Surgery for Obesity and Related Diseases最新文献

英文中文

Surgical management of candy cane syndrome after Roux-en-Y gastric bypass Roux-en-Y胃旁路术后糖手杖综合征的外科治疗。

IF 3.5 3区医学 Q1 SURGERY

Surgery for Obesity and Related Diseases

Pub Date : 2025-01-09 DOI: 10.1016/j.soard.2024.12.019

Hassan Nasser M.D.

引用次数: 0

Comment on: Pregnancy and birth complications among women undergoing bariatric surgery: sleeve gastrectomy versus Roux-en-Y gastric bypass

IF 3.5 3区医学 Q1 SURGERY

Surgery for Obesity and Related Diseases

Pub Date : 2025-01-09 DOI: 10.1016/j.soard.2024.12.020

Yasamin Taghikhan D.O., Victoria Lyo M.D., M.T.M., F.A.C.S.

引用次数: 0

Comments on: Bariatric surgery targeting opioid prescribing: a national model for effectively reducing opioid use after bariatric surgery

IF 3.5 3区医学 Q1 SURGERY

Surgery for Obesity and Related Diseases

Pub Date : 2025-01-09 DOI: 10.1016/j.soard.2024.12.021

Lee Ying M.D., Ph.D., M.S., M.Phil., Saber Ghiassi M.D., M.P.H., F.A.C.S., F.A.S.M.B.S.

引用次数: 0

Comment on: Pregnancy and birth complications among women undergoing bariatric surgery: sleeve gastrectomy versus Roux-en-Y gastric bypass

IF 3.5 3区医学 Q1 SURGERY

Surgery for Obesity and Related Diseases

Pub Date : 2025-01-08 DOI: 10.1016/j.soard.2024.12.018

L. Renee Hilton M.D.

引用次数: 0

Changes in pancreatic steatosis by computed tomography 24 months after sleeve gastrectomy in youth with severe obesity 袖带胃切除术后 24 个月，通过计算机断层扫描观察重度肥胖症青少年胰腺脂肪变性的变化。

IF 3.5 3区医学 Q1 SURGERY

Surgery for Obesity and Related Diseases

Pub Date : 2025-01-01 DOI: 10.1016/j.soard.2024.08.034

Imen Becetti M.D. , Ana Paola Lopez Lopez M.D. , Francesca Galbiati M.D. , Clarissa C. Pedreira M.D. , Meghan Lauze B.S. , Karen Olivar Carreno M.D. , Florian A. Huber M.D. , Olivier Bitoun M.D. , Hang Lee Ph.D. , Brian Carmine M.D. , Vibha Singhal M.D., M.P.H. , Madhusmita Misra M.D., M.P.H. , Miriam A. Bredella M.D., M.B.A.

Background

Pancreatic steatosis has been associated with obesity and the metabolic syndrome. Studies in adults have demonstrated improvement in pancreatic steatosis following sleeve gastrectomy (SG) with concomitant improvement in glucose homeostasis.

Objectives

To examine changes in pancreatic steatosis in youth with severe obesity 24 months following SG.

Setting

Academic hospital system.

Methods

Forty-seven youth (13–24 years) with severe obesity (37 females) were followed for 24 months; 23 had SG and 24 were nonsurgical (NS) controls. Attenuations of the pancreas and spleen were measured using computed tomography (CT) at baseline, 12- and 24-month follow-up. Subjects underwent magnetic resonance imaging (MRI) for subcutaneous and visceral adipose tissue (SAT, VAT), dual energy x-ray absorptiometry (DXA) for body composition, blood sampling for glycated hemoglobin (A1C), and fasting and postprandial insulin and glucose. Linear mixed effects (LMEs) models were used to compare within- and between-group changes over 24 months.

Results

At baseline, SG had higher body mass index (BMI) versus NS (P = .033). Over 24 months, significant reductions were noted in weight, BMI, VAT, SAT, fat mass (FM), and lean mass (LM) in the SG versus NS groups (P ≤ .0001). There was a significant 24-month decrease in pancreatic steatosis in the SG group (P = .006). In the whole group, 24-month reductions in pancreatic steatosis correlated with BMI and FM decreases. No associations were found between pancreatic steatosis and glucose homeostasis parameters.

Conclusions

Pancreatic steatosis measured by CT improved after SG in youth. Further studies are needed to understand the relationship between pancreatic steatosis and glucose homeostasis.

背景：胰腺脂肪变性与肥胖和代谢综合征有关。成人研究表明，袖带胃切除术（SG）后胰腺脂肪变性有所改善，同时葡萄糖稳态也得到改善：目的：研究袖带胃切除术 24 个月后，重度肥胖青少年胰腺脂肪变性的变化：地点：学术医院系统：对 47 名患有严重肥胖症的青少年（13-24 岁）（37 名女性）进行了为期 24 个月的随访；其中 23 人接受了 SG 治疗，24 人为非手术（NS）对照组。在基线、12 个月和 24 个月的随访期间，使用计算机断层扫描（CT）测量了胰腺和脾脏的衰减情况。受试者接受了皮下和内脏脂肪组织（SAT、VAT）的磁共振成像（MRI）、身体成分的双能 X 射线吸收测量（DXA）、糖化血红蛋白（A1C）的血液采样以及空腹和餐后胰岛素和葡萄糖的检测。线性混合效应（LMEs）模型用于比较 24 个月中组内和组间的变化：基线时，SG 的体重指数（BMI）高于 NS（P = .033）。在 24 个月内，SG 组与 NS 组相比，体重、BMI、VAT、SAT、脂肪量（FM）和瘦肉量（LM）均有明显下降（P ≤ .0001）。24 个月后，SG 组的胰腺脂肪变性明显减少（P = .006）。在全组中，胰腺脂肪变性在 24 个月内的减少与 BMI 和 FM 的减少相关。胰腺脂肪变性与糖稳态参数之间没有关联：结论：青少年接受 SG 治疗后，通过 CT 测量的胰腺脂肪变性有所改善。需要进一步研究以了解胰腺脂肪变性与葡萄糖稳态之间的关系。

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引用次数: 0

The relationship of decision regret with quality of life and comfort level in patients undergoing laparoscopic sleeve gastrectomy: a cross-sectional study 腹腔镜袖状胃切除术患者决策后悔与生活质量和舒适度的关系：一项横断面研究。

IF 3.5 3区医学 Q1 SURGERY

Surgery for Obesity and Related Diseases

Pub Date : 2025-01-01 DOI: 10.1016/j.soard.2024.08.030

Tülay Kılınç Ph.D. , Ayşegül Yayla Ph.D. , Zeynep Karaman Özlü Ph.D. , Duygu Balaban M.Sc.

Background

Laparoscopic sleeve gastrectomy (SG) is one of the effective methods of weight loss. It is essential to determine patients' regret and predictive factors to improve their quality of life and comfort. No study has investigated decision regret and affecting factors in patients undergoing SG in Turkey.

Objectives

The study aimed to determine the relationship of decision regret with quality of life and comfort level in patients undergoing SG.

Setting

The research was carried out with patients who had undergone SG in a private hospital in the west of Turkey.

Methods

The research was conducted as a descriptive, correlational, and cross-sectional study. Data were collected between March and May 2023, and the study was completed with 286 patients. Data were collected using the Personal Information Form, Decision Regret Scale (DRS), Quality of Life Following Obesity Surgery Scale (QoL-OS), and Comfort Scale.

Results

Patients’ mean score on the DRS was 5.27 ± 13.41 (0-100), the total mean score on the QoL-OS-Biopsychosocial dimension was 79.57 ± 9.35 (18-90), the mean score on the QoL-OS-Complications dimension was 17.17 ± 4.60 (7-35), and the environmental comfort score average was 8.87 ± 2.23 (0-10). Patients’ decision regret was significantly affected by the QoL-OS-Biopsychosocial Area dimension in the first place (Beta = −.516; P < .001), social comfort in the second place (Beta = −.278; P < .001), postoperative weight gain in the third place (Beta = .221; P < .001), and complication development in the fourth place (Beta = .163; P < .001).

Conclusions

The study revealed that patients’ decision regret levels were very low up to 3 years after surgery and found that low postoperative quality of life and social comfort level, postoperative weight gain, and complications affected decision regret.

背景：腹腔镜袖带胃切除术（SG）是有效的减肥方法之一。为提高患者的生活质量和舒适度，确定患者的后悔程度和预测因素至关重要。在土耳其，还没有研究对接受袖带胃切除术的患者的后悔决定及其影响因素进行调查：该研究旨在确定接受胃肠切除术的患者的决策后悔与生活质量和舒适度之间的关系：研究对象为在土耳其西部一家私立医院接受 SG 手术的患者：研究以描述性、相关性和横断面研究的形式进行。数据收集时间为 2023 年 3 月至 5 月，共有 286 名患者完成了研究。数据收集使用了个人信息表、决定后悔量表（DRS）、肥胖手术后生活质量量表（QoL-OS）和舒适量表：患者在 DRS 上的平均得分为 5.27 ± 13.41（0-100）分，QoL-OS-生物心理社会维度的总平均得分为 79.57 ± 9.35（18-90）分，QoL-OS-并发症维度的平均得分为 17.17 ± 4.60（7-35）分，环境舒适度的平均得分为 8.87 ± 2.23（0-10）分。QoL-OS-Biopsychosocial Area维度对患者决策后悔度的影响明显，排在第一位（Beta = -.516; P < .001），社会舒适度排在第二位（Beta = -.278; P < .001），术后体重增加排在第三位（Beta = .221; P < .001），并发症发展排在第四位（Beta = .163; P < .001）：研究显示，患者在术后3年内的决策后悔程度很低，并发现术后生活质量和社会舒适度低、术后体重增加和并发症影响了决策后悔程度。

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引用次数: 0

A review of brain structural and functional changes using MRI technology in patients who received bariatric surgery 利用核磁共振成像技术回顾减肥手术患者的大脑结构和功能变化。

IF 3.5 3区医学 Q1 SURGERY

Surgery for Obesity and Related Diseases

Pub Date : 2025-01-01 DOI: 10.1016/j.soard.2024.08.036

Hugo Sandoval Ph.D. , Benjamin Clapp M.D. , Laura E. O’Dell Ph.D. , Deborah J. Clegg Ph.D.

According to the World Health Organization, obesity is one of the most significant health issues currently because it increases risk for type 2 diabetes and cancer, heart disease, bone health, reproduction, and quality of living and it impacts approximately 500 million adults worldwide. This review analyzed the existing literature focusing on the effects of Metabolic and bariatric surgeries (MBS), including Roux-en-Y gastric bypass and sleeve gastrectomy on changes in brain function and anatomy using magnetic resonance imaging (MRI) technology. A PubMed search using the key words bariatric surgery and MRI conducted in December 2023 resulted in 544 articles. Our literature review identified 24 studies addressing neuroanatomic, neurophysiological, cognitive, and behavioral changes that occurred at different time intervals after different types of bariatric surgery. Our review of the literature found several reports indicating that MBS reverse neuroanatomic alterations and changes in functional connectivity associated with obesity. There were also reported improvements in cognitive performance, memory, executive function, attention, as well as decreased gustatory brain responses to food cues and resting state measures following bariatric surgery. There were instances of improved neural functioning associated with weight loss, suggesting that some neuroanatomic changes can be reversed following weight loss induced by bariatric surgery. Additionally, there were data suggesting that brain connectivity and metabolic health are improved following a bariatric surgical intervention. Together, the existing literature indicates an overall improvement in brain connectivity and health outcomes following bariatric surgery.

世界卫生组织指出，肥胖是当前最重要的健康问题之一，因为它会增加罹患 2 型糖尿病和癌症、心脏病、骨骼健康、生殖和生活质量的风险，影响着全球约 5 亿成年人。本综述利用磁共振成像（MRI）技术对现有文献进行了分析，重点研究代谢和减肥手术（MBS），包括Roux-en-Y胃旁路术和袖带胃切除术对大脑功能和解剖结构变化的影响。2023 年 12 月，我们在 PubMed 上以减肥手术和 MRI 为关键词进行了搜索，共搜索到 544 篇文章。我们的文献综述确定了 24 项研究，涉及不同类型减肥手术后在不同时间间隔内发生的神经解剖、神经生理学、认知和行为变化。我们的文献综述发现，有几篇报告指出，MBS 可逆转与肥胖相关的神经解剖改变和功能连接变化。还有报告称，减肥手术后，认知能力、记忆力、执行功能、注意力都有所改善，大脑对食物线索的味觉反应和静息状态测量也有所下降。有研究表明，神经功能的改善与体重减轻有关，这表明通过减肥手术减轻体重后，一些神经解剖学的变化是可以逆转的。此外，还有数据表明，在减肥手术干预后，大脑的连接性和新陈代谢健康状况会得到改善。总之，现有文献表明，减肥手术后大脑连通性和健康状况会得到全面改善。

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引用次数: 0

Outcomes of adolescent bariatric surgery: liver disease 青少年减肥手术的结果：肝脏疾病。

IF 3.5 3区医学 Q1 SURGERY

Surgery for Obesity and Related Diseases

Pub Date : 2025-01-01 DOI: 10.1016/j.soard.2024.08.040

Christine Brichta M.D., M.P.H. , Mark Fishbein M.D. , Justin R. Ryder Ph.D.

The prevalence of metabolic dysfunction–associated steatotic liver disease (MASLD) is increasing among children in the United States as pediatric obesity rates continue to rise. As such, metabolic and bariatric surgery (MBS) has become a more recognized option for treatment of obesity and has been recommended by the American Academy of Pediatrics. Although MBS is known to improve many obesity-associated comorbidities, such as hypertension and type 2 diabetes, less is known about its effect as a treatment for MASLD. This article reviewed the impact MBS has on the course of liver disease as measured by histopathology, serum markers, and radiographic imaging, among adolescents with severe obesity. Improvements were seen in alanine transaminase (ALT) liver enzymes, rates of hepatocyte steatosis, and degree of fibrosis on histopathology, and fat content in the liver on computed tomography and magnetic resonance imaging. Greater improvements in ALT were seen in patients with higher baseline values and/or a higher stage of biopsy-confirmed steatohepatitis. Biopsy-proven MASLD and metabolic dysfunction–associated steatohepatitis (MASH) have even been shown to disappear completely, but fibrosis does not completely resolve by 12 months post-MBS. To better understand the outcome of pediatric MASLD following MBS treatment, more longitudinal radiographic data and liver histology in patients with fibrosis would be informative beyond 12 months post-MBS.

随着小儿肥胖率的不断上升，代谢功能障碍相关性脂肪肝（MASLD）在美国儿童中的发病率也在不断增加。因此，代谢和减肥手术（MBS）已成为公认的治疗肥胖症的方法，并被美国儿科学会推荐使用。虽然众所周知代谢与减肥手术可以改善许多与肥胖相关的并发症，如高血压和 2 型糖尿病，但人们对其治疗 MASLD 的效果却知之甚少。这篇文章通过组织病理学、血清标志物和放射影像学测量，回顾了MBS对重度肥胖青少年肝病病程的影响。丙氨酸转氨酶（ALT）肝酶、肝细胞脂肪变性率、组织病理学纤维化程度以及计算机断层扫描和磁共振成像显示的肝脏脂肪含量均有所改善。基线值较高和/或活检证实的脂肪性肝炎阶段较高的患者，ALT 的改善幅度更大。活检证实的 MASLD 和代谢功能障碍相关性脂肪性肝炎（MASH）甚至可以完全消失，但纤维化在 MBS 术后 12 个月内不会完全消退。为了更好地了解小儿MASLD在接受MBS治疗后的结果，在MBS治疗后12个月后，对纤维化患者进行更多的纵向放射学数据和肝脏组织学检查将具有参考价值。

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引用次数: 0

Postoperative pulmonary complications in patients with chronic obstructive pulmonary disease undergoing primary laparoscopic bariatric surgery: an MBSAQIP analysis 接受初级腹腔镜减肥手术的慢性阻塞性肺病患者术后肺部并发症：MBSAQIP分析。

IF 3.5 3区医学 Q1 SURGERY

Surgery for Obesity and Related Diseases

Pub Date : 2025-01-01 DOI: 10.1016/j.soard.2024.08.032

Roberto J. Valera M.D. , Mauricio Sarmiento Cobos M.D. , Francisco X. Franco M.D. , Bakhtawar Mushtaq M.D. , Lisandro Montorfano M.D. , Emanuele Lo Menzo M.D., Ph.D., F.A.C.S., F.A.S.M.B.S. , Samuel Szomstein M.D., F.A.C.S., F.A.S.M.B.S. , Raul J. Rosenthal M.D., F.A.C.S., F.A.S.M.B.S.

Background

Recent research has shown beneficial effects of bariatric surgery (BaS) on the risk of developing acute exacerbations of chronic obstructive pulmonary disease (COPD). However, this patient population may be at increased risk of complications, especially postoperative pulmonary complications (PPC).

Objectives

To analyze the incidence of PPC in patients with COPD undergoing BaS.

Setting

Academic Hospital, United States.

Methods

We performed a retrospective analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database for patients aged ≥18 years undergoing laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass during 2015–2019. The primary outcome of the study was any PPC, defined as a composite variable including postoperative pneumonia, mechanical ventilation >48 hours and unplanned endotracheal intubation. A univariate analysis was performed to compare patients with and without COPD, and a multivariate logistic regression was performed to adjust for confounders. A subgroup analysis was performed to compare endpoints in patients with COPD with or without home oxygen requirements.

Results

A total of 752,722 patients were included in our analysis (laparoscopic sleeve gastrectomy = 73.2%, Roux-en-Y gastric bypass = 26.8%). PPC occurred in 2390 patients, 0.3% without COPD versus 1.3% with COPD (P < .001). Multivariable analysis confirmed that COPD independently increases the risk of PPC (OR = 1.7, CI = 1.4–2.1). Subgroup analysis showed that patients who are oxygen dependent had a much higher risk for PPC (2.4% versus 1.1%, P < .001).

Conclusion

PPC are higher among patients with obesity and concomitant COPD. Oxygen dependency confers an even higher complication rate. The risk and benefits of BaS in this population must be carefully addressed.

背景：最近的研究表明，减肥手术（BaS）对慢性阻塞性肺病（COPD）急性加重的风险有好处。然而，这类患者发生并发症的风险可能会增加，尤其是术后肺部并发症（PPC）：目的：分析接受巴氏手术的慢性阻塞性肺病患者的肺部并发症发生率：地点：美国学术医院：我们对代谢与减肥手术认证和质量改进计划数据库进行了回顾性分析，研究对象为2015-2019年期间接受腹腔镜袖带胃切除术和Roux-en-Y胃旁路术的≥18岁患者。研究的主要结果是任何 PPC，定义为复合变量，包括术后肺炎、机械通气 >48 小时和计划外气管插管。对患有和不患有慢性阻塞性肺病的患者进行了单变量分析比较，并进行了多变量逻辑回归以调整混杂因素。对有或无家庭供氧需求的慢性阻塞性肺病患者的终点进行了亚组分析比较：共有 752 722 名患者纳入我们的分析（腹腔镜袖带胃切除术 = 73.2%，Roux-en-Y 胃旁路术 = 26.8%）。2390名患者发生了PPC，其中无慢性阻塞性肺病的患者占0.3%，而有慢性阻塞性肺病的患者占1.3%（P < .001）。多变量分析证实，慢性阻塞性肺病会单独增加发生 PPC 的风险（OR = 1.7，CI = 1.4-2.1）。亚组分析显示，依赖氧气的患者发生 PPC 的风险更高（2.4% 对 1.1%，P < .001）：结论：肥胖并伴有慢性阻塞性肺病的患者发生 PPC 的风险更高。结论：肥胖并伴有慢性阻塞性肺病的患者发生 PPC 的几率更高，对氧气的依赖会导致更高的并发症发生率。必须仔细考虑在这类人群中使用 BaS 的风险和益处。

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引用次数: 0

Response to “Exploring the persistent questions regarding the long-term influence of bariatric surgery on psoriasis” 回应 "探讨减肥手术对银屑病长期影响的顽固问题"。

IF 3.5 3区医学 Q1 SURGERY

Surgery for Obesity and Related Diseases

Pub Date : 2025-01-01 DOI: 10.1016/j.soard.2024.10.012

Ali Hosseininasab M.D., Hesam Mosavari M.D., Foolad Eghbali M.D.

引用次数: 0

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