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

{"title":"Comment on: Diagnosis of gestational diabetes after Roux-en-Y gastric bypass: a comparative analysis of 3 methods.","authors":"Robert L Dubin","doi":"10.1016/j.soard.2025.05.007","DOIUrl":"https://doi.org/10.1016/j.soard.2025.05.007","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":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251600","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":"Efficacy and safety of direct oral anticoagulants (DOACs) for postoperative thromboprophylaxis in patients after bariatric surgery: a systematic review and meta-analysis.","authors":"Pedro Bicudo Bregion, Josélio Rodrigues de Oliveira-Filho, Victor Kenzo Ivano, João Caetano Dallegrave Marchesini, Everton Cazzo","doi":"10.1016/j.soard.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.soard.2025.05.004","url":null,"abstract":"<p><p>Bariatric surgery is effective for achieving substantial weight loss and improving metabolic comorbidities in patients with severe obesity. However, both obesity and bariatric surgery elevate the risk of thromboembolic events. Traditionally, venous thromboembolism (VTE) prophylaxis in individuals who undergo bariatric surgery has relied on heparins, particularly enoxaparin. Concerns regarding pharmacologic limitations linked to the adipose tissue-related impact on the drug's pharmacodynamics in high-BMI patients have led to increased interest in direct oral anticoagulants (DOACs) as a potential alternative. This systematic review and meta-analysis aimed to assess the efficacy and safety of DOACs for thromboprophylaxis in people undergoing bariatric surgery. We systematically searched PubMed, EMBASE, and Cochrane Central for studies evaluating DOAC use for VTE prophylaxis in bariatric surgery patients up to November 2024. Primary outcomes included thrombotic and bleeding event rates (classified as major or minor), with secondary outcomes including the prevalence of allergic reactions. Randomized controlled trials and observational studies were included. Study weights were calculated using the inverse variance method, with statistical analyses performed using R version 4.4.0 (R Foundation for Statistical Computing, Vienna, Austria). Seven studies with a total of 7706 patients were included. The incidence of thrombotic events post-surgery with DOAC use was .23% (95% CI: .14-.39). Major bleeding events were reported at .33% (95% CI: .11-1.03), minor bleeding at 1.27% (95% CI: .45-3.54), and allergic reactions at 1.33% (95% CI: .59-2.98). There was one reported death due to pulmonary embolism. These findings suggest a low incidence of adverse effects with DOAC use in this population. Our meta-analysis supports the use of DOACs as a safe and effective option for thromboprophylaxis in individuals undergoing bariatric surgery. Further research, including direct comparisons with enoxaparin, is needed to establish definitive guidelines for postoperative management.</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":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287693","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":"Assessing outcomes following magnetic duodenoileal anastomosis with sleeve gastrectomy.","authors":"Tauheed Akram, Benyamin Alam, Amir Reza Akbari","doi":"10.1016/j.soard.2025.05.012","DOIUrl":"https://doi.org/10.1016/j.soard.2025.05.012","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":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268310","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: \"Morbidity and mortality of incisional hernia repairs in patients with obesity: a retrospective bicentric study on the impact of an initial bariatric surgery approach\".","authors":"Ahmed M Mohammed Abdelsalam","doi":"10.1016/j.soard.2025.05.005","DOIUrl":"https://doi.org/10.1016/j.soard.2025.05.005","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":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319096","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 practice of preoperative patient education in metabolic bariatric surgery: results of a national survey.","authors":"Karen Diane Groller, Brenna Curley, William Gourash","doi":"10.1016/j.soard.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.soard.2025.05.006","url":null,"abstract":"<p><strong>Background: </strong>Few evidence-based studies addressing metabolic and bariatric surgery patient education (MBS-PE) practices exist.</p><p><strong>Objective: </strong>To examine how preoperative MBS-PE is provided nationally.</p><p><strong>Setting: </strong>National Certification Program.</p><p><strong>Methods: </strong>Descriptive analysis of an internet survey distributed in 2021 to integrated health professionals of American Society for Metabolic and Bariatric Surgery and active Certified Bariatric Nurses.</p><p><strong>Results: </strong>The sample (n = 269), representing 43 states, was divided into 2 groups: nurses (65.8%) and other integrated health professionals (OIHPs) (34.2%). More than 74% in both groups rated 15 education content areas as \"very important\" or \"extremely important.\" Content areas were developed \"most of time\" or \"always\" (by nurses and OIHP) using clinical experience (79.0% and 75.0%), implementing information from literature (69.3% and 75.3%), and theory (55.4% and 76.1%). Educational materials were delivered through printed materials (95.2%), website/portal (69.5%), and social media (53.2%). Delivery methods (used by nurses and OIHP) included didactic presentation (71.2%, 77.2%), behavioral modification (60.5%, 77.2%), and motivational interviewing delivery (47.5%, 69.6%). Delivery settings were \"most of the time\" or \"always\" conducted individually by nurses (76.3%) and OIHP (66.3%). The effectiveness of MBS knowledge acquired through education was evaluated by 62.1%. Informal discussions, written tests, and quality metrics were used predominantly to identify knowledge gaps. A majority perceived preoperative MBS-PE to be moderately or highly related to surgical outcomes.</p><p><strong>Conclusions: </strong>Results provide insights on preoperative MBS-PE practices from integrated health professionals, offering opportunities for clinicians to reflect on, incorporate recommended practice changes, and research patient education practices using educational constructs of content, delivery methods, knowledge measurement, and clinical outcomes.</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":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201231","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":"https://doi.org/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":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","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":"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":"https://doi.org/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":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","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":"Validation of the Michigan Bariatric Surgery Collaborative outcomes calculator in a Hispanic population.","authors":"Shahrukh Chaudhry, Ray Portela, Richard Peterson, Farah Husain, Benjamin Clapp","doi":"10.1016/j.soard.2025.05.003","DOIUrl":"https://doi.org/10.1016/j.soard.2025.05.003","url":null,"abstract":"<p><strong>Background: </strong>The Michigan Bariatric Surgery Collaborative (MBSC) has developed an app that calculates outcomes, to include predicted weight loss and venous thromboembolism rates. The app is called Weigh the Odds. This app provides an important method for discussing outcomes with patients.</p><p><strong>Objectives: </strong>We sought to determine the validity of the MBSC outcomes calculator in a Hispanic population.</p><p><strong>Setting: </strong>Community practice in Texas.</p><p><strong>Methods: </strong>A community practice with a large percentage of Hispanic patients was used to validate the MBSC calculator. The correlation coefficient was calculated. A chi-square test was used to compare quantitative variables between the operation types. Lin's concordance correlation along with the Bland-Altman plot were performed to estimate the level of agreement between actual and expected weights at 1 year.</p><p><strong>Results: </strong>Two hundred seventy-six patients met the eligibility criteria and were included in the study. The average body mass index (BMI) at the time of initial bariatric surgery was 45.2 kg/m² (standard deviation [SD], 6.68). One hundred seventy-seven patients underwent sleeve gastrectomy (SG), and 99 patients underwent Roux-en-Y gastric bypass (RYGB) as their initial bariatric operation. The mean actual weight at 1 year for the entire cohort was 90.8 kg (SD, 19.6), while the mean expected weight was 89.2 kg (SD, 16.9), leading to a mean difference of 1.6 kg. The concordance correlation coefficient of .80 (95% CI: .76-.84, P < .001) demonstrates a strong agreement between actual and expected weights at 1 year. There was a lower correlation coefficient for RYGB patients.</p><p><strong>Conclusion: </strong>The concordance correlation coefficient demonstrated a strong agreement between actual and expected weights at 1 year. These findings validate the MBSC outcomes calculator in a Hispanic 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":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144277176","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":"https://doi.org/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":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","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":"Morbidity and mortality of incisional hernia repairs in patients with obesity: a retrospective bicentric study on the impact of an initial bariatric surgery approach.","authors":"Clément Louis-Gaubert, Marie de Montrichard, David Jacobi, Alya Zouaghi Bellemin, David Moszkowicz, Claire Blanchard","doi":"10.1016/j.soard.2025.04.468","DOIUrl":"https://doi.org/10.1016/j.soard.2025.04.468","url":null,"abstract":"<p><strong>Background: </strong>Abdominal hernias are a prevalent complication of abdominal surgery, occurring in 13% of midline laparotomy. The recurrence rate is considerable, reaching 28% within 2 years postrepair. The most significant factor contributing to recurrence after hernia repair and complications is obesity.</p><p><strong>Objectives: </strong>This study assesses the impact of a two-stage approach, comprising initial bariatric surgery (BS) followed by hernia repair, on morbidity and mortality associated with hernia surgery.</p><p><strong>Setting: </strong>Bicentric retrospective study conducted at two university hospitals (France).</p><p><strong>Methods: </strong>Patients with obesity who were eligible for BS and underwent incisional hernia repair (IHR) between January 2013 and August 2023 were divided into two groups: those who underwent IHR alone and those who received initial BS followed by IHR. Data included demographic, anthropometric, and procedural details, as well as short- and long-term complications.</p><p><strong>Results: </strong>The 140 patients were divided into two groups: 103 undergoing IHR alone (body mass index [BMI] 40.5kg/m²) and 37 in the BS-then-IHR group (BMI reduction from 43.7kg/m² to 32.4kg/m²). Intraoperative data showed a lower incidence of complications in the BS-first group (0%) than in the IHR-group (13.7%), even after excluding emergency surgeries (P < .05). Postoperative morbidity was lower in the two-stage group, with intensive care unit admissions at 5.4% versus 17.5% and no mortalities. Median hospital stay was shorter (4.5 days vs. 7 days, P < .05). Three-year clinical recurrence was 8.3% versus 19.8%.</p><p><strong>Conclusion: </strong>A two-stage approach may improve IHR outcomes by reducing recurrence, hospital stay, and postoperative morbidity and mortality. This approach should be considered if the patient is eligible for BS.</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":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188755","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}