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

{"title":"Comment on: Addressing recurrent weight gain after Roux-en-Y gastric bypass: efficacy of a dual surgical approach-short-term results of a single center cohort study.","authors":"Dimitrios Kehagias, Charalampos Lampropoulos, Ioannis Kehagias","doi":"10.1016/j.soard.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.soard.2025.02.007","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":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618093","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":"Addressing recurrent weight gain after Roux-en-Y gastric bypass: efficacy of a dual surgical approach-short-term results of a single-center cohort study.","authors":"Arturo Estrada, Jorge Humberto Rodriguez Quintero, Xavier Pereira, Ya Zhou, Erin Moran-Atkin, Jenny Choi, Diego Camacho","doi":"10.1016/j.soard.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.soard.2025.02.004","url":null,"abstract":"<p><strong>Background: </strong>There is no gold standard for recurrent weight gain following Roux-en-Y gastric bypass (RYGB). Combining jejuno-jejunostomy distalization type 1 (JJD1) and sleeve resection of the gastrojejunostomy and gastric pouch (GJ-P) may be a potential approach for these patients.</p><p><strong>Objectives: </strong>To describe 1-year perioperative and nutritional outcomes of patients who underwent JJD1 with sleeve resection of the GJ-P.</p><p><strong>Setting: </strong>High-volume academic bariatric center of excellence.</p><p><strong>Methods: </strong>Patients with recurrent weight gain after RYGB who underwent JJD1 with sleeve resection of the GJ-P from 2020 to 2022 were included and studied for 1 year postoperatively. During the procedure, we aimed for a total alimentary limb length (TALL) of 350-500 cm, a new common channel (CC) of 200-350 cm, and a gastrojejunostomy <2 cm in diameter.</p><p><strong>Results: </strong>A total of 61 patients underwent this combined revisional procedure. The median preoperative body mass index (BMI) was 42.59 kg/m². The median lengths of the biliopancreatic limb (BPL) before and after distalizatiovn were 50 cm (interquartile range [IQR]: 42.5-75) and 175 cm (IQR: 150-200), respectively. After revision, the median new CC was 270 cm (IQR: 250-300) and the median TALL was 400 cm (interquartile range [IQR]: 362.5-450). The median total small bowel length (TSBL) was 580 cm (IQR 550-640 cm), and the median BPL/TSBL ratio was .32 (IQR .29-.34). At 1, 6, and 12 months, the median BMI of the cohort was reduced to 39.14, 35.55, and 32.9 kg/m², respectively. At 1 year, the total weight loss (%TWL) was 22.18%. Only 3 (n = 3) patients developed major complications at 1 year. After distalization, the resolution of all obesity-related co-morbidities improved, including type 2 diabetes (3.2%), sleep apnea (13.1%), hypertension (HTN) (11.4%), and hyperlipidemia (HLD) (1.6%).</p><p><strong>Conclusions: </strong>The combination of JJD1 and sleeve resection of the GJ-P for RYGB revision was safe and effective, with substantial improvement in weight loss at 1 year.</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":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631144","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":"Evaluation of patients on immunosuppressants undergoing sleeve gastrectomy, Roux-en-Y gastric bypass, and duodenal switch: analysis of 19,414 patients.","authors":"Emily A Grimsley, Melissa A Kendall, Tyler Zander, Paul C Kuo, Salvatore Docimo","doi":"10.1016/j.soard.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.soard.2025.02.001","url":null,"abstract":"<p><strong>Background: </strong>Bariatric surgery is being offered to more medically complex patients, including patients on immunosuppressants, although outcomes after different bariatrics surgeries have not been studied in this population.</p><p><strong>Objectives: </strong>We compared perioperative safety of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and duodenal switch (DS) in patients on immunosuppression.</p><p><strong>Setting: </strong>National sample from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database.</p><p><strong>Methods: </strong>The MBSAQIP database was queried from the years 2015 to 2021 for adult patients on chronic immunosuppression who underwent SG, RYGB, or DS. Revisional, open, endoscopic, or emergency surgeries were excluded, as were patients with an American Society of Anesthesiologists class of 5 and patients without full 30-day follow-up. Propensity-score matching was performed with a 3:3:1 ratio (SG:RYGB:DS) controlling for surgical approach, sex, age, functional status, American Society of Anesthesiologists, body mass index, and comorbidities.</p><p><strong>Results: </strong>There were 19,414 patients on immunosuppression who underwent SG (n = 14,358), RYGB (n = 4864), or DS (n = 192). After propensity-score matching , RYGB and DS had longer LOS (P < .01), greater global 30-day complication (P < .01), and 30-day reoperation rates (P = .048). Compared with SG and RYGB, DS had greater rates of patients requiring mechanical ventilation >48-hour postoperatively (P < .05). Compared with SG, DS had greater rates of renal insufficiency (P = .01), organ space infection (P = .01), unplanned intubation (P < .01), and unplanned intensive care unit admission (P < .01).</p><p><strong>Conclusions: </strong>For patients on immunosuppression, SG carried the lowest complication and reoperation rates, whereas DS had overall complication rates in line with RYGB.</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":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538289","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":"Impact of high-protein bariatric diet on the prevention of postoperative nausea and vomiting.","authors":"Brigitte Anderson, Amrita Iyer, Martina Rama, Abigail M O'Connell, Anna P Torres, Scott H Koeneman, Renee Tholey, Alec Beekley, Francesco Palazzo, Talar Tatarian","doi":"10.1016/j.soard.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.soard.2025.02.002","url":null,"abstract":"<p><strong>Background: </strong>Postoperative nausea and vomiting (PONV) commonly occurs following metabolic/bariatric surgery, contributing to increased health care utilization and length of stay (LOS). Studies have suggested the benefit of protein-predominant meals in suppressing gastric tachyarrhythmia and PONV.</p><p><strong>Objective: </strong>To investigate the impact of a high-protein postoperative liquid diet on PONV and LOS after primary sleeve gastrectomy (SG).</p><p><strong>Setting: </strong>University Hospital, United States.</p><p><strong>Methods: </strong>This prospective randomized trial included adult patients undergoing primary SG. Exclusion criteria were history of bariatric/foregut surgery, chronic nausea/vomiting, HbA1C ≥9, or therapeutic anticoagulation. Patients were randomized 1:1 to receive a clear liquid (control) or high-protein full-liquid diet (intervention) starting 4 hours postoperatively. The primary endpoint was incidence of PONV. Secondary endpoint was increased LOS due to PONV. Pearson's chi squared test for independence compared outcomes between groups on an intention to treat basis.</p><p><strong>Results: </strong>One-hundred and twelve patients were randomized (56 control, 56 intervention). Most patients were female (80.4%). All underwent laparoscopic (72.3%) or robotic (27.7%) SG and 90.2% received inhalational anesthesia. In the intervention arm, 15 patients had zero protein intake due to PONV, 6 had missing data, and 35 had a mean intake of 24.2 grams. There was no observed treatment effect on PONV (78.6% control versus 89.3% intervention; P = .20). Almost 70% of patients were discharged home on postoperative day (POD) 1. Delay in discharge due to PONV was not significant between groups (32.1% control versus 28.6% intervention; P = .84).</p><p><strong>Conclusions: </strong>Early introduction of liquid protein after SG does not improve PONV or LOS.</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":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639953","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":"Sex difference in the safety and efficacy of bariatric procedures: a systematic review and meta-analysis.","authors":"Renata Risi, Giovanni Rossini, Rossella Tozzi, Silvia Pieralice, Lavinia Monte, Davide Masi, Lidia Castagneto-Gissey, Ida Francesca Gallo, Lidia Strigari, Giovanni Casella, Vincenzo Bruni, Silvia Manfrini, Lucio Gnessi, Dario Tuccinardi, Mikiko Watanabe","doi":"10.1016/j.soard.2022.03.022","DOIUrl":"10.1016/j.soard.2022.03.022","url":null,"abstract":"<p><p>With the prevalence of obesity alarmingly increasing, it is of primary interest to identify those factors predicting the success of anti-obesity therapeutic strategies currently adopted in clinical practice, and in particular, those of bariatric procedures showing the greatest success in terms of weight loss and maintenance in both the short and long term. Given sex-related differences in psychosocial status, hormonal homeostasis, and body fat distribution, it is likely that the response to different weight management strategies differs by sex. The objective was to elucidate the effect of sex on different bariatric procedures' efficacy and safety outcomes. Searches of PubMed, Cochrane, and Embase databases were performed, followed by hand-searching of reference lists from all relevant articles. We included all the studies evaluating the effect of bariatric procedures on body mass index loss (BMIL), and/or percentage excess weight loss (%EWL), and/or percentage excess body mass index loss, and/or percentage of responders, and/or short-/long-term complications and co-morbidity resolution, broken down by sex. Twenty-seven studies with a total of 114,919 patients were included. Men were more likely to achieve greater BMIL, consistent with higher male baseline BMI, and women were 2.87 times more likely to be classified as weight responders (95% confidence interval [CI]: 1.90-4.34), as well as to perform better in terms of %EWL (95% CI: .13-.54). Upon subgroup analysis based on bariatric procedure, women were more likely to be successful in terms of %EWL upon bioenteric intragastric balloon (BIB) placement (.72, 95% CI: .42-1.02). There was no sex difference regarding investigated co-morbidity resolution (hypertension, diabetes, and obstructive sleep apnea syndrome) or occurrence of short-term complications, whereas women were more likely to develop long-term complications, with an odds ratio of 1.97 (95% CI: 1.57-2.49). Sex does not have a clear effect on efficacy outcomes of bariatric procedures. Differentiating by procedure, BIB may be more effective in women, although results are discordant based on the weight loss outcome considered. If the short-term postoperative complication rate is similar across both sexes, long-term complications occur more frequently in women. To clarify the real effect of sex on bariatric procedure-derived health benefits, it is crucial to report sex-stratified results in future studies, as well as evaluate body composition changes that go beyond simple body weight reduction.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":"6 1","pages":"983-996"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87653873","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}

{"title":"Long-term results of revisional one-anastomosis gastric bypass.","authors":"S. Carandina, A. Soprani, M. Nedelcu","doi":"10.1016/j.soard.2022.05.004","DOIUrl":"https://doi.org/10.1016/j.soard.2022.05.004","url":null,"abstract":"","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75933042","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":"After weight loss, what skin removal procedure has the most effect using Body Q metrics?","authors":"Matthias M. Aitzetmüller, Laura Raschke, Marie-Luise Klietz, M. Kueckelhaus, T. Hirsch, P. Wiebringhaus, K. Harati","doi":"10.1016/j.soard.2022.04.019","DOIUrl":"https://doi.org/10.1016/j.soard.2022.04.019","url":null,"abstract":"","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76654934","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":"Long-term comparative effectiveness of gastric bypass and sleeve gastrectomy on use of antireflux medication: a difference-in-differences analysis.","authors":"Ryan Howard, Jie Yang, J. Thumma, D. Arterburn, Andrew Ryan, Grace F. Chao, D. Telem, J. Dimick","doi":"10.1016/j.soard.2022.04.016","DOIUrl":"https://doi.org/10.1016/j.soard.2022.04.016","url":null,"abstract":"","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75700143","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}