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

{"title":"Decreased liver volume after bariatric surgery and its positive impact on liver function tests and lipid profile.","authors":"Mauricio Sarmiento-Cobos, Avraham Adelman, Kyle Murchison, Carlos Rivera, Roberto Valera, Lisandro Montorfano, Luis Felipe Okida, Elliot Wasser, Emanuele Lo Menzo, Samuel Szomstein, Raul J Rosenthal","doi":"10.1016/j.soard.2024.12.015","DOIUrl":"https://doi.org/10.1016/j.soard.2024.12.015","url":null,"abstract":"<p><strong>Background: </strong>Obesity is associated with a higher incidence of fatty liver disease, intrahepatic triglyceride content, and hepatic fibrosis. These abnormalities could progress to severe liver disease.</p><p><strong>Objectives: </strong>To evaluate the effects of bariatric surgery (BaS)-induced weight loss on liver volume, hepatic function tests, and lipid profile.</p><p><strong>Setting: </strong>Academic Hospital, United States.</p><p><strong>Methods: </strong>We conducted a retrospective review of an institutional review board (IRB)-approved database on patients who underwent BaS from 2006 to 2018. To determine changes in liver volume, we reviewed abdominal computed tomography scans before BaS (Group 1) and up to 18 months after (Group 2). Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and lipid profiles were collected before and after BaS.</p><p><strong>Results: </strong>Seventy-three patients met the inclusion criteria. Patients were predominantly females 78.1% (57), with an average age of 51.29+12.54 years. The liver volume was 1870.73 + 638.5 mm³ before and 1555.15 + 464.8 after BaS (P = .004). ALT was 36.9 + 25.3 before versus 23.8 + 19.3 after BaS (P = .024).Triglyceride levels changed from 135.62 + 69.98 before to 97.50 + 47.33 after BaS (P = .009). Low-density lipoprotein decreased from 107.9 + 38.1 to 89.6 + 32.8 (P = .048).</p><p><strong>Conclusions: </strong>BaS-induced weight loss determines significant liver shrinkage by reducing liver volume, and coincides with improvements in hepatic function tests and lipid profile. Our results suggest that BaS might contribute to reduction of the progression of fatty liver disease to fibrosis.</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":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076735","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 \"Comparative survival of sleeve gastrectomy versus Roux-en-Y gastric bypass in adults with obesity: a systematic review and meta-analysis\".","authors":"Shubham Kumar, Ahmad Neyazi, Rachana Mehta, Ranjana Sah","doi":"10.1016/j.soard.2024.12.012","DOIUrl":"https://doi.org/10.1016/j.soard.2024.12.012","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":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928892","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 drivers of gastric sleeve procedures performed using robotic platform.","authors":"Benjamin L Clapp, Shahrukh Chaudry, Helmuth T Billy, Rami Lutfi, S Julie-Ann Lloyd, I-Wen Pan","doi":"10.1016/j.soard.2024.12.008","DOIUrl":"https://doi.org/10.1016/j.soard.2024.12.008","url":null,"abstract":"<p><strong>Background: </strong>Robotic bariatric surgery adoption rates have increased, and the higher costs associated with robotic sleeve gastrectomy (rSG) are a concern.</p><p><strong>Objectives: </strong>To investigate the factors associated with increased costs of rSG.</p><p><strong>Setting: </strong>US hospital database.</p><p><strong>Methods: </strong>Patients who underwent rSG between January 1, 2018 and December 31, 2022 were extracted from PINC AI Healthcare Data. Inpatient total, variable, and fixed costs were converted to 2022 USD. Factors including patients and provider characteristics, types of staplers used (laparoscopic bedside staplers [LBS], other unspecified bedside staplers [OBS], and robotic staplers [RS]) were evaluated. Univariate and bivariate analyses were used to examine baseline balance among groups. Multivariable general linear model was used to identify cost drivers.</p><p><strong>Results: </strong>There were 27,778 patient records, of which 25.6% used LBS, 10.3% used OBS, and 64.1% were RS cases. Increased costs were driven by type of stapler, patients aged 55-64, male, non-White race, non-Medicare insurance, higher comorbidity, and disease severity, and hospitals in West region, rural, more than 500 beds, with the lower hospital and surgeon's volume. After adjusting for other cost drivers, the procedures done by LBS significantly reduced variable costs by $651 ± $86 (mean difference ± standard error) and $564 ± $54 and fixed costs by $1716 ± $62 and $2297 ± $54 compared to OBS and RS. In total, the use of LBS significantly reduced total inpatient costs by $2384 ± $118 and $2692 ± $90 compared to OBS and RS, respectively. Also, LBS had fewer blood transfusions and intensive care unit visits than OBS and RS.</p><p><strong>Conclusions: </strong>RS and OBS were critical cost drivers in patients undergoing rSG compared to major brand bedside staplers.</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":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960828","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":"Gestational diabetes and other maternal and neonatal-associated conditions could improve after bariatric surgery.","authors":"Micaela Milagros Rossi, Franco José Signorini, Ramiro Leandro Veliz, Martín Andrada, Nicolás Zoela, Sofía Ramirez, Federico Moser","doi":"10.1016/j.soard.2024.11.020","DOIUrl":"https://doi.org/10.1016/j.soard.2024.11.020","url":null,"abstract":"<p><strong>Background: </strong>Women represent 40% of patients undergoing bariatric surgery. This highlights the importance of understanding its effects on pregnancy and newborns (NBs).</p><p><strong>Objective: </strong>To compare pregnancy and neonatal outcomes between a group of pregnant women with obesity and those who had prior bariatric surgery.</p><p><strong>Setting: </strong>University Hospital, Argentina; Private Practice.</p><p><strong>Methods: </strong>A retrospective analysis of patients with bariatric surgery before pregnancy (n = 49) and women with obesity (body mass index [BMI] ≥ 30 kg/m2) without previous bariatric surgery (n = 146) was performed. Variables assessed included type of bariatric surgery, age at pregnancy, interval between surgery and conception, maternal weight and BMI at pregnancy onset and end, weight gain during pregnancy, NB weight, gestational age, premature birth, macrosomia, low birth weight, pregnancy-induced hypertension, gestational diabetes mellitus (GDM), anemia, pre-eclampsia, congenital anomalies, fetal deaths, and mode of delivery.</p><p><strong>Results: </strong>BMI at the start and end of pregnancy was lower in the postbariatric group compared to the group with obesity (P < .001). Weight gain during pregnancy was greater in the postbariatric group compared to the group with obesity (P < .001). The weight of NBs was lower in the postbariatric group compared to the group with obesity (P < .001). The incidence of GDM was lower in the postbariatric group compared to the group with obesity (P < .001). Other variables did not show significant differences between the 2 groups.</p><p><strong>Conclusion: </strong>Pregnant women with obesity have high rates of gestational diabetes and neonatal macrosomia compared to those who underwent surgery.</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":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928915","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":"Rare gene variants and weight loss at 10 years after sleeve gastrectomy and gastric bypass - a randomized clinical trial.","authors":"Petra Loid, Sofia Grönroos, Saija Hurme, Paulina Salminen, Outi Mäkitie","doi":"10.1016/j.soard.2024.11.021","DOIUrl":"https://doi.org/10.1016/j.soard.2024.11.021","url":null,"abstract":"<p><strong>Background: </strong>Genetic background of severe obesity is inadequately understood. The effect of genetic factors on weight loss after metabolic bariatric surgery (MBS) has shown inconclusive results.</p><p><strong>Objectives: </strong>To determine the prevalence of rare obesity-associated gene variants in a secondary analysis of a randomized clinical trial (RCT) comparing laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) for the treatment of severe obesity and examine their association with long-term weight loss at 10 years.</p><p><strong>Setting: </strong>University Hospital, Finland.</p><p><strong>Methods: </strong>Targeted sequencing panel was used to examine variants in 79 obesity-associated genes and 16p11.2 copy number variants. Weight loss was evaluated by percentage total weight loss (%TWL).</p><p><strong>Results: </strong>Out of 240 patients, 113 patients [mean body mass index 48.4 kg/m², (6.8 standard deviation [SD]) kg/m² and median age 49 (range 26-64) years, LSG n = 60, LRYGB n = 53] were available for this post-hoc study. We identified 7 rare heterozygous likely/suspected pathogenic (LP/SP) variants in SH2B1, PCSK1, DNMT3A, BDNF, and AFF4 in 6 patients (5.3%), 5 heterozygous variants of uncertain significance in PLXNA4, PLXNA2, NRP1, and SEMA3D in 5 patients (4.4%), heterozygous Bardet-Biedl syndrome variants in 3 patients (2.7%), and PCKS1 risk allele p.Asn221Asp in 9 patients (8.0%). The patients with LP/SP variants had earlier age of obesity onset (P = .0089) and higher %TWL (P = .0446) compared with patients without LP/SP variants.</p><p><strong>Conclusions: </strong>There were LP/SP pathogenic variants in 5% of the patients supporting the potential benefits of genetic testing to optimize targeted therapies in the future. Despite deleterious gene defects the long-term MBS outcome can be favorable.</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":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916744","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":"Improved erectile function after bariatric surgery: role of testosterone and other factors-a cohort prospective study.","authors":"Piotr Małczak, Michał Wysocki, Ilona Kawa, Tomasz Wikar, Magdalena Pisarska-Adamczyk, Michał Pędziwiatr, Piotr Major","doi":"10.1016/j.soard.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.soard.2024.12.004","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of obesity has risen dramatically worldwide. Beyond its metabolic implications, obesity profoundly impacts sexual health, particularly in males, with erectile dysfunction (ED) emerging as a prevalent and distressing co-morbidity. Studies show that bariatric surgery alleviates ED. Patients suffering from obesity have lower testosterone levels, which increase after weight loss surgery.</p><p><strong>Objectives: </strong>This study aims to investigate the relationship between ED improvement, weight loss, and hormonal changes after surgery.</p><p><strong>Setting: </strong>University Hospital, Poland.</p><p><strong>Methods: </strong>This prospective study included 108 patients who underwent sleeve gastrectomy from 2022 to 2023. All patients completed a section of International Index of Erectile Function questionnaire before surgery and 1 year postoperatively. Patients with a score <25 were included in the analysis. Linear regression models were created to evaluate the impact of weight loss and hormonal changes on ED remission.</p><p><strong>Results: </strong>Sixty patients with ED underwent analysis. The mean age was 41.9 and mean body mass index was 46.67. The average excess weight loss of the analyzed group was 59%. Significant improvements in erectile functioning were observed postsurgery: 40% of patients experienced full remission, and another 40% showed symptom alleviation. Multiple regression model identified preoperative severity of ED, weight loss, and diabetes as independent factors influencing ED remission Although testosterone levels increased significantly after the surgery, it was not an independent factor. Loss to follow-up was 20%.</p><p><strong>Conclusions: </strong>Bariatric surgery improves erectile function, with weight loss and diabetes mellitus being key factors influencing ED. ED should be considered as an obesity-related co-morbidity similarly as hypertension.</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":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049366","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":"Trends (2017-2022) in adolescent metabolic and bariatric surgery.","authors":"Zachary Ballinger, Jonathan Green, Muriel Cleary, Kaitlyn Wong, Nicole Cherng, Jeremy Aidlen","doi":"10.1016/j.soard.2024.12.003","DOIUrl":"https://doi.org/10.1016/j.soard.2024.12.003","url":null,"abstract":"<p><strong>Background: </strong>Metabolic and Bariatric Surgery (MBS) is often difficult to access for the adolescent population. Eligibility criteria have been recently updated to attempt to remove barriers in accessing this care.</p><p><strong>Objectives: </strong>Analyze recent trends in adolescent MBS in the context of these recent policy changes.</p><p><strong>Setting: </strong>Member programs of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP).</p><p><strong>Methods: </strong>Adolescents age 10-17 who underwent MBS from 2017 to 2022 were identified. Demographic trends and surgical details were analyzed through standard statistical comparison methods, linear regression, and multivariate logistic regression.</p><p><strong>Results: </strong>From 2017-2022, 2229 adolescent patients underwent MBS. These approximately 372 cases per year represent about 15%-20% of the total estimated annual cases in the US. Of these, 69% were female, 59% were white, and mean age was 16.1 years. There were no significant differences in age and sex distributions by year. Body mass index (BMI) at surgery did not vary with age. Fourteen and 15 year olds had the highest rates of diabetes (20% and 21% versus 16% for the overall cohort), whereas sleep apnea was more common in 13-year-old patients (36% versus 22%). Females had lower BMI at surgery (46 versus 49) and higher rates of robotic-assisted surgery (16% versus 11%). Case volume decreased with COVID and rapidly increased thereafter. Sleeve gastrectomy increased in relative prevalence compared to bypass, and robotic-assisted cases are increasing twice as fast as laparoscopic procedures. The overall complication rate was 2.9%, with dehydration being most common. Readmission, reoperation, and reintervention did not vary by year.</p><p><strong>Conclusions: </strong>Despite recent efforts to expand care to younger patients, the majority of pediatric MBS is performed for white, female patients over age 16. Cases have returned to prepandemic levels, with robotic-assisted cases increasing. Complication rates and reoperation rates remain low.</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":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974198","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 population based study of bariatric surgery in Illinois.","authors":"Catherine S Valukas, Joseph Sanchez, Dominic Vitello, Eric P Hungness, Ezra N Teitelbaum, Joe Feinglass","doi":"10.1016/j.soard.2024.11.022","DOIUrl":"10.1016/j.soard.2024.11.022","url":null,"abstract":"<p><strong>Background: </strong>Utilization of metabolic and bariatric surgery has increased significantly over the last 2decades, yet barriers to access remain.</p><p><strong>Objectives: </strong>This study aimed to 1) define rates of metabolic and bariatric surgery utilization for qualifying adults in Illinois and 2) describe patient characteristics associated with undergoing surgery at Illinois hospitals with low metabolic and bariatric surgery volume.</p><p><strong>Setting: </strong>Metabolic and bariatric surgery at all nonfederal Illinois hospitals was included.</p><p><strong>Methods: </strong>Illinois hospital administrative data for 2016-2022 metabolic and bariatric surgery procedures (numerators) and Illinois Behavioral Risk Factor Surveillance System population estimates (denominators) were used to compute metabolic and bariatric surgery rates per estimated 100,000 Illinois residents ages 18-69 who qualified for metabolic and bariatric surgery based on National Institutes of Health Guidelines. Zip code median income was obtained from census data. Multivariable logistic regression was used to identify patient characteristics associated with receiving metabolic and bariatric surgery at low volume hospitals (LVHs), defined as less than 50 annual bariatric procedures.</p><p><strong>Results: </strong>The average annual metabolic and bariatric surgery rate was 702 per 100,000 qualifying Illinois adults. Rates were highest among non-Hispanic Black patients (890/100,000) and lowest for Hispanic patients (396/100,000) and patients from zip codes with median household income <$75,000. Lower median household income was the only characteristic associated with use of LVHs.</p><p><strong>Conclusions: </strong>Metabolic and bariatric surgery procedures almost doubled over the study period in Illinois, increasing the most for non-Hispanic Black and Medicaid patients. However, Hispanic and low-income patients still have rates well below the state average.</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":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974181","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 \"One-anastomosis/mini gastric bypass: have we forgotten the lessons of the past?\"","authors":"S. Chiappetta, M. Kermansaravi","doi":"10.1016/j.soard.2022.05.006","DOIUrl":"https://doi.org/10.1016/j.soard.2022.05.006","url":null,"abstract":"","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76041280","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":"American Society for Metabolic and Bariatric Surgery review on fasting for religious purposes after surgery.","authors":"Lillian Craggs-Dino, M. El Chaar, F. Husain, A. Rogers, A. Lima, M. Sadegh, Jumana Bashiti, Katie Chapmon","doi":"10.1016/j.soard.2022.04.020","DOIUrl":"https://doi.org/10.1016/j.soard.2022.04.020","url":null,"abstract":"","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84896768","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}