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

{"title":"Microbiome and genetic predictors of weight loss 12 months postsleeve gastrectomy: insights from a pilot retrospective cohort study.","authors":"Inti Pedroso, Shreyas V Kumbhare, Shaneeta Johnson, Karthik M Muthukumar, Santosh K Saravanan, Carmel Irudayanathan, Garima Sharma, Lawrence Tabone, Ranjan Sinha, Daniel E Almonacid, Nova Szoka","doi":"10.1016/j.soard.2025.05.008","DOIUrl":"10.1016/j.soard.2025.05.008","url":null,"abstract":"<p><strong>Background: </strong>Gut microbiome and genetic biomarkers are increasingly guiding obesity treatment. Bariatric surgery leads to shifts in gut microbial composition and function, while genome-wide association studies reveal genetic underpinnings of polygenic obesity, informing risk, therapeutic outcomes, and nutrigenomics-based interventions.</p><p><strong>Objectives: </strong>This pilot study aimed to identify gut microbiome and genetic biomarkers associated with weight loss 12 months after sleeve gastrectomy (SG).</p><p><strong>Setting: </strong>Single academic institution university clinic.</p><p><strong>Methods: </strong>Sixty-seven patients 12 months post-SG were enrolled: 34 had successful excess weight loss (EWL ≥50%), while 33 had unsuccessful EWL (EWL <50%). Microbiome and genetic profiles were collected and analyzed using ANOVA and regression methods.</p><p><strong>Results: </strong>The genus Akkermansia was significantly associated with EWL (P = 9.9 × 10^-6). Several microbial pathways, including propionate synthesis and menaquinone (vitamin K2) production, showed nominally significant (P < .05) associations with greater weight loss. No differences emerged in the Firmicutes/Bacteroidetes ratio. Genetic analyses revealed significant correlations between EWL and polygenic scores for dietary needs and metabolic responses, including distinct vitamin D and K requirements, as well as higher LDL cholesterol levels and predisposition for major depression.</p><p><strong>Conclusions: </strong>These findings suggest that both the gut microbiome and genetics may modulate weight loss following bariatric surgery. Integrating microbiome and genetic profiling into bariatric care pathways could enhance personalized obesity treatment. While this pilot, exploratory, and proof-of-concept study has limitations, it supports prior work linking gut microbial pathways to weight loss and suggests new associations. Follow-up studies are warranted to validate these results and further inform precision obesity interventions.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":"1035-1041"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328277","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 food environment on weight loss after bariatric surgery.","authors":"John Cord Helmken, Noelle Luzzi, Dawn Blackhurst, Jacqueline Grace Wallenborn, John D Scott","doi":"10.1016/j.soard.2025.04.469","DOIUrl":"10.1016/j.soard.2025.04.469","url":null,"abstract":"<p><strong>Background: </strong>The impact of food environment on weight loss after Roux-en-Y gastric bypass and sleeve gastrectomy in South Carolina is not well studied. Specifically, there is a lack of evidence in the Upstate region of South Carolina regarding the efficacy of weight loss surgery in patients who live in a poor food environment.</p><p><strong>Objectives: </strong>Assess the relationship between food environment after bariatric surgery.</p><p><strong>Setting: </strong>South Carolina, USA.</p><p><strong>Methods: </strong>Our study is a single-center, retrospective review of 134 postbariatric surgery patients. We determined patients' food environments using the Center for Disease Control modified retail food environment index (mRFEI) and the South Carolina Department of Health and Environmental Control food desert map. We assessed weight loss using percent of total body weight loss (TBWL%).</p><p><strong>Results: </strong>We found no linear correlations between weight loss and food environment in bivariate analyses at 6 months (r = -.121; P = .165), 13 months (r = -.109; P = .275), 18 months (r = -.124; P = .326), or 36 months (r = -.331; P = .106) after bariatric surgery. At 24 months, there was a low negative correlation between weight loss and food environment (r = -.302; P = .041). In repeated measures multivariate analysis, adjusting for age, sex, race, payor status, and type of surgery, we found no statistically significant association between mRFEI and TBWL% (P = .214).</p><p><strong>Conclusions: </strong>Our data suggest there is no significant association between weight loss after bariatric surgery and living in an area with poor access to healthy food retailers. This study supports bariatric surgery as an effective method for weight loss regardless of patients' food environment.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":"1012-1017"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236352","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":"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":"1073-1083"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","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":"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":"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":"1004-1010"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","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}

{"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":"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":"1010-1011"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","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 relationship between bariatric surgery and risk of hip or knee replacement in severe osteoarthritis is obesity class-specific.","authors":"Julien Paccou, Soxna Faatimatu Kiné Fall, Xavier Lenne, Didier Theis, François Pattou, Amélie Bruandet","doi":"10.1016/j.soard.2025.04.467","DOIUrl":"10.1016/j.soard.2025.04.467","url":null,"abstract":"<p><strong>Background: </strong>In patients with osteoarthritis, bariatric surgery is associated with diminished joint pain and improved functionality.</p><p><strong>Objectives: </strong>To evaluate the relationship between the risk of total joint replacement (TJR) and the fact of having undergone bariatric surgery (yes or no) in people living with obesity.</p><p><strong>Settings: </strong>Data from the French National Hospitals Database.</p><p><strong>Methods: </strong>This case-control study was conducted to identify hospitalizations for TJR. The main exposure of interest was having undergone (or not) a bariatric surgery procedure between January 2017 and December 2021. After a 6-month run-in phase, data on hospitalizations for the first TJR (i.e., hip or knee) from July 2017 to December 2023 were classified by obesity class and surgical type.</p><p><strong>Results: </strong>One hundred sixty thousand seven hundred seventy-three patients who had undergone bariatric surgery (mean age: 40.8 years, 79.5% females) and 160,773 matched controls were identified. The most frequent surgical technique was sleeve gastrectomy (72.2%), followed by gastric bypass (27.8%). The average follow-up was 4.7 years. An increase in the overall risk of TJR, with a hazard ratio (HR) of 1.09 (95% confidence interval [CI], 1.03-1.15), was observed. Depending on obesity class, patients with body mass index (BMI) < 40 kg/m² had a lower risk of TJR (HR: 5.85; 95% CI: .78-.93), whereas a higher risk was observed in patients with BMI ≥40 kg/m² (HR: 5 1.25; 95% CI: 1.16-1.34).</p><p><strong>Conclusions: </strong>In France, hospitalizations for TJR following bariatric surgery were associated with an increase of 25% in patients with BMI ≥ 40 kg/m², whereas it was associated with a decrease of 15% in patients with BMI < 40 kg/m².</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":"996-1003"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113239","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":"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":"Reproductive health counseling, menstruation, contraception, and conception after sleeve gastrectomy: a cross-sectional study.","authors":"Ahmad Badrieh, Ram Elazary, Tair Ben-Porat, Shiri Sherf-Dagan, Amihai Rottenstreich","doi":"10.1016/j.soard.2025.08.017","DOIUrl":"https://doi.org/10.1016/j.soard.2025.08.017","url":null,"abstract":"<p><strong>Background: </strong>Reproductive-aged women constitute a substantial proportion of patients undergoing weight loss procedures. Little is known regarding reproductive health outcomes among women after sleeve gastrectomy (SG).</p><p><strong>Objective: </strong>We aim to explore reproductive health patterns and outcomes after SG.</p><p><strong>Setting: </strong>University hospital.</p><p><strong>Methods: </strong>A cross-sectional study performed among reproductive-aged women who underwent SG at a university hospital. Women were surveyed using a questionnaire developed as a collaborative, multidisciplinary effort of a maternal-fetal medicine expert, general gynecologist, and a bariatric surgeon.</p><p><strong>Results: </strong>Overall, 1030 women of childbearing age (median 34 years) underwent SG at our center during the study period. Of them, 928 women completed the questionnaire (response rate of 90%) with a median follow-up duration of 8.4 years. Menstrual irregularity rate (11.9% vs. 43.5%, P < .001) and duration of menstrual bleeding (median 5 vs. 6 days, P < .001) were significantly reduced after surgery as compared to preoperatively. Only 632 (68.1%) women received contraceptive advice perioperatively, with oral contraception being the most commonly used method following surgery (n = 322, 34.7%). Most women (n = 867, 93.4%) received a recommendation to delay conception after surgery, however, 65 (7.5%) women were sexually active in the first year postoperatively without using any mode of contraception. Overall, 301 (32.4%) women delivered after surgery, with pregnancy reported as unintended by 22 (7.3%) women, most of them (n = 14) using oral contraception.</p><p><strong>Conclusions: </strong>Menstrual cycle pattern significantly improves after SG. Adequate reproductive-health counseling is important after SG in order to inform optimal contraceptive care and potentially prevent unintended pregnancies particularly in the early period 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":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103260","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}