Surgery for Obesity and Related Diseases最新文献

{"title":"Conversion of sleeve gastrectomy to Roux-en-Y laparoscopic gastric bypass: a comprehensive 14-year follow-up study on efficacy and outcomes","authors":"Yulia Petriuk B.Sc. ,&nbsp;Shlomi Rayman M.D. ,&nbsp;Reut El-On M.D. ,&nbsp;Danit Dayan M.D. ,&nbsp;Shai Eldar M.D. ,&nbsp;Adam Abu-Abeid M.D. ,&nbsp;Andrei Keidar M.D.","doi":"10.1016/j.soard.2024.08.021","DOIUrl":"10.1016/j.soard.2024.08.021","url":null,"abstract":"<div><h3>Background</h3><div>Failed sleeve gastrectomy (SG), defined by inadequate weight loss or weight regain and by reflux and structural complications, can be treated by a laparoscopic conversion to Roux-en-Y gastric bypass (RYGB).</div></div><div><h3>Objectives</h3><div>To examine the efficacy and outcomes of conversion surgery over a 14-year follow-up period.</div></div><div><h3>Setting</h3><div>Government and private medical centers in university settings.</div></div><div><h3>Methods</h3><div>We conducted a cohort study of 58 patients who underwent conversion of SG to RYGB for 2 indications: invalidating reflux or weight recurrence during 2009–2023. Weight dynamics analysis was performed with 2 references of weight: before SG (with intention to treat) and before conversion.</div></div><div><h3>Results</h3><div>At conversion surgery, the mean weight, body mass index (BMI), percentage of excess weight loss (%EWL), and percentage of total weight loss (%TWL) (calculated with intention to treat, from the weight before SG) were 92.2 ± 25.2 kg, 34.3 ± 8.0 kg/m², 55.2% ± 39.9%, and 22.8% ± 15.2%, respectively. Mean nadir weight, BMI, %EWL, and %TWL after conversion (calculated from the weight before SG) were 71.1 ± 18.4 kg, 26.7 ± 5.5 kg/m², 96.5% ± 30.5%, and 40.2% ± 10.6%, respectively. At follow-up, the mean weight, BMI, %EWL, and %TWL (calculated from the weight before SG) were 80.4 ± 17.7 kg, 29.6 ± 5.4 kg/m², 78.9% ± 26.8%, and 33.3% ± 11.2%, respectively. The mean percentages of %EWLio and %TWLio (calculated from the weight before conversion = EWL from index operation) at nadir were 73.2% ± 92.7% and 20.1% ± 12.2% after conversion, respectively, and decreased to 41.9% ± 94.0% and 13.2% ± 15.2% at last follow-up (mean 6.6 yr), respectively.</div></div><div><h3>Conclusions</h3><div>SG to RYGB conversion provides moderate to low complementary weight loss in the short term. By 3–4 years, there is a clear trend toward weight gain.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 12","pages":"Pages 1279-1287"},"PeriodicalIF":3.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142219341","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":"Preoperative nonalcoholic steatohepatitis and resolution of metabolic comorbidities after bariatric surgery","authors":"Sebastian Storms M.D. ,&nbsp;Grace H. Oberhoff M.D. ,&nbsp;Lena Schooren M.D. ,&nbsp;Andreas Kroh M.D. ,&nbsp;Alexander Koch M.D. ,&nbsp;Karl-Peter Rheinwalt M.D. ,&nbsp;Florian W.R. Vondran M.D. ,&nbsp;Ulf P. Neumann M.D. ,&nbsp;Patrick H. Alizai M.D. ,&nbsp;Sophia M.-T. Schmitz M.D.","doi":"10.1016/j.soard.2024.08.026","DOIUrl":"10.1016/j.soard.2024.08.026","url":null,"abstract":"<div><h3>Background</h3><div>Most patients undergoing bariatric surgery demonstrate elements of the metabolic syndrome (MetS) and can therefore be diagnosed with metabolically unhealthy obesity (MUO). Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) as hepatic manifestations of the MetS occur in many patients with obesity, but their leverage on postoperative improvement to Metabolic Health (MH), defined as absence of any metabolic comorbidity, remains unclear.</div></div><div><h3>Objectives</h3><div>The aim of this study was to assess the influence of liver health status, operative procedure, and sex on postoperative switch from a MUO to an MH phenotype. Secondary objective was weight loss to MH.</div></div><div><h3>Setting</h3><div>University Hospital, Germany.</div></div><div><h3>Methods</h3><div>Patients who underwent either Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) at our obesity surgery center were included in this retrospective study. Liver biopsy was taken and evaluated for presence of NAFLD/NASH. For diagnosis of MH, blood pressure and laboratory values referring to the MetS were assessed preoperatively and at 3, 6, 12, and 24 months’ postoperatively.</div></div><div><h3>Results</h3><div>One hundred thirty-three patients (73% female) with a mean body mass index of 52.0 kg/m² and mean age of 43 years were included in this study. A total of 55.6% underwent RYGB and 44.4% underwent SG. NAFLD was found in 51.1% of patients and NASH in 33.8%. All patients were diagnosed MUO at baseline. Postoperatively, 38.3% patients (n = 51) switched to a MH condition. Mean time to MH was 321 days and mean excess body mass index loss to MH was 63.8%. There were no differences regarding liver health status, operative procedure, or sex.</div></div><div><h3>Conclusions</h3><div>Bariatric surgery can resolve MUO independent of liver health status, operative procedure, and sex. However, patients should be closely monitored to ensure sustainable long-term outcomes following the switch to the MH condition.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 12","pages":"Pages 1288-1296"},"PeriodicalIF":3.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: Safety of gastric bypass with same-day discharge: a propensity score–matched analysis of the Dutch Audit for Treatment of Obesity","authors":"Etienne St-Louis M.D., Ph.D.,&nbsp;Radu Pescarus M.D.","doi":"10.1016/j.soard.2024.08.011","DOIUrl":"10.1016/j.soard.2024.08.011","url":null,"abstract":"","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 12","pages":"Pages 1232-1233"},"PeriodicalIF":3.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147261","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":"Comment on: Beyond race: social vulnerability and access to metabolic and bariatric surgery","authors":"Shaneeta Johnson M.D., M.B.A.,&nbsp;Ryan Hill D.O.,&nbsp;Tuesday Cook M.D.,&nbsp;Larry Hobson M.D.","doi":"10.1016/j.soard.2024.08.009","DOIUrl":"10.1016/j.soard.2024.08.009","url":null,"abstract":"","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 12","pages":"Pages e23-e24"},"PeriodicalIF":3.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142219369","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":"Metabolic disease remission after Roux-en-Y gastric bypass depends on preoperative disease severity: use of a new objective metabolic scoring system","authors":"Annie Wang M.D. ,&nbsp;Victoria Lyo M.D., M.T.M. ,&nbsp;John C. Lew M.S., R.D. ,&nbsp;Tiffany L. Wong B.S. ,&nbsp;Sandra L. Taylor Ph.D. ,&nbsp;Zainab Akinjobi M.Sc. ,&nbsp;Hazem N. Shamseddeen M.D. ,&nbsp;Shushmita M. Ahmed M.D., D.A.B.O.M. ,&nbsp;Mohamed R. Ali M.D., F.A.C.S., F.A.S.M.B.S.","doi":"10.1016/j.soard.2024.08.022","DOIUrl":"10.1016/j.soard.2024.08.022","url":null,"abstract":"<div><h3>Background</h3><div>Severity stratification and longitudinal evaluation of metabolic conditions in response to Roux-en-Y gastric bypass (RYGB) are not standardized. Our Assessment of Obesity-related Metabolic Comorbidities (AOMC) scoring tool combines pharmacotherapy and biochemical data to objectively define type 2 diabetes (T2D), hypertension (HTN), and dyslipidemia (DYS) severity. We previously showed that AOMC more accurately describes disease severity than clinical history alone.</div></div><div><h3>Objectives</h3><div>We aimed to show that AOMC more precisely and reproducibly measures metabolic disease response to RYGB and preoperative disease severity influences remission rates.</div></div><div><h3>Setting</h3><div>University hospital, United States.</div></div><div><h3>Methods</h3><div>AOMC scores for T2D, DYS, and HTN were calculated preoperatively and postoperatively (1-, 2-, and 5-years) for patients who underwent RYGB over 14 years. Generalized linear mixed-effect models were used to evaluate AOMC score trends and remission over time.</div></div><div><h3>Results</h3><div>Of 351 patients, 214, 188, and 303, presented with any T2D, DYS, or HTN respectively. One-year remission rates were: T2D 57.1%, DYS 59.7%, and HTN 29.3%. Over 5 years post-RYGB, remission rates declined for T2D (<em>P</em> &lt; .05) and DYS (<em>P</em> &lt; .05) but remained steady for HTN (<em>P</em> &gt; .05). Remission was associated with preoperative disease severity: those with premetabolic disease had the highest remission rates (i.e., 1-year: pre-T2D 81.4%, pre-DYS 91.4%, pre-HTN 53.5%, all <em>P</em> &lt; .05), while those with most severe scores preoperatively (untreated/uncontrolled) had the lowest remission rates.</div></div><div><h3>Conclusions</h3><div>AOMC allows precise assessment of comorbidity severity and disease-specific postoperative quantification of comorbidity responses and remission rates. These findings can guide preoperative metabolic disease optimization and postoperative metabolic recovery expectations and standardize communication regarding comorbidity severity.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 12","pages":"Pages 1343-1350"},"PeriodicalIF":3.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142219401","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":"Impact of COVID-19 pandemic on adolescents undergoing metabolic bariatric surgery","authors":"Nicholas Schmoke M.D. ,&nbsp;Christopher Nemeh M.D. ,&nbsp;Robert W. Crum M.D. ,&nbsp;Emily C. McManus B.S. ,&nbsp;Alexey Abramov M.D. ,&nbsp;Chunhui Wang M.D., M.P.H. ,&nbsp;Paul Kurlansky M.D. ,&nbsp;Jeffrey Zitsman M.D.","doi":"10.1016/j.soard.2024.07.012","DOIUrl":"10.1016/j.soard.2024.07.012","url":null,"abstract":"<div><h3>Background</h3><div>While the lasting effect of the COVID-19 pandemic continues to unfold, the impact on adolescents undergoing bariatric surgery remains unseen.</div></div><div><h3>Objective</h3><div>We examined the impact of the pandemic on adolescents undergoing metabolic bariatric surgery.</div></div><div><h3>Setting</h3><div>Academic hospital, New York, NY.</div></div><div><h3>Methods</h3><div>A single-institution review of prospectively collected data evaluated adolescents who underwent laparoscopic sleeve gastrectomy between 2010 and 2023, forming two cohorts: pre-COVID (before March 1, 2019) and COVID (after March 1, 2020). Absolute and percent weight loss and body mass index (BMI) change at 6 and 12 months postsurgery were compared between cohorts. Multivariable linear regression models were constructed to estimate the association between weight loss, adjusting for age, gender, ethnicity, and BMI.</div></div><div><h3>Results</h3><div>A total of 358 patients were included: 245 in the pre-COVID cohort and 113 in the COVID cohort. There were no significant differences in baseline characteristics. There were no significant differences between cohorts at 6 months in weight loss (21.6 kg vs. 22.5 kg, <em>P</em> = .43), percent weight loss (18% vs. 18%, <em>P</em> = .63), and BMI change (8.0 vs. 8.4, <em>P</em> = .39) which was maintained at 12 months. In multivariate models, after adjusting for age, gender, ethnicity, and baseline BMI, undergoing surgery during the pandemic was not associated with a difference in weight loss or BMI change at 6 and 12 months postoperatively.</div></div><div><h3>Conclusion</h3><div>Despite the severe societal impact of the COVID-19 pandemic, laparoscopic sleeve gastrectomy remained a durable intervention for adolescent obesity, with no observed differences in weight loss in patients undergoing surgery during the pandemic compared to prepandemic.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 12","pages":"Pages 1329-1333"},"PeriodicalIF":3.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141771517","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":"Comment on: The long-term impact of bariatric surgery on psoriasis symptoms and severity: a prospective observational study","authors":"Hassan Nasser M.D.","doi":"10.1016/j.soard.2024.08.007","DOIUrl":"10.1016/j.soard.2024.08.007","url":null,"abstract":"","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 12","pages":"Page 1215"},"PeriodicalIF":3.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147262","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":"Cost-effectiveness and safety of continuous pulse oximetry for management of undiagnosed obstructive sleep apnea in bariatric surgery: a nationwide cohort study","authors":"Sophie L. van Veldhuisen M.D., Ph.D. ,&nbsp;Willem R. Keusters M.Sc. ,&nbsp;Kim Kuppens M.D. ,&nbsp;Christel A.L. de Raaff M.D., Ph.D. ,&nbsp;Ruben N. van Veen M.D., Ph.D. ,&nbsp;Marinus J. Wiezer M.D., Ph.D. ,&nbsp;Dingeman J. Swank M.D., Ph.D. ,&nbsp;Ahmet Demirkiran M.D., Ph.D. ,&nbsp;Evert-Jan G. Boerma M.D., Ph.D. ,&nbsp;Jan-Willem M. Greve M.D., Ph.D. ,&nbsp;Francois M.H. van Dielen M.D., Ph.D. ,&nbsp;Steve M.M. de Castro M.D., Ph.D. ,&nbsp;Geert W.J. Frederix Ph.D. ,&nbsp;Eric J. Hazebroek M.D., Ph.D.","doi":"10.1016/j.soard.2024.06.009","DOIUrl":"10.1016/j.soard.2024.06.009","url":null,"abstract":"<div><h3>Background</h3><div>Undetected obstructive sleep apnea (OSA) is highly prevalent in patients undergoing bariatric surgery and increases perioperative risks. Screening for OSA using preoperative polygraphy (PG) with subsequent continuous positive airway pressure (CPAP) is costly and time-consuming. Postoperative continuous pulse oximetry (CPOX) is less invasive, and is hypothesized to be a safe and cost-effective alternative.</div></div><div><h3>Objectives</h3><div>This nationwide multicenter prospective observational cohort study compared CPOX monitoring with OSA-screening using PG.</div></div><div><h3>Setting</h3><div>High-volume bariatric centers.</div></div><div><h3>Methods</h3><div>Patients were either postoperatively monitored using CPOX without preoperative OSA-screening, or underwent preoperative PG and CPAP treatment when OSA was diagnosed. Cohort placement was based on local hospital protocols. Cost-effectiveness was analyzed using quality adjusted life years (QALYs) and healthcare costs. Surgical outcomes were also analyzed. Propensity score matching was used in sensitivity analyses.</div></div><div><h3>Results</h3><div>A total of 1390 patients were included. QALYs were similar between groups at baseline and 1-year postoperatively. Postoperative complications, intensive care unit (ICU)-admissions and admissions, particularly OSA-related, did not differ between groups. Mean costs per patient/year in the CPOX group was €3094 versus €3680 in the PG group; mean difference €−586 (95% CI €−933–€−242). Following propensity score matching, 1090 of 1390 included patients remained, and similar findings for cost-effectiveness, complications, and ICU admissions were observed.</div></div><div><h3>Conclusion</h3><div>CPOX monitoring without preoperative OSA-screening was not associated with higher complication or readmission rates compared to PG. CPOX resulted in lower costs from a healthcare perspective and can therefore be considered a cost-effective alternative to routine OSA-screening in patients undergoing bariatric surgery.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 12","pages":"Pages 1244-1252"},"PeriodicalIF":3.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689981","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.2024.10.028","DOIUrl":"10.1016/j.soard.2024.10.028","url":null,"abstract":"","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 12","pages":"Page 1405"},"PeriodicalIF":3.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743412","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":"Response to “banded versus non-banded Roux-en-Y gastric bypass: short, mid, and long-term surgical outcomes—a systematic review and meta-analysis”","authors":"Kayleigh van Dam M.D.,&nbsp;Geert Verkoulen M.D.,&nbsp;Jan Willem Greve M.D., Ph.D.,&nbsp;Evert-Jan Boerma M.D., Ph.D.","doi":"10.1016/j.soard.2024.07.003","DOIUrl":"10.1016/j.soard.2024.07.003","url":null,"abstract":"","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 12","pages":"Pages 1396-1397"},"PeriodicalIF":3.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141771516","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}