METHODS: Participants were 56 adults (93% female) seeking consultation for BCS after bariatric surgery; 42.9% (n = 24) went on to have BCS. Participants completed established measures assessing WBI, eating-disorder psychopathology, and depressive symptoms at baseline following the BCS consultation, then repeated at 1-month and 3-month follow-ups.</p><p><strong>Results: </strong>WBI was positively associated with eating-disorder psychopathology and depression at all assessments (all P < .01) including baseline (all r > .40), 1-month (all r > .33), and 3-month (all r > .45) follow-ups. In a prospective analysis of WBI, a significant group by time interaction was observed (P = .03) owing to lower postbaseline levels among BCS at both 1-month (P = .03) and 3-months (P = .009) assessments. Groups with and without BCS did not differ significantly on body mass index (BMI), weight loss, or eating-disorder psychopathology.</p><p><strong>Conclusions: </strong>WBI is associated significantly with greater eating-disorder psychopathology and depressive symptoms, but not BMI or weight loss, in patients seeking BCS after bariatric surgery. Group differences in WBI at 1-month and 3-month follow-ups suggest that BCS may help reduce WBI independent of BMI. Bariatric teams should be aware that higher WBI may persist for patients unable to obtain BCS.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056506","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}