Surgery for Obesity and Related Diseases最新文献

{"title":"Accuracy of the Metabolic and Bariatric Surgery Accreditation Quality Improvement Program risk/benefit calculator in predicting outcomes of revisional bariatric surgery","authors":"Qais AbuHasan M.D. ,&nbsp;Bogdana Chesnova B.S. ,&nbsp;Diala Sanduka M.D. ,&nbsp;Sara Saeidi M.D. ,&nbsp;Wentao Chang M.D., Ph.D. ,&nbsp;Tarik K. Yuce M.D., M.S. ,&nbsp;Dimitrios Stefanidis M.D., Ph.D.","doi":"10.1016/j.soard.2025.06.019","DOIUrl":"10.1016/j.soard.2025.06.019","url":null,"abstract":"<div><h3>Background</h3><div>The Metabolic and Bariatric Surgery Accreditation Quality Improvement Program (MBSAQIP) risk/benefit calculator is an important tool used to counsel patients and predict postoperative risk and outcomes after bariatric surgery.</div></div><div><h3>Objectives</h3><div>We aimed to assess the accuracy of the calculator in predicting outcomes after revisional bariatric procedures compared with primary procedures.</div></div><div><h3>Setting</h3><div>Single-institution and national data.</div></div><div><h3>Methods</h3><div>Postoperative outcomes (30-day complications and body mass index [BMI] at 6 months and 1 year) of patients undergoing primary and revisional bariatric procedures between 2016 and 2021 were recorded and compared with the predictions of the online calculator. Receiver operating characteristic curves were constructed to assess the predictive utility for binominal outcomes. For BMI, predictive error (predicted – actual BMI) was calculated. We also queried the MBSAQIP participant use files between 2021 and 2022 to examine the calculator use nationally.</div></div><div><h3>Results</h3><div>Out of 1026 patients, 864 (84.2%) had primary, and 162 (15.8%) had revisional bariatric surgery. The area under the curve for any complication, serious complications, surgical site infections (SSIs), and readmissions were .63, .74, .67, and .52 for primary procedures, and .61, .73, .52, and .57 for revisions. The correlation coefficient of predicted and observed 1-year BMI was .74, <em>P</em> &lt; .001 for primary procedures, and .55, <em>P</em> &lt; .001 for revisions. The mean predictive error for 1-year BMI for revisions was higher than that for primary procedures (−3.8 ± 5.2 vs. −.30 ± 4.3, <em>P</em> &lt; .001) with 75% of revisions having a negative predictive error. At the national level, the calculator was used in 18.4% of primary procedures and 16.1% (<em>P</em> &lt; .001) of revisions.</div></div><div><h3>Conclusions</h3><div>The MBSAQIP calculator is being used to counsel patients undergoing primary and revisional bariatric surgery. While calculator predictions for some outcomes are similar between primary and revisional cases, they are inaccurate for SSIs and weight loss outcomes after revisional surgeries. The development of a revision-specific calculator that provides more accurate estimates is recommended.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"21 12","pages":"Pages 1326-1333"},"PeriodicalIF":3.8,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cartoon","authors":"","doi":"10.1016/j.soard.2025.07.004","DOIUrl":"10.1016/j.soard.2025.07.004","url":null,"abstract":"","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"21 10","pages":"Page 1180"},"PeriodicalIF":3.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of reduced retroperitoneal adipose tissue and kidney volume on renal function and blood pressure following metabolic surgery in patients with severe obesity","authors":"Takafumi Iwasaki M.D. ,&nbsp;Akira Sasaki M.D., Ph.D. ,&nbsp;Akira Umemura M.D., Ph.D. ,&nbsp;Yutaka Hasegawa M.D., Ph.D. ,&nbsp;Yasushi Ishigaki M.D., Ph.D. ,&nbsp;Koichi Asahi M.D., Ph.D.","doi":"10.1016/j.soard.2025.07.011","DOIUrl":"10.1016/j.soard.2025.07.011","url":null,"abstract":"<div><h3>Background</h3><div>Patients with severe obesity have glomerular hyperfiltration even without the overt renal dysfunction, but improvements are reported with metabolic surgery (MS). However, the mechanism underlying these effects of MS has not been investigated.</div></div><div><h3>Objective</h3><div>The aim of the present study was to determine whether MS for patients with severe obesity alters retroperitoneal adipose tissue (RAT) and kidney volume (KV), and whether these alterations lead to improvements in renal function and hypertension (HTN).</div></div><div><h3>Setting</h3><div>University hospital, Japan.</div></div><div><h3>Methods</h3><div>This single-center study included 80 patients with severe obesity who underwent laparoscopic sleeve gastrectomy (LSG). RAT, KV, body weight, and metabolic-related parameters were evaluated using computed tomography volumetry preoperatively and 1 year after LSG and correlations were analyzed.</div></div><div><h3>Results</h3><div>All patients were seen as per protocol. RAT (1149.5 vs 734.5 mL) and KV (right 218.5 vs 201 mL, left 220 vs 206.5 mL) were significantly decreased at 1 year after LSG. Significant reductions were observed in the personalized estimated glomerular filtration rate (103.5 vs 93.7 mL/min), standard estimated creatinine clearance (eCrCl) (157.2 vs 134.8 mL/min/1.73 m²), and personalized eCrCl (200.4 vs 153.4 mL/min/1.73 m²) (all <em>P</em> &lt; .001). The degree of change in RAT was correlated with the degree of change in the personalized eCrCl (ρ = .219, <em>P</em> = .005). The rate of change in KV was correlated with the rate of change in the standard/personalized eCrCl (ρ = .232, <em>P</em> = .043, ρ = .232, <em>P</em> = .043).</div></div><div><h3>Conclusion</h3><div>LSG reduced body weight in patients with severe obesity and reduction of glomerular hyperfiltration and HTN correlating with RAT and KV reduction.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"21 11","pages":"Pages 1210-1218"},"PeriodicalIF":3.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of racial disparities between adolescents and adults undergoing bariatric surgery: analysis from the MBSAQIP database","authors":"Allison Frederick M.D. ,&nbsp;Georgia Lydon M.D. ,&nbsp;Aaron P. Lesher M.D., M.S.C.R. ,&nbsp;Mary K. Bryant M.D., M.S.C.R.","doi":"10.1016/j.soard.2025.07.008","DOIUrl":"10.1016/j.soard.2025.07.008","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic surgery has emerged as a safe and efficacious treatment for adolescents and adults with obesity, although racial disparities exist in the bariatric population.</div></div><div><h3>Objectives</h3><div>This study analyzed patient characteristics and perioperative outcomes to determine if racial disparities differ across age groups in Black and White bariatric patients.</div></div><div><h3>Setting</h3><div>U.S. Metabolic and Bariatric Surgery Accreditation and Quality Initiative Program (MBSAQIP) data file.</div></div><div><h3>Methods</h3><div>Adolescents (≤19 years) and adults (&gt;19 years) who underwent primary metabolic and bariatric surgery (MBS) from 2020–2022 were identified in the MBSAQIP data file. Patient characteristics and 30-day outcomes were compared by race and age group.</div></div><div><h3>Results</h3><div>Two thousand eight hundred twenty-nine adolescents (n = 793, 28% Black) and 434,775 adults (n = 102,973, 23.7% Black) were included. Preoperative median body mass index (BMI) was higher in Black versus White adolescents (48.6 versus 45.4, <em>P</em> &lt; .001) and Black versus White adults (45.3 versus 43.3, <em>P</em> &lt; .001). Co-morbidity burden was similar between Black and White adolescents. Compared to White adults, Black adults had higher rates of diabetes, hypertension, and renal insufficiency, <em>P</em> &lt; .001. Black adolescents (7.1% versus 3.5%) and adults (4.1% versus 3.1%) were less likely to receive perioperative venous thromboembolism (VTE) prophylaxis versus White patients, <em>P</em> &lt; .001. Incidence of postoperative pulmonary embolism (PE) was higher in Black adolescents (.3% versus 0%, <em>P</em> = .02) and adults (.2% versus .09%, <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Disparities exist for Black adolescents and adults undergoing MBS. While most outcomes were not clinically significantly worse in Black patients, ensuring appropriate VTE prophylaxis is an important modifiable target for improving outcomes.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"21 10","pages":"Pages 1160-1167"},"PeriodicalIF":3.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and short-term results of bariatric destination care: experience from a single Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program-accredited center","authors":"Voranaddha Vacharathit M.D. ,&nbsp;Benefsha Mohammad M.D. ,&nbsp;Mark J. Dudash M.D. ,&nbsp;Alexandra M. Falvo M.D. ,&nbsp;David M. Parker M.D. ,&nbsp;Anthony T. Petrick M.D.","doi":"10.1016/j.soard.2025.06.018","DOIUrl":"10.1016/j.soard.2025.06.018","url":null,"abstract":"<div><h3>Background</h3><div>Employers are adopting “destination care” (DC) to manage employee health care costs and assure quality. Providing bariatric surgical care in centers remote from the patient’s home raises legitimate safety and follow-up concerns.</div></div><div><h3>Objectives</h3><div>To evaluate outcomes and complications of patients traveling for an initial bariatric procedure as part of a workplace health care benefit program compared to those locally referred. Secondary outcomes were to describe DC program patient satisfaction, 1-year follow-up, and cost.</div></div><div><h3>Setting</h3><div>Single center, tertiary referral, Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP)-accredited bariatric surgery center, United States.</div></div><div><h3>Methods</h3><div>A retrospective review of a prospectively maintained database was conducted of DC (n = 63) and non-DC patients (n = 632) from December 2016 through July 2018.</div></div><div><h3>Results</h3><div>Sixty-three DC patients had either sleeve gastrectomy (SG) (36.5%; n = 23) or Roux-en-Y gastric bypass (63.5%; n = 40), with a higher ratio of SG procedure selection compared to locals. Despite DC patients being of higher acuity (age, body mass index, comorbidities, number of home medications, higher American Society of Anesthesiologists classification, decreased functional status), there were no statistically significant differences in 30-day complication (4.8% DC vs 8.2% non-DC; <em>P</em> = .464), readmission (4.8% DC vs 4.4% non-DC; <em>P</em> = .755), or mortality (0%). Weight loss was comparable. DC patients reported higher satisfaction. All DC patients had successful video conference follow-up at 6 months and 82.5% (n = 52) at 1 year. Of those that did not, 63% (n = 7) had follow-up data provided by their primary care physicians or followed-up at 2 years.</div></div><div><h3>Conclusions</h3><div>A thoughtfully designed national DC program can be both feasible and effective, offering short-term outcomes comparable to those of locally treated patients in a high-volume, MBSAQIP-accredited bariatric center. However, these findings should be interpreted with caution, as the study was not powered to detect small differences. Moreover, the short follow-up period and single-institution design may limit the generalizability of the results. Successful implementation of such a program requires close coordination among providers, patients, and payers.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"21 11","pages":"Pages 1276-1285"},"PeriodicalIF":3.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of inferior vena cava filter placement with perioperative outcomes after bariatric surgery: a contemporary analysis of 721,161 patients","authors":"Armaun D. Rouhi B.A. ,&nbsp;Sebastian Leon M.D. ,&nbsp;Juan E. Perez M.D. ,&nbsp;Colleen M. Tewksbury Ph.D., R.D. ,&nbsp;Victoria M. Gershuni M.D., M.S.G.M., M.S.T.R. ,&nbsp;Maria S. Altieri M.D., M.S. ,&nbsp;Noel N. Williams M.D. ,&nbsp;Kristoffel R. Dumon M.D.","doi":"10.1016/j.soard.2025.07.009","DOIUrl":"10.1016/j.soard.2025.07.009","url":null,"abstract":"<div><h3>Background</h3><div>Inferior vena cava filters (IVCFs) are utilized to mitigate the incidence of thromboembolic complications after bariatric surgery.</div></div><div><h3>Objectives</h3><div>This study compared 30-day outcomes between patients with and without IVCFs present at the time of sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB).</div></div><div><h3>Setting</h3><div>Patients reported to the 2018-2021 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database.</div></div><div><h3>Methods</h3><div>Adults undergoing primary SG or RYGB, with and without IVCFs present (SG-IVCF and SG-only or RYGB-IVCF and RYGB-only, respectively), were identified. Baseline characteristics by IVCF status for each procedure were adjusted using entropy balancing. Multivariable weighted logistic and linear regressions were subsequently developed to evaluate the independent association between the presence of IVCF at the time of bariatric surgery and outcomes of interest.</div></div><div><h3>Results</h3><div>Of 721,161 patients included, 71.9% (n = 518,454) underwent SG and 28.1% (n = 202,707) underwent RYGB, of which .3% (n = 1471) and .3% (n = 643) had IVCFs present, respectively. Compared to SG-only and RYGB-only, SG-IVCF and RYGB-IVCF had higher unadjusted 30-day rates of deep vein thrombosis, while only RYGB-IVCF had higher rates of pulmonary embolism (PE). After multivariate adjustment, SG-IVCF was associated with significantly higher odds of unplanned intensive care unit admission, reoperation, and ED visit, but lower odds of PE. RYGB-IVCF demonstrated higher odds of reoperation but no association with PE. Both SG-IVCF and RYGB-IVCF were linked to a lower likelihood of mortality.</div></div><div><h3>Conclusions</h3><div>While IVCFs may associate with distinct outcomes by procedure, this study did not indicate a clear protective effect, instead demonstrating an association with greater postoperative morbidity after risk adjustment.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"21 11","pages":"Pages 1232-1240"},"PeriodicalIF":3.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical, nutritional, and behavioral characteristics of patients experiencing weight regain following sleeve gastrectomy","authors":"Yafit Kessler ,&nbsp;Gal Churi ,&nbsp;Mona Boaz ,&nbsp;Limor Mardi-Tilbor ,&nbsp;Asnat Raziel ,&nbsp;Nasser Sakran ,&nbsp;Shiri Sherf-Dagan","doi":"10.1016/j.soard.2025.07.016","DOIUrl":"10.1016/j.soard.2025.07.016","url":null,"abstract":"<div><h3>Background</h3><div>Weight regain (WR) following sleeve gastrectomy is linked to recurring health complications, warranting focused attention. Characterizing patients with WR while focusing on eating and lifestyle behaviors may help design future interventions.</div></div><div><h3>Objective</h3><div>This study aimed to assess medical, nutritional, and behavioral characteristics of patients who experienced WR of ≥10% from nadir weight following primary SG, and to explore gender differences.</div></div><div><h3>Setting</h3><div>Medical center.</div></div><div><h3>Methods</h3><div>A cross-sectional data analysis was conducted. Information on anthropometrics, functionality, adherence to behavioral recommendations, dietary intake, and maladaptive eating behaviors were collected.</div></div><div><h3>Results</h3><div>The study included 100 participants, 7.8l ± 2.8 years post-SG, 76% women, with a mean age of 49.8l ± 11.6 years, body mass index (BMI) of 33.1l ± 5.4 kg/m² at present, and 25.7l ± 13.4% WR from nadir weight. Up to 65% reported consistently following the eating recommendations. Protein intake targets of ≥60 gr/day, ≥1 gr/kg ideal body weight (IBW), and ≥1.5 gr/kg IBW were met by 74%, 50%, and 11%, respectively. Vitamin D insufficiency (&lt;30 ng/ml) was observed among 82.7%; 57.1% had low blood ferritin levels (&lt;30 ng/ml), 33.8% exhibited low transferrin saturation (&lt;20%), and 25.5% were diagnosed with anemia. Adherence with daily multivitamin, ≥150 minutes of moderate-intensity aerobic activity/week, and 7-9 hours of sleep/night were 33%, 15%, and 35%, respectively. Symptoms of grazing and binge eating were reported by 67% and 32%, respectively. Some gender differences in behavioral adherence, maladaptive eating behaviors, and nutritional deficiencies were noted.</div></div><div><h3>Conclusions</h3><div>Low adherence to eating and behavioral recommendations, nutritional deficiencies, and maladaptive eating behaviors were common among patients who experienced WR following primary SG, with notable gender differences.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"21 11","pages":"Pages 1246-1255"},"PeriodicalIF":3.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving obesity treatment: metabolic and bariatric surgery + body contour surgery","authors":"Esther Ferrero Celemín M.D. ,&nbsp;Carlos Delgado Miguel M.D. ,&nbsp;Patricia Ortega Domene M.D. ,&nbsp;José Daniel Sánchez López Ph. D. ,&nbsp;María Hernández O´Reilly M.D. ,&nbsp;Fátima Sánchez Cabezudo M.D. ,&nbsp;José María Gil López M.D. ,&nbsp;Antonio Luis Picardo Nieto Ph.D.","doi":"10.1016/j.soard.2025.07.010","DOIUrl":"10.1016/j.soard.2025.07.010","url":null,"abstract":"<div><h3>Background</h3><div>Currently, the most effective treatment for obesity is metabolic and bariatric surgery (MBS), but when body contouring surgery (BCS) is added to the treatment, the results in terms of weight loss improve.</div></div><div><h3>Objectives</h3><div>The objective of this study is to demonstrate that BCS achieves a higher percentage of weight loss and that this weight loss is maintained over time. In addition, the suboptimal response to MBS is lower in patients undergoing BCS.</div></div><div><h3>Setting</h3><div>University Hospital, Spain, Public Practice</div></div><div><h3>Methods</h3><div>A retrospective cohort study was performed in a population of patients who underwent MBS in our hospital. The patients were divided into two groups, one with MBS only and the other with MBS + BCS, comparing weights before MBS and at the current time. With a mean follow-up of 69 months.</div></div><div><h3>Results</h3><div>Statistically significant results are obtained in relation to the change in body mass index (BMI) and the current BMI in favor of the MBS + BCS group (<em>P</em> = 0,003 and &lt; 0,001, respectively). That is, BCS improves the outcome of MBS alone. In addition, BCS reduces the rate of suboptimal response to treatment compared to MBS alone (<em>P</em> = 0,001), also with statistically significant results.</div></div><div><h3>Conclusions</h3><div>Patients undergoing MBS who also undergo BCS have a lower BMI and a lower rate of suboptimal treatment response compared to patients who do not undergo BCS. However, patients who undergo BCS do not lose more weight after this technique, they lose weight sooner, and they maintain weight loss after BCS. Therefore, BCS does not appear to promote weight loss, but rather weight maintenance.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"21 11","pages":"Pages 1241-1245"},"PeriodicalIF":3.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleeve to gastric bypass conversion: a multiinstitutional study of 217 patients","authors":"Georges Kaoukabani M.D., M.S. ,&nbsp;Amin Andalib M.D.C.M., M.Sc., F.A.C.S., F.A.S.M.B.S. ,&nbsp;Romulo Lind M.D. ,&nbsp;Ali Safar M.D. ,&nbsp;Abdulaziz Ali M.D. ,&nbsp;Karl Hage M.D. ,&nbsp;Katarzyna Bartosiak M.D. ,&nbsp;Noura Jawhar M.D. ,&nbsp;Muhammad Ghanem M.D. ,&nbsp;Andre F. Teixera M.D. ,&nbsp;Omar M. Ghanem M.D., F.A.C.S.","doi":"10.1016/j.soard.2025.07.013","DOIUrl":"10.1016/j.soard.2025.07.013","url":null,"abstract":"<div><h3>Background</h3><div>Revision of a sleeve gastrectomy (SG) to a Roux-en-Y gastric bypass (RYGB) is indicated for gastroesophageal reflux disease (GERD) and for weight recurrence. Existing literature is conflicting and lacks long-term follow-up.</div></div><div><h3>Objectives</h3><div>To evaluate the resolution of GERD and additional weight loss after conversion of SG to RYGB.</div></div><div><h3>Setting</h3><div>Retrospective study of prospectively maintained multicentric bariatric surgery data sets.</div></div><div><h3>Methods</h3><div>Patients who underwent a conversion from SG to RYGB were divided in two groups based on the indication (GERD versus weight). Outcomes included total weight loss (TWL), GERD symptoms resolution, nutritional parameters, and postoperative complications such as reoperations and readmissions. The outcomes were compared between both groups.</div></div><div><h3>Results</h3><div>One hundred twenty-four patients with GERD versus 93 weight patients were included in the study. At the time of the revision, the weight group had a significantly higher body mass index (BMI) (42.3 ± 5.5 versus 34.7 ± 6.6kg/m², <em>P</em> &lt; .0001). Both groups achieved comparable TWL following the revision (GERD:13 ± 8% versus weight 16 ± 7%, <em>P</em> = .529; 23/93 lost to follow-up in the weight group). At the 1-year follow-up, more than 75% of the patients had their GERD symptoms resolved (18/124 lost to follow-up). For postoperative outcomes, immediate postoperative complications were comparable between both groups (<em>P</em> = .754). Over an average follow-up period of 4 years following the revision, patients with GERD had more late reoperations (GERD: 14% versus weight: 4%, <em>P</em> = .016).</div></div><div><h3>Conclusions</h3><div>SG-to-RYGB conversion for GERD or weight recurrence helped achieve resolution of GERD symptoms as well as additional weight loss. GERD patients suffered from worse clinical outcomes following a revision RYGB in comparison to the weight recurrence patients.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"21 11","pages":"Pages 1190-1196"},"PeriodicalIF":3.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards a better mouse model of vertical sleeve gastrectomy","authors":"Neil B. Blok M.D., Ph.D. ,&nbsp;Simon S. Evers Ph.D. ,&nbsp;Alfor G. Lewis Ph.D. ,&nbsp;Mouhamadoul H. Toure D.V.M. ,&nbsp;Nadejda Bozadjieva-Kramer Ph.D. ,&nbsp;Randy J. Seeley Ph.D. ,&nbsp;Andriy Myronovych M.D., Ph.D.","doi":"10.1016/j.soard.2025.06.017","DOIUrl":"10.1016/j.soard.2025.06.017","url":null,"abstract":"<div><h3>Background</h3><div>The gold standard for treatment of obesity remains bariatric surgery. The mechanisms underlying the effectiveness of these operations remain incompletely understood. Rodent models of these surgeries have proven essential to efforts to elucidate these mechanisms. The most commonly used such model is the mouse vertical sleeve gastrectomy (VSG).</div></div><div><h3>Objective</h3><div>This study aimed to evaluate technical approaches and complications of mouse VSG.</div></div><div><h3>Setting</h3><div>Academic research laboratory, United States.</div></div><div><h3>Methods</h3><div>Wild-type male mice were subjected to variations of VSG. Important metabolic outcomes, including body weight, body composition, and glucose tolerance, were assessed at relevant time points postoperation. A necropsy was performed on all mice at 2 months postsurgery to evaluate the gastric sleeve for any complications.</div></div><div><h3>Results</h3><div>Chronic, contained gastric leak is a relatively high-frequency complication after mouse VSG. A scoring system was developed to quantify and sort mice with leaks. Data from mouse cohorts performed by different methods demonstrate that no surgical approach used in the study could prevent the risk of leak. It shows that significant leaks impact commonly measured metabolic parameters after VSG, likely secondary to the effects of chronic local and systemic inflammation.</div></div><div><h3>Conclusions</h3><div>The presence of chronic gastric leak is common after mouse VSG. The effects of these leaks are likely to confound data analysis when using this surgical model. The use of the scoring and sorting approach developed and described in this study provides an important tool for quality control of murine VSG studies. Careful elimination of mice with this complication enables the effective and reliable use of this surgical model.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"21 11","pages":"Pages 1198-1209"},"PeriodicalIF":3.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}