Pub Date : 2024-06-15DOI: 10.1016/j.soard.2024.05.019
{"title":"American Society for Metabolic and Bariatric Surgery position statement on describing and coding paraesophageal hernia repair with concurrent bariatric surgery","authors":"","doi":"10.1016/j.soard.2024.05.019","DOIUrl":"10.1016/j.soard.2024.05.019","url":null,"abstract":"","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 9","pages":"Pages 795-797"},"PeriodicalIF":3.5,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141404837","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}
Pub Date : 2024-06-13DOI: 10.1016/j.soard.2024.06.001
{"title":"Comment on: Evaluating the incidence, risk factors, and postoperative complications associated with leaks following duodenal switch procedures: an analysis of the MBSAQIP","authors":"","doi":"10.1016/j.soard.2024.06.001","DOIUrl":"10.1016/j.soard.2024.06.001","url":null,"abstract":"","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 9","pages":"Pages 812-813"},"PeriodicalIF":3.5,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141411342","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}
Pub Date : 2024-06-11DOI: 10.1016/j.soard.2024.05.009
The 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) updated the indications for metabolic and bariatric surgery (MBS), replacing the previous guidelines established by the National Institutes of Health (NIH) over 30 years ago. The evidence supporting these updated guidelines has been strengthened to assist metabolic and bariatric surgeons, nutritionists, and other members of multidisciplinary teams (MDTs), as well as patients. This study aims to assess the level of evidence and the strength of recommendations compared to the previously published criteria.
{"title":"Scientific evidence for the updated guidelines on indications for metabolic and bariatric surgery (IFSO/ASMBS)","authors":"","doi":"10.1016/j.soard.2024.05.009","DOIUrl":"10.1016/j.soard.2024.05.009","url":null,"abstract":"<div><div>The 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) updated the indications for metabolic and bariatric surgery (MBS), replacing the previous guidelines established by the National Institutes of Health (NIH) over 30 years ago. The evidence supporting these updated guidelines has been strengthened to assist metabolic and bariatric surgeons, nutritionists, and other members of multidisciplinary teams (MDTs), as well as patients. This study aims to assess the level of evidence and the strength of recommendations compared to the previously published criteria.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 11","pages":"Pages 991-1025"},"PeriodicalIF":3.5,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141411438","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}
Pub Date : 2024-06-05DOI: 10.1016/j.soard.2024.05.015
Background
Metabolic and bariatric surgery (MBS) is under-accessed by non-White patients, who are disproportionately affected by obesity. We hypothesized that unique barriers experienced by socially vulnerable patients drive disparate MBS utilization.
Objectives
To determine whether socially vulnerable patients experience greater attrition and face more insurance-mandated medical weight management (MWM) requirements.
Setting
Urban, academic center.
Methods
This retrospective cohort study included adults evaluated for MBS in 2018. Social vulnerability was determined using the 2018 Social Vulnerability Index. Outcomes included attrition, or failure to undergo surgery within 1year, and the number and duration of MWM requirements. Multivariable logistic regression and negative binomial regression tested these associations.
Results
In 2018, 339 patients were evaluated for MBS (83% female, 70% Black). The attrition rate was 57%. On adjusted analyses, patients in the highest social vulnerability quartile had double the odds of attrition compared to their least vulnerable counterparts (OR 2.33, 95% CI 1.11-4.92, P = .03). Highly vulnerable patients had double the number (IRR 2.29, 95% CI 1.42-3.72, P = .001) and nearly quadruple the duration (IRR 3.90, 95% CI 1.93-7.86, P < .001) of MWM requirements compared to those with low social vulnerability. Odds of attrition increased by 11% and 20% for each additional MWM visit (OR 1.11, 95% CI 1.02-1.20, P = .02) and month (OR 1.20, 95% CI 1.08-1.33, P = .001), respectively.
Conclusions
Patients with high social vulnerability were less likely to undergo MBS and faced more insurance-mandated preoperative requirements, which independently predicted attrition. Insurance-mandated MWM is inequitable and may contribute to disparate care of patients with severe obesity.
背景非白人患者接受代谢和减肥手术（MBS）的比例偏低，而他们受肥胖症的影响尤为严重。我们假设，社会弱势患者经历的独特障碍导致了不同的 MBS 利用率。目标确定社会弱势患者是否会经历更多的减员，并面临更多保险规定的医疗体重管理（MWM）要求。使用2018年社会脆弱性指数确定社会脆弱性。结果包括自然减员，或 1 年内未能接受手术，以及 MWM 要求的数量和持续时间。多变量逻辑回归和负二项回归测试了这些关联。结果2018年，339名患者接受了MBS评估（83%为女性，70%为黑人）。自然减员率为 57%。经调整分析，社会脆弱性最高的四分位数患者与社会脆弱性最低的四分位数患者相比，减员几率增加了一倍（OR 2.33，95% CI 1.11-4.92，P = .03）。与社会弱势程度低的患者相比，社会弱势程度高的患者所需的 MWM 数量是社会弱势程度低的患者的两倍（IRR 2.29，95% CI 1.42-3.72，P = .001），持续时间几乎是社会弱势程度低的患者的四倍（IRR 3.90，95% CI 1.93-7.86，P <.001）。每增加一次 MWM 访问（OR 1.11，95% CI 1.02-1.20，P = .02）和每增加一个月（OR 1.20，95% CI 1.08-1.33，P = .001），自然减员的几率分别增加 11% 和 20%。保险规定的MWM是不公平的，可能会导致重度肥胖症患者的护理存在差异。
{"title":"Beyond race: social vulnerability and access to metabolic and bariatric surgery","authors":"","doi":"10.1016/j.soard.2024.05.015","DOIUrl":"10.1016/j.soard.2024.05.015","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic and bariatric surgery (MBS) is under-accessed by non-White patients, who are disproportionately affected by obesity. We hypothesized that unique barriers experienced by socially vulnerable patients drive disparate MBS utilization.</div></div><div><h3>Objectives</h3><div>To determine whether socially vulnerable patients experience greater attrition and face more insurance-mandated medical weight management (MWM) requirements.</div></div><div><h3>Setting</h3><div>Urban, academic center.</div></div><div><h3>Methods</h3><div><span>This retrospective cohort study included adults evaluated for MBS in 2018. Social vulnerability was determined using the 2018 Social Vulnerability Index. Outcomes included attrition, or failure to undergo surgery within 1</span> <span>year, and the number and duration of MWM requirements. Multivariable logistic regression and negative binomial regression tested these associations.</span></div></div><div><h3>Results</h3><div>In 2018, 339 patients were evaluated for MBS (83% female, 70% Black). The attrition rate was 57%. On adjusted analyses, patients in the highest social vulnerability quartile had double the odds of attrition compared to their least vulnerable counterparts (OR 2.33, 95% CI 1.11-4.92, <em>P</em> = .03). Highly vulnerable patients had double the number (IRR 2.29, 95% CI 1.42-3.72, <em>P</em> = .001) and nearly quadruple the duration (IRR 3.90, 95% CI 1.93-7.86, <em>P</em> < .001) of MWM requirements compared to those with low social vulnerability. Odds of attrition increased by 11% and 20% for each additional MWM visit (OR 1.11, 95% CI 1.02-1.20, <em>P</em> = .02) and month (OR 1.20, 95% CI 1.08-1.33, <em>P</em> = .001), respectively.</div></div><div><h3>Conclusions</h3><div>Patients with high social vulnerability were less likely to undergo MBS and faced more insurance-mandated preoperative requirements, which independently predicted attrition. Insurance-mandated MWM is inequitable and may contribute to disparate care of patients with severe obesity.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 11","pages":"Pages 1146-1153"},"PeriodicalIF":3.5,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141412219","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}
Pub Date : 2024-06-04DOI: 10.1016/j.soard.2024.05.014
Background
An important quality benchmark after bariatric surgery is 30-day emergency department (ED) visits.
Objectives
We aimed to identify risk factors for ED visits not requiring readmission and thus deemed preventable.
Setting
University Hospital.
Methods
Patients who underwent a minimally invasive sleeve gastrectomy between 2017 and 2022 at a single institution were identified. Among these patients, those who presented to the ED within 30 days after surgery were matched 3:1 to controls. Sociodemographic and clinical variables were collected from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database and the electronic medical record. Univariate conditional logistic regression analysis was performed to determine predictive factors of ED visits.
Results
Overall, 648 patients underwent sleeve gastrectomy, of which 53 (8.2%) presented to the ED within 30 days postoperatively without requiring readmission. Patients who presented to the ED were more likely to be unemployed (42% versus 24%, P = .04) and have government insurance (68% versus 41%, P = .001). Significant risk factors included lower versus upper socioeconomic bracket (odds ratio [OR] 3.6, P = .042), primary care physician (PCP) outside the health system versus within (OR 2.15, P = .032), greater number of PCP visits within the past year (OR 1.27, P < .001), and greater number of postoperative clinic phone calls (OR 2.04, P < .001). The number of ED visits within 1 year before surgery was a significant risk factor, with an OR of 1.44 for each visit (P < .001).
Conclusions
Modifiable and unmodifiable risk factors contribute to ED visits after bariatric surgery. Identifying these risk factors can aid in the development of quality improvement initiatives.
{"title":"Sociodemographic factors leading to preventable emergency department visits after bariatric surgery: a single-institution analysis","authors":"","doi":"10.1016/j.soard.2024.05.014","DOIUrl":"10.1016/j.soard.2024.05.014","url":null,"abstract":"<div><h3>Background</h3><div>An important quality benchmark after bariatric surgery<span> is 30-day emergency department (ED) visits.</span></div></div><div><h3>Objectives</h3><div>We aimed to identify risk factors for ED visits not requiring readmission and thus deemed preventable.</div></div><div><h3>Setting</h3><div>University Hospital.</div></div><div><h3>Methods</h3><div>Patients who underwent a minimally invasive sleeve gastrectomy<span><span> between 2017 and 2022 at a single institution were identified. Among these patients, those who presented to the ED within 30 days after surgery were matched 3:1 to controls. Sociodemographic and clinical variables were collected from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database and the electronic medical record<span>. Univariate conditional logistic regression analysis was performed to determine </span></span>predictive factors of ED visits.</span></div></div><div><h3>Results</h3><div>Overall, 648 patients underwent sleeve gastrectomy, of which 53 (8.2%) presented to the ED within 30 days postoperatively without requiring readmission. Patients who presented to the ED were more likely to be unemployed (42% versus 24%, <em>P</em> = .04) and have government insurance (68% versus 41%, <em>P</em> = .001). Significant risk factors included lower versus upper socioeconomic bracket (odds ratio [OR] 3.6, <em>P</em><span> = .042), primary care<span> physician (PCP) outside the health system versus within (OR 2.15, </span></span><em>P</em> = .032), greater number of PCP visits within the past year (OR 1.27, <em>P</em> < .001), and greater number of postoperative clinic phone calls (OR 2.04, <em>P</em> < .001). The number of ED visits within 1 year before surgery was a significant risk factor, with an OR of 1.44 for each visit (<em>P</em> < .001).</div></div><div><h3>Conclusions</h3><div>Modifiable and unmodifiable risk factors contribute to ED visits after bariatric surgery. Identifying these risk factors can aid in the development of quality improvement initiatives.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 11","pages":"Pages 1130-1138"},"PeriodicalIF":3.5,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141414011","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}
Pub Date : 2024-06-04DOI: 10.1016/j.soard.2024.05.016
Background
Obesity and type 2 diabetes mellitus (T2DM) are risk factors for severe COVID-19 infection. Bariatric surgery (BSG) is an effective treatment of obesity through weight loss and may reduce COVID-19 severity.
Objectives
We examined the effect of BSG on COVID-19 outcomes in patients with or at risk of T2DM.
Setting
Electronic health record data from the PaTH Clinical Data Research Network, a partnership of 5 health systems reviewed from March 1, 2020, to December 31, 2020.
Methods
Ambulatory and in-hospital patient encounters with COVID-19 diagnosis and obesity were identified. We constructed 2 patient groups: BSG and non-BSG (NBSG). The BSG group included patients with at least 1 encounter for the BSG procedure code and/or 1 BSG diagnosis code; the NBSG group included patients with no procedure or diagnosis code for BSG with body mass index (BMI) ≥40 or BMI ≥35 and at least 2 obesity-related co-morbidities. We matched 1 patient in the BSG group to 2 patients in the NBSG group based on age, gender (sex defined at birth), race and ethnicity, group (T2DM and at risk of T2DM), and site. The primary outcome was 30-day outcomes of COVID-19 severity.
Results
After matching, we found that patients with BSG had lower odds of respiratory failure (41%) and ventilation/intensive care unit (ICU) admission/death (52%). Patients in the BSG group had lower odds of hospitalization, pneumonia, respiratory failure, and the most severe COVID-19 outcomes combined (ventilation/ICU admission/death). T2DM was identified as a risk factor for COVID-19 severity in the BSG group.
Conclusions
This retrospective, matched-cohort analysis found BSG to have a protective effect against severe COVID-19 outcomes.
{"title":"Bariatric surgery and COVID-19 outcomes: results from the PaTH to Health: Diabetes study","authors":"","doi":"10.1016/j.soard.2024.05.016","DOIUrl":"10.1016/j.soard.2024.05.016","url":null,"abstract":"<div><h3>Background</h3><div>Obesity and type 2 diabetes mellitus (T2DM) are risk factors for severe COVID-19 infection. Bariatric surgery (BSG) is an effective treatment of obesity through weight loss and may reduce COVID-19 severity.</div></div><div><h3>Objectives</h3><div>We examined the effect of BSG on COVID-19 outcomes in patients with or at risk of T2DM.</div></div><div><h3>Setting</h3><div>Electronic health record data from the PaTH Clinical Data Research Network, a partnership of 5 health systems reviewed from March 1, 2020, to December 31, 2020.</div></div><div><h3>Methods</h3><div>Ambulatory and in-hospital patient encounters with COVID-19 diagnosis and obesity were identified. We constructed 2 patient groups: BSG and non-BSG (NBSG). The BSG group included patients with at least 1 encounter for the BSG procedure code and/or 1 BSG diagnosis code; the NBSG group included patients with no procedure or diagnosis code for BSG with body mass index (BMI) ≥40 or BMI ≥35 and at least 2 obesity-related co-morbidities. We matched 1 patient in the BSG group to 2 patients in the NBSG group based on age, gender (sex defined at birth), race and ethnicity, group (T2DM and at risk of T2DM), and site. The primary outcome was 30-day outcomes of COVID-19 severity.</div></div><div><h3>Results</h3><div>After matching, we found that patients with BSG had lower odds of respiratory failure (41%) and ventilation/intensive care unit (ICU) admission/death (52%). Patients in the BSG group had lower odds of hospitalization, pneumonia, respiratory failure, and the most severe COVID-19 outcomes combined (ventilation/ICU admission/death). T2DM was identified as a risk factor for COVID-19 severity in the BSG group.</div></div><div><h3>Conclusions</h3><div>This retrospective, matched-cohort analysis found BSG to have a protective effect against severe COVID-19 outcomes.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 11","pages":"Pages 1039-1045"},"PeriodicalIF":3.5,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141411266","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}
Pub Date : 2024-06-01DOI: 10.1016/j.soard.2024.04.098
{"title":"A431 Laparoscopic delivery of a novel enterotomy capture device between self-forming magnetic anastomosis in Roux-en-Y gastric bypass (RYGB) patients for the creation of a side-side jejunal-jejunal anastomosis","authors":"","doi":"10.1016/j.soard.2024.04.098","DOIUrl":"https://doi.org/10.1016/j.soard.2024.04.098","url":null,"abstract":"","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 6","pages":"Pages S27-S28"},"PeriodicalIF":3.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141302529","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}
Pub Date : 2024-06-01DOI: 10.1016/j.soard.2024.04.100
{"title":"A386 Impact of Re-sleeve and Common Channel Length on Weight Loss in Conversion of Sleeve Gastrectomy to Biliopancreatic Diversion with Duodenal Switch","authors":"","doi":"10.1016/j.soard.2024.04.100","DOIUrl":"https://doi.org/10.1016/j.soard.2024.04.100","url":null,"abstract":"","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 6","pages":"Page S28"},"PeriodicalIF":3.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141302531","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}
Pub Date : 2024-06-01DOI: 10.1016/j.soard.2024.04.051
{"title":"A258 Roux-en-O creation during robotic 2nd stage Roux-en-Y gastric bypass after open AGB removal: how to prevent it and correct it","authors":"","doi":"10.1016/j.soard.2024.04.051","DOIUrl":"https://doi.org/10.1016/j.soard.2024.04.051","url":null,"abstract":"","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 6","pages":"Page S11"},"PeriodicalIF":3.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141302704","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}
Pub Date : 2024-06-01DOI: 10.1016/j.soard.2024.04.096
{"title":"A030 Identifying the ideal STOP-Bang screening score for obstructive sleep apnea among bariatric surgery patients: resource utilization, healthcare cost, and delays in treatment","authors":"","doi":"10.1016/j.soard.2024.04.096","DOIUrl":"https://doi.org/10.1016/j.soard.2024.04.096","url":null,"abstract":"","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 6","pages":"Page S27"},"PeriodicalIF":3.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141302712","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}
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