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

{"title":"Duodeno-ileal magnetic compression anastomoses in metabolic surgery: a systematic review and meta-analysis.","authors":"Patrick Noel, Laurent Biertho, Jaime Ponce, Pierre Garneau, Rami Lutfi, Michel Gagner","doi":"10.1016/j.soard.2026.08.020","DOIUrl":"https://doi.org/10.1016/j.soard.2026.08.020","url":null,"abstract":"<p><strong>Background: </strong>Sutureless duodeno-ileal magnetic compression anastomosis (DI-MCA) is a novel technology for metabolic and bariatric surgery, but pooled evidence on feasibility, safety, and early efficacy is lacking.</p><p><strong>Objectives: </strong>To systematically review feasibility, safety, and early efficacy of DI-MCA across device classes and procedural contexts.</p><p><strong>Setting: </strong>International; prospective clinical studies.</p><p><strong>Methods: </strong>MEDLINE, EMBASE, CENTRAL, Web of Science, and ClinicalTrials.gov were searched to 31 March 2026. Eligible studies reported DI-MCA using linear (LMAS), biofragmentable (BMAS), self-forming (SNAP/SNAP-S), or immediately-patent (IMPA-DI) devices. Cohort overlap was resolved by investigator correspondence. Proportions were pooled with Freeman-Tukey transformation; continuous outcomes with REML and Hartung-Knapp correction. Bias: MINORS; certainty: Grading of Recommendations, Assessment, Development, and Evaluations.</p><p><strong>Results: </strong>Twelve prospective studies (220 enrolled, 218 implanted) met inclusion criteria; after de-duplication, 153 enrolled adults (151 implanted) were verified-unique. The pooled device-related leak rate was .0% (95% confidence interval [CI] .0-1.7), with zero 30-day mortality. Efficacy is reported descriptively by procedural context. Primary DI-MCA with concurrent sleeve gastrectomy: 6-month percent total weight loss (%TWL) 28.1% (n = 24, LMAS 1.9 cm) and 10.7% (n = 17, BMAS 4-5 cm), with 12-month data in 5 patients (%TWL 34.0%). Revisional solo DI-MCA: %TWL 5.4% at 6 months (n = 24) and 5.3% at 12 months (n = 23). Solo biofragmentable DI-MCA in mild obesity with type 2 diabetes: 12-month %TWL 8.7% (n = 8/15); HbA1c 8.2%→6.6%. Protein-energy malnutrition (9.3%, 5/54) was confined to the SNAP subset. Certainty of evidence was low to very low.</p><p><strong>Conclusions: </strong>DI-MCA is feasible, with no device-related anastomotic leak and no 30-day mortality; early efficacy is device- and context-dependent. All available data are derived from small, industry-sponsored single-arm studies in highly selected patients at experienced investigational centers, and support feasibility and early safety rather than comparative effectiveness or generalizability to routine practice. Larger comparative studies with longer follow-up are needed; the SNAP malnutrition signal warrants prospective surveillance.</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":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077231","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":"Reply to comment on \"The long-term cardiovascular benefits of metabolic and bariatric surgery versus pharmacological therapies in patients with type 2 diabetes and obesity: a systematic review and meta-analysis\".","authors":"Yao Lu, Liyong Zhu","doi":"10.1016/j.soard.2026.08.026","DOIUrl":"https://doi.org/10.1016/j.soard.2026.08.026","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":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003255","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":"Robotic versus laparoscopic sleeve gastrectomy in adolescents: trends and short-term complications.","authors":"Josélio Rodrigues de Oliveira Filho, Ghadeer Shnawa, Matthew Hornick, Jun Tashiro, James Healy, Christine Finck, Kanika Bowen-Jallow, Jeffrey L Zitsman, Gillian L Fell, Janey S Pratt, Abdelrahman A Nimeri, Cornelia L Griggs","doi":"10.1016/j.soard.2026.08.019","DOIUrl":"https://doi.org/10.1016/j.soard.2026.08.019","url":null,"abstract":"<p><strong>Background: </strong>Robotic sleeve gastrectomy (SG) is increasingly used, but national comparative data in adolescents and young adults remain limited.</p><p><strong>Objectives: </strong>To evaluate robotic SG trends and compare 30-day outcomes after robotic versus laparoscopic SG among patients aged 13 to 21 years.</p><p><strong>Setting: </strong>Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, United States, 2015-2024.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of patients aged 13 to 21 years undergoing minimally invasive SG. Outcomes included grouped complications, 30-day readmission, overall complications, and operative time. Multivariable regression adjusted for age, sex, body mass index, comorbidities, smoking, and year; propensity score matching and inverse probability weighting were sensitivity analyses.</p><p><strong>Results: </strong>Among 21,746 patients, 17,444 underwent laparoscopic SG and 4302 underwent robotic SG. Robotic utilization increased from 6.8% in 2015 to 34.3% in 2024. Robotic SG was not associated with higher adjusted odds of infectious complications (odds ratio, 1.04; 95% confidence interval, .65-1.62), pulmonary complications (1.34; .50-3.22), thromboembolic complications (1.85; .73-4.34), surgical complications (1.43; .91-2.18), readmission (1.01; .80-1.27), or overall complications (1.05; .85-1.29). Low event rates limited power for rare outcomes. Sensitivity analyses were concordant. Robotic SG had longer operative time by 21.2 min.</p><p><strong>Conclusions: </strong>Robotic SG use increased nationally and was not associated with higher adjusted odds of complications, supporting short-term safety. Future studies should evaluate longer-term outcomes, cost, and access.</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":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066835","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: Anastomotic marginal ulceration after conversion of sleeve gastrectomy to Roux-en-Y gastric bypass.","authors":"Benjamin Clapp","doi":"10.1016/j.soard.2026.08.024","DOIUrl":"https://doi.org/10.1016/j.soard.2026.08.024","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":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027432","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":"Cost-effectiveness of endoscopic sleeve gastroplasty using a disease progression model.","authors":"Junxing Chay, Ravishankar Asokkumar, Kwang Wei Tham, Chenhui Wang, Eric Andrew Finkelstein","doi":"10.1016/j.soard.2026.08.017","DOIUrl":"https://doi.org/10.1016/j.soard.2026.08.017","url":null,"abstract":"<p><strong>Background: </strong>The clinical efficacy of endoscopic sleeve gastroplasty (ESG) is well established, yet evidence on its cost-effectiveness is limited.</p><p><strong>Objectives: </strong>This analysis assessed the lifetime cost-effectiveness of ESG and lifestyle management (ESG + lifestyle modification [LM]) compared with LM alone in ESG-eligible patients.</p><p><strong>Setting: </strong>Singapore health system perspective.</p><p><strong>Methods: </strong>We developed a Markov model to simulate the incidence of type 2 diabetes (T2D), stroke, myocardial infarction, and cardiovascular death. Disease risks were modeled as functions of age, sex, and key clinical risk factors. For each intervention arm, we simulated annual transitions between disease states, tracking associated healthcare costs and quality-adjusted life years (QALYs), both of which were discounted at an annual rate of 3%, over a lifetime horizon. We conducted one-way and probabilistic sensitivity analyses to assess the robustness of the results to changes in key model parameters.</p><p><strong>Results: </strong>The average cost of the ESG procedure in Singapore was SG$ 14,145 (US$ 10,590). In the base case (lifetime horizon), ESG + LM cost SG$ 9110 (US$ 6820) more and accrued .37 more QALYs than LM, generating an incremental cost-effectiveness ratio (ICER) of SG$ 24,580/QALY (US$ 18,410/QALY). The ICER for patients without T2D was SG$ 19,320/QALY (US$ 14,470/QALY). The ICER for patients with T2D was SG$ 37,320/QALY (US$ 27,950/QALY). At SG$ 75,000/QALY (US$ 56,170/QALY) threshold, ESG + LM was cost-effective in 98.8% of the probabilistic sensitivity analyses iterations.</p><p><strong>Conclusions: </strong>Over a lifetime horizon, ESG + LM is likely cost-effective for treating obesity in Singapore and may merit subsidy consideration for eligible patients.</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":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019176","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":"When your path to weight loss is changing: new questions for body contouring surgery to optimize patient outcomes.","authors":"Faina Linkov","doi":"10.1016/j.soard.2026.08.027","DOIUrl":"https://doi.org/10.1016/j.soard.2026.08.027","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":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121340","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":"Bougie size and antral resection distance influence gastroesophageal reflux following laparoscopic sleeve gastrectomy: a randomized trial.","authors":"Yong Choi","doi":"10.1016/j.soard.2026.08.025","DOIUrl":"https://doi.org/10.1016/j.soard.2026.08.025","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":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066908","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":"Comparative safety profile of metabolic and bariatric surgery procedures: an analysis spanning twelve years.","authors":"Alain Elian, David Richter, Mussa Ibrahim, Rami Madani, Desmond Zeng, Saad Shebrain","doi":"10.1016/j.soard.2026.08.018","DOIUrl":"https://doi.org/10.1016/j.soard.2026.08.018","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic sleeve gastrectomy (LSG) and gastric bypass (LRYGB) are the most commonly performed metabolic and bariatric surgery (MBS) procedures, while laparoscopic biliopancreatic diversion with duodenal switch (LBPD/DS) remains a less common alternative. We used pairwise propensity score matching (PSM) to compare the short-term outcomes of the 3 procedures.</p><p><strong>Objectives: </strong>This study aimed to compare early postoperative outcomes among patients undergoing LSG, LRYGB, and LBPD/DS. Primary outcomes included 30-day all-cause mortality, serious morbidity, and overall morbidity. Secondary outcomes included readmission, unplanned reoperation, length of hospital stay, and operative time.</p><p><strong>Setting: </strong>A national, multicenter study of patients who underwent MBS at hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP).</p><p><strong>Methods: </strong>Cases of LSG, LRYGB, and LBPD/DS performed between 2005 and 2017 were identified from the ACS-NSQIP database. Pairwise PSM and logistic regression analysis were performed to compare postoperative outcomes within 30 days of surgery.</p><p><strong>Results: </strong>Of the 188,012 patients identified, 6324 were matched (2108 in each group). Compared to LRYGB, LSG was associated with lower odds of serious morbidity (odds ratio [OR] .61, P = .016), reoperation (OR .31, P < .001), and readmission (OR .39, P < .001). In contrast, LBPD/DS was associated with higher odds of serious morbidity (OR 1.76, P < .001), minor morbidity (OR 1.65, P < .001), and readmission (OR 1.37, P = .039).</p><p><strong>Conclusions: </strong>Despite adjusting for baseline characteristics, LBPD/DS remained associated with the highest odds of 30-day complications, whereas LSG demonstrated the most favorable safety profile. Careful patient selection and thorough preoperative optimization are essential for achieving optimal outcomes in patients undergoing MBS.</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":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003265","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: Anastomotic marginal ulceration after conversion of sleeve gastrectomy to Roux-en-Y gastric bypass.","authors":"Abdelrahman Nimeri","doi":"10.1016/j.soard.2026.08.023","DOIUrl":"https://doi.org/10.1016/j.soard.2026.08.023","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":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066855","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":"Management of gastro-gastric fistula after Roux-en-Y gastric bypass: a systematic review and meta-analysis of endoscopic versus surgical outcomes.","authors":"Maryam Hassanesfahani, Dominique Popescu, Mrinalini Alla, Nageswara Mandava, Noman Khan, Darshak Shah","doi":"10.1016/j.soard.2026.08.016","DOIUrl":"https://doi.org/10.1016/j.soard.2026.08.016","url":null,"abstract":"<p><p>Gastro-gastric fistula is an uncommon but clinically significant complication after Roux-en-Y gastric bypass, presenting with weight regain, epigastric pain, bile reflux, or recurrent marginal ulceration. Although multiple endoscopic and surgical techniques have been described, comparative outcome data remain limited. We conducted a systematic review and meta-analysis of studies published between 1990 and 2025 evaluating endoscopic and surgical management of gastro-gastric fistula. Seventy-six studies underwent full-text assessment for eligibility, and 9 studies were eligible for quantitative analysis (5 endoscopic series, n = 127; 4 surgical series, n = 65). Endoscopic therapy achieved durable fistula closure in 29.9% of patients, with a low major adverse event rate (1.6%). Surgical revision demonstrated 100% clinical success, with a 26.2% postoperative complication rate and no procedure-related mortality. Random-effects modeling yielded consistent pooled estimates with low statistical heterogeneity. These findings suggest that endoscopic management offers an excellent safety profile but limited long-term durability, whereas surgical revision was associated with higher rates of durable fistula closure at the cost of higher perioperative morbidity. Given the observational nature of the available evidence, these findings should be interpreted cautiously and should not be considered evidence of definitive treatment superiority. Treatment selection should, therefore, be guided by fistula characteristics, chronicity, and patient risk profile. Standardized reporting and prospective evaluation of emerging endoscopic and hybrid techniques are needed to optimize management strategies.</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":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043150","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}