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

{"title":"The hidden burden: how binge-eating symptoms impact postmetabolic and bariatric surgery success.","authors":"Victoria Ferrari Canedo de Sant'Anna, Rafaela Dutra, Alessandra Pinheiro Mulder","doi":"10.1016/j.soard.2026.09.016","DOIUrl":"https://doi.org/10.1016/j.soard.2026.09.016","url":null,"abstract":"<p><strong>Background: </strong>Binge-eating symptoms after metabolic and bariatric surgery (MBS) may impair dietary intake, postoperative outcomes, and health-related quality of life, yet their manifestations remain insufficiently characterized OBJECTIVES: To evaluate whether binge-eating symptoms are associated with dietary intake, postoperative outcomes, and health-related quality of life in women after MBS, and to characterize reported binge-eating episodes quantitatively and qualitatively SETTING: Obesity Outpatient Unit of Policlinic Piquet Carneiro, State University of Rio de Janeiro.</p><p><strong>Methods: </strong>This cross-sectional study included 66 women at least 12 months after MBS without nutritional follow-up in the previous 6 months, classified as controls (Binge Eating Scale (BES) <17; n = 37) or with binge-eating symptoms (BES ≥17; n = 29). Anthropometric, body composition, dietary, and quality-of-life data were obtained; dietary intake and episodes were assessed using 24-hour recalls and classified by NOVA (the NOVA food classification system, based on the extent and purpose of industrial processing).</p><p><strong>Results: </strong>Women with binge-eating symptoms showed lower excess weight loss, higher body fat percentage, higher energy and carbohydrate intake, and lower relative protein intake than controls. High quality of life was less frequent, and BES score was inversely associated with Bariatric Analysis and Reporting Outcome System (BAROS) score (rho = -.418, P = .0005). Episodes were energy-dense, carbohydrate-predominant, emotionally triggered, and often occurred without hunger, mainly at home and later in the day. Overall NOVA distribution did not differ between groups; however, episodes themselves were markedly dominated by ultra-processed foods (81.3% of caloric content), versus unprocessed/minimally processed foods (12.5%) and processed foods (6.3%).</p><p><strong>Conclusions: </strong>Binge-eating symptoms after MBS were associated with poorer dietary intake, less favorable postoperative outcomes, and poorer health-related quality of life.</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":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187234","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":"Gastroesophageal reflux disease as a risk factor for postoperative complications in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program registry (2015-2022): implications for preoperative evaluation.","authors":"Héctor J García-Navas, Emily Jordan, Florina Corpodean, Carlos Galvani, Elizabeth M Hechenbleikner, Maria V Hayes, Philip R Schauer, Vance L Albaugh, Michael W Cook, Michael Kachmar, Thomas H Shin","doi":"10.1016/j.soard.2026.09.010","DOIUrl":"https://doi.org/10.1016/j.soard.2026.09.010","url":null,"abstract":"<p><strong>Background: </strong>Gastroesophageal reflux disease (GERD) is frequently reported in metabolic surgery patients and has been associated with increased postoperative complications. However, variability in GERD diagnosis, reliance on self-reported symptoms, and medication use may be confounding factors.</p><p><strong>Objectives: </strong>Evaluate GERD as an independent risk factor for postoperative outcomes.</p><p><strong>Setting: </strong>Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), 2015-2022.</p><p><strong>Methods: </strong>A total of 1,577,175 cases (sleeve gastrectomy [SG], Roux-en-Y gastric bypass [RYGB], or biliopancreatic diversion/duodenal switch) were available for inclusion. Exclusions included age <18, body mass index <30, missing sex or operative length, and revisions/conversions. Adjusted logistic regression models evaluated GERD as a predictor of 30-day and procedure-specific outcomes (SG, RYGB). All statistical analyses were performed using R, version 4.4.1.</p><p><strong>Results: </strong>Overall, a total of 1,282,883 patients met inclusion criteria, and patients were more likely to undergo SG than RYGB regardless of the GERD status. GERD diagnosis was present in 30.5% of patients. Preoperatively, GERD was associated with clinically relevant differences in cardiac history and was also associated with increased odds of postoperative complications, including infections (odds ratio [OR], 1.27), serious complications (OR, 1.20), and 30-day readmission (OR, 1.26).</p><p><strong>Conclusion: </strong>After adjustment for co-morbidities, GERD was associated with modestly increased odds of adverse events after metabolic and bariatric surgery. In addition, SG was the most performed procedure among patients with GERD despite clinical recommendations favoring RYGB. Surgeons should consider a preoperative GERD diagnosis-as defined in the MBSAQIP-as a potential marker for identifying patients who may warrant enhanced perioperative risk assessment and optimization of coexisting co-morbidities.</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":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198130","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 venous thromboembolism prophylaxis with postoperative bleeding in bariatric surgery: an observational study.","authors":"Kate V Lauer, Jamie Ho, Dawda Jawara, Mads Owen, Andre Acra, Megha Brahmbhatt, Glen E Leverson, David A Harris, Anne O Lidor, Luke M Funk","doi":"10.1016/j.soard.2026.08.030","DOIUrl":"https://doi.org/10.1016/j.soard.2026.08.030","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing bariatric surgery are at an increased risk of postoperative venous thromboembolism (VTE). VTE prophylaxis protocols vary and can contribute to postoperative bleeding.</p><p><strong>Objective: </strong>Evaluate whether implementation of a VTE prophylaxis protocol is associated with a change in frequency of postoperative bleeding after bariatric surgery.</p><p><strong>Setting: </strong>Single United States university hospital.</p><p><strong>Methods: </strong>Patients who underwent sleeve gastrectomy or gastric bypass between 2020 and 2024 were assigned to the preprotocol or postprotocol group based on the date of surgery. Preprotocol patients received 40 mg of enoxaparin intraoperatively followed by 40 mg twice daily, whereas postprotocol patients received 60 mg of enoxaparin intraoperatively followed by 60 mg daily. Frequency of bleeding requiring transfusion and/or endoscopic or surgical intervention was compared using Fisher exact tests. A multivariable analysis identified characteristics associated with bleeding.</p><p><strong>Results: </strong>Six hundred sixty preprotocol and 797 postprotocol patients met inclusion criteria (mean [standard deviation] age, 45.4 [10.8] years; 85.5% White; 82.0% female; 60.6% sleeve gastrectomy). Bleeding frequency was similar between groups (2.3% preprotocol versus 3.0% postprotocol; P = .419). A multivariable analysis revealed that gastric bypass was associated with increased odds of bleeding (odds ratio, 1.94; confidence interval, 1.02‑3.70; P = .044), whereas higher body mass index was associated with decreased odds (odds ratio, .50; confidence interval, .29‑.87; P = .015).</p><p><strong>Conclusions: </strong>A standardized VTE prophylaxis protocol using a higher intraoperative enoxaparin dose but lower total once daily dose was not superior to a twice daily regimen in regards to the frequency of clinically significant bleeding. These results suggest that protocolized prophylaxis can be applied safely but that patients with lower preoperative weights may be at a higher risk of bleeding and warrant dose adjustment.</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":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic bariatric surgery versus GLP-1 receptor agonists in dialysis patients with diabetes and obesity: a target trial emulation study.","authors":"Chenxi Gao, Gayathri Menon, Yusi Chen, Yiting Li, Sunjae Bae, Bonnie E Lonze, Christine J Ren-Fielding, Karan R Chhabra, Dorry L Segev, Mara A McAdams-DeMarco, Babak J Orandi","doi":"10.1016/j.soard.2026.09.014","DOIUrl":"https://doi.org/10.1016/j.soard.2026.09.014","url":null,"abstract":"<p><strong>Background: </strong>Metabolic and bariatric surgery (MBS) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) are effective treatments for obesity and type 2 diabetes, but their comparative survival and waitlisting benefits in end-stage kidney disease (ESKD) remain unclear.</p><p><strong>Objectives: </strong>To compare survival and kidney transplant (KT) waitlisting after MBS and GLP-1RA use among patients with ESKD, using dipeptidyl peptidase-4 inhibitors (DPP-4is) as an active comparator.</p><p><strong>Setting: </strong>US Renal Data System, 2010-2022.</p><p><strong>Methods: </strong>We included adults with ESKD, type 2 diabetes, and ≥class II obesity treated with MBS, GLP-1RA, or DPP-4i. Three target trials were emulated: MBS versus GLP-1RA (N = 1818), MBS versus DPP-4i (N = 2111), and GLP-1RA versus DPP-4i (N = 4338). Cox models estimated adjusted hazard ratios (aHRs) for all-cause mortality and KT waitlisting over 1-5 years.</p><p><strong>Results: </strong>MBS recipients were younger at dialysis initiation than matched GLP-1RA and DPP-4i users. MBS was associated with higher short-term mortality than matched GLP-1RA (1-year aHR = 2.68, 95% confidence interval [CI]:1.98-3.63; 3-year aHR = 1.34, 95% CI: 1.09-1.64) and DPP-4i users (1-year aHR = 1.74, 95% CI: 1.35-2.25), but comparable longer-term mortality. GLP-1RA users had consistently lower mortality than matched DPP-4i users. MBS was associated with higher KT waitlisting than GLP-1RA and DPP-4i use, with no differences between GLP-1RA and DPP-4i users.</p><p><strong>Conclusions: </strong>Among patients with ESKD, type 2 diabetes, and obesity, MBS was associated with higher short-term but comparable long-term mortality, whereas GLP-1RA use was associated with lower mortality than DPP-4i use. MBS was also associated with higher KT waitlisting than GLP-1RA and DPP-4i use, suggesting distinct risk-benefit profiles of metabolic treatment in this high-risk population.</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":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149240912","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: Helicobacter pylori, gastric cancer, and bariatric surgery: lesson from the past for the future.","authors":"Mario Musella, Antonio Franzese","doi":"10.1016/j.soard.2026.09.008","DOIUrl":"https://doi.org/10.1016/j.soard.2026.09.008","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":3.8,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187125","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: Screening and management of Helicobacter pylori and gastric intestinal metaplasia in bariatric surgery: clinical implications and a decision framework.","authors":"George Ibrahim, Francesco Palazzo","doi":"10.1016/j.soard.2026.09.005","DOIUrl":"https://doi.org/10.1016/j.soard.2026.09.005","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":3.8,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149240849","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":"Magnetic anastomosis in metabolic surgery: from feasibility to clinical purpose.","authors":"Manoel Galvao Neto, Andre Teixeira","doi":"10.1016/j.soard.2026.09.007","DOIUrl":"https://doi.org/10.1016/j.soard.2026.09.007","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":3.8,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187156","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: Management of gastro-gastric fistula after Roux-en-Y gastric bypass: a systematic review and meta-analysis of endoscopic versus surgical outcomes.","authors":"Anagha J Deshpande, Matthew Kroh","doi":"10.1016/j.soard.2026.09.001","DOIUrl":"https://doi.org/10.1016/j.soard.2026.09.001","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":3.8,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217777","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: Analysis of the efficacy of metabolic and bariatric surgery on sarcopenic obesity: a systematic review and meta-analysis.","authors":"Marius Nedelcu, Marc Danan, Anamaria Nedelcu","doi":"10.1016/j.soard.2026.08.021","DOIUrl":"https://doi.org/10.1016/j.soard.2026.08.021","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":3.8,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003262","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":"Short-term outcomes of primary laparoscopic single-anastomosis gastric bypass versus revisional procedures: a multicenter retrospective cohort study.","authors":"Sergio Susmallian, Irena Babis","doi":"10.1016/j.soard.2026.08.029","DOIUrl":"https://doi.org/10.1016/j.soard.2026.08.029","url":null,"abstract":"<p><strong>Objective: </strong>To compare early postoperative outcomes between primary and revisional laparoscopic single-anastomosis gastric bypass (LSAGB) and to evaluate the association between early postoperative physiological abnormalities and life-threatening complications.</p><p><strong>Setting: </strong>Multicenter study conducted across 4 tertiary referral bariatric centers.</p><p><strong>Methods: </strong>In this multicenter retrospective cohort study, 5334 consecutive patients undergoing LSAGB between 2016 and 2020 were analyzed, including 4800 primary and 534 revisional procedures. Postoperative complications were classified using the Clavien-Dindo system. Multivariable logistic regression identified independent predictors of morbidity. Early postoperative physiological abnormalities were evaluated individually and cumulatively to assess their association with life-threatening complications (grade ≥ IIIa).</p><p><strong>Results: </strong>Revisional LSAGB was associated with significantly higher overall (42.9% versus 20.2%; P < .001) and major complication rates (10.7% versus 3.7%; P < .001). In multivariable analysis, revisional surgery remained the strongest independent predictor of postoperative morbidity (adjusted OR 2.58, 95% CI 2.17-3.07; P < .001) and major complications (adjusted odds ratio [OR] 3.18, 95% confidence interval [CI] 2.32-4.36; P < .001). Operative duration (OR 1.15 per 10 min), age (OR 1.03 per year), comorbidity burden (OR 1.41), and diabetes mellitus (OR 1.29) were also independently associated with increased risk. Early postoperative abnormalities were strongly associated with life-threatening complications, with a marked non-linear increase in risk from .12% (no abnormalities) to 53.6% (≥4 abnormalities), demonstrating clear risk stratification.</p><p><strong>Conclusions: </strong>Revisional LSAGB represents a higher-risk procedure compared with primary surgery. Early postoperative physiological abnormalities, particularly when cumulative, provide a clinically actionable framework for early detection of life-threatening complications and may support improved postoperative surveillance and timely intervention.</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":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121332","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}