{"title":"套筒胃切除术前GLP-1受体激动剂的探索性评估：回顾性匹配分析。","authors":"Guillaume Luc, Arnaud Dedieu, Guillaume Canard, Amélie Cesard, Amandine Brunet, Camille Furois, Angèle Leterrier, Barbara Daridon, Lea Mendes, Emilie Brighen, Lucie Fournet, Anaelle David, Ludivine Muzard","doi":"10.1007/s11695-025-08258-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Preoperative treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) before bariatric surgery has not been studied. Therefore, we investigated the impact of neoadjuvant treatment with GLP-1 RAs on weight loss and postoperative outcomes in patients who underwent sleeve gastrectomy for severe obesity.</p><p><strong>Method: </strong>A retrospective single-center study was conducted between January 2022 and December 2023. Patients with morbid obesity who were treated preoperatively with a GLP-1 RA (GLP-1 group) were matched with patients who were not preoperatively treated with a GLP-1 RA (No GLP-1 group) using propensity scores calculated according to age and body mass index (BMI). Between-group differences in demographics, comorbidities, surgical parameters, complications, weight loss, and comorbidity outcomes were analyzed.</p><p><strong>Results: </strong>Fourteen patients were included in the GLP-1 group and matched with 28 controls (1:2 ratio). Preoperative weight loss was significantly greater in the GLP-1 group (7.8 ± 6.8 kg) than in the control group (0.2 ± 4.5 kg), with a mean difference of + 7.54 kg (95% CI: [3.47;11.6], p = 0.001, Cohen's d = 1.41). Mixed-effects ANOVA revealed a significant effect of time, with progressive BMI reduction in both groups (p = 0.019), no main effect of group (p = 0.080), and no group-time interaction (p = 0.972), indicating similar BMI trajectories throughout the perioperative period and no between-group difference at 12 months. Postoperative vomiting occurred in 21.4% of patients in the GLP-1 group versus 0% in the No GLP-1 group (p = 0.031). No significant differences in surgical parameters or the comorbidity resolution rate at one year were found.</p><p><strong>Conclusion: </strong>Neoadjuvant GLP-1 RA treatment increased preoperative weight loss before sleeve gastrectomy, but the benefit was not sustained postoperatively. Preoperative GLP-1 RA use could be considered to optimize surgical preparation, but further data regarding postoperative outcomes and long-term weight benefits are needed.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"4383-4392"},"PeriodicalIF":3.1000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Exploratory Assessment of Preoperative GLP-1 Receptor Agonists Before Sleeve Gastrectomy: A Retrospective Matched Analysis.\",\"authors\":\"Guillaume Luc, Arnaud Dedieu, Guillaume Canard, Amélie Cesard, Amandine Brunet, Camille Furois, Angèle Leterrier, Barbara Daridon, Lea Mendes, Emilie Brighen, Lucie Fournet, Anaelle David, Ludivine Muzard\",\"doi\":\"10.1007/s11695-025-08258-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Preoperative treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) before bariatric surgery has not been studied. Therefore, we investigated the impact of neoadjuvant treatment with GLP-1 RAs on weight loss and postoperative outcomes in patients who underwent sleeve gastrectomy for severe obesity.</p><p><strong>Method: </strong>A retrospective single-center study was conducted between January 2022 and December 2023. Patients with morbid obesity who were treated preoperatively with a GLP-1 RA (GLP-1 group) were matched with patients who were not preoperatively treated with a GLP-1 RA (No GLP-1 group) using propensity scores calculated according to age and body mass index (BMI). Between-group differences in demographics, comorbidities, surgical parameters, complications, weight loss, and comorbidity outcomes were analyzed.</p><p><strong>Results: </strong>Fourteen patients were included in the GLP-1 group and matched with 28 controls (1:2 ratio). Preoperative weight loss was significantly greater in the GLP-1 group (7.8 ± 6.8 kg) than in the control group (0.2 ± 4.5 kg), with a mean difference of + 7.54 kg (95% CI: [3.47;11.6], p = 0.001, Cohen's d = 1.41). Mixed-effects ANOVA revealed a significant effect of time, with progressive BMI reduction in both groups (p = 0.019), no main effect of group (p = 0.080), and no group-time interaction (p = 0.972), indicating similar BMI trajectories throughout the perioperative period and no between-group difference at 12 months. Postoperative vomiting occurred in 21.4% of patients in the GLP-1 group versus 0% in the No GLP-1 group (p = 0.031). No significant differences in surgical parameters or the comorbidity resolution rate at one year were found.</p><p><strong>Conclusion: </strong>Neoadjuvant GLP-1 RA treatment increased preoperative weight loss before sleeve gastrectomy, but the benefit was not sustained postoperatively. Preoperative GLP-1 RA use could be considered to optimize surgical preparation, but further data regarding postoperative outcomes and long-term weight benefits are needed.</p>\",\"PeriodicalId\":19460,\"journal\":{\"name\":\"Obesity Surgery\",\"volume\":\" \",\"pages\":\"4383-4392\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Obesity Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11695-025-08258-w\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/9/10 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Obesity Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11695-025-08258-w","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/10 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
Exploratory Assessment of Preoperative GLP-1 Receptor Agonists Before Sleeve Gastrectomy: A Retrospective Matched Analysis.
Background: Preoperative treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) before bariatric surgery has not been studied. Therefore, we investigated the impact of neoadjuvant treatment with GLP-1 RAs on weight loss and postoperative outcomes in patients who underwent sleeve gastrectomy for severe obesity.
Method: A retrospective single-center study was conducted between January 2022 and December 2023. Patients with morbid obesity who were treated preoperatively with a GLP-1 RA (GLP-1 group) were matched with patients who were not preoperatively treated with a GLP-1 RA (No GLP-1 group) using propensity scores calculated according to age and body mass index (BMI). Between-group differences in demographics, comorbidities, surgical parameters, complications, weight loss, and comorbidity outcomes were analyzed.
Results: Fourteen patients were included in the GLP-1 group and matched with 28 controls (1:2 ratio). Preoperative weight loss was significantly greater in the GLP-1 group (7.8 ± 6.8 kg) than in the control group (0.2 ± 4.5 kg), with a mean difference of + 7.54 kg (95% CI: [3.47;11.6], p = 0.001, Cohen's d = 1.41). Mixed-effects ANOVA revealed a significant effect of time, with progressive BMI reduction in both groups (p = 0.019), no main effect of group (p = 0.080), and no group-time interaction (p = 0.972), indicating similar BMI trajectories throughout the perioperative period and no between-group difference at 12 months. Postoperative vomiting occurred in 21.4% of patients in the GLP-1 group versus 0% in the No GLP-1 group (p = 0.031). No significant differences in surgical parameters or the comorbidity resolution rate at one year were found.
Conclusion: Neoadjuvant GLP-1 RA treatment increased preoperative weight loss before sleeve gastrectomy, but the benefit was not sustained postoperatively. Preoperative GLP-1 RA use could be considered to optimize surgical preparation, but further data regarding postoperative outcomes and long-term weight benefits are needed.
期刊介绍：
Obesity Surgery is the official journal of the International Federation for the Surgery of Obesity and metabolic disorders (IFSO). A journal for bariatric/metabolic surgeons, Obesity Surgery provides an international, interdisciplinary forum for communicating the latest research, surgical and laparoscopic techniques, for treatment of massive obesity and metabolic disorders. Topics covered include original research, clinical reports, current status, guidelines, historical notes, invited commentaries, letters to the editor, medicolegal issues, meeting abstracts, modern surgery/technical innovations, new concepts, reviews, scholarly presentations and opinions.
Obesity Surgery benefits surgeons performing obesity/metabolic surgery, general surgeons and surgical residents, endoscopists, anesthetists, support staff, nurses, dietitians, psychiatrists, psychologists, plastic surgeons, internists including endocrinologists and diabetologists, nutritional scientists, and those dealing with eating disorders.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
