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Pazouki A, Shahabi S, Yarigholi F, Fathi M. Previous Body-Contouring Surgery Before Metabolic and Bariatric Surgery: Does It Matter? Obes Surg 2023; 33:4168-4169. [PMID: 37833488 DOI: 10.1007/s11695-023-06873-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 09/26/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023]
Affiliation(s)
- Abdolreza Pazouki
- Minimally Invasive Surgery Research Center, Center of Excellence for Minimally Invasive Surgery Training, Iran University of Medical Sciences, Mansouri St., Niyayesh Ave., Sattarkhan St., Rasoule-Akram Hospital, Tehran, Iran
| | - Shahab Shahabi
- Minimally Invasive Surgery Research Center, Center of Excellence for Minimally Invasive Surgery Training, Iran University of Medical Sciences, Mansouri St., Niyayesh Ave., Sattarkhan St., Rasoule-Akram Hospital, Tehran, Iran
| | - Fahime Yarigholi
- Minimally Invasive Surgery Research Center, Center of Excellence for Minimally Invasive Surgery Training, Iran University of Medical Sciences, Mansouri St., Niyayesh Ave., Sattarkhan St., Rasoule-Akram Hospital, Tehran, Iran
| | - Mohammad Fathi
- Minimally Invasive Surgery Research Center, Center of Excellence for Minimally Invasive Surgery Training, Iran University of Medical Sciences, Mansouri St., Niyayesh Ave., Sattarkhan St., Rasoule-Akram Hospital, Tehran, Iran.
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Cao L, Liang S, Yu X, Guan B, Yang Q, Ming WK, Chen Y. Change in Mineral Status After Bariatric Surgery: a Meta-analysis. Obes Surg 2023; 33:3907-3931. [PMID: 37872256 DOI: 10.1007/s11695-023-06888-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/03/2023] [Accepted: 10/04/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND The risk of protein and vitamin deficiencies after bariatric surgery has been well studied, but the change in mineral status has not gotten enough attention. This study aimed to perform a meta-analysis regarding the change in mineral levels after bariatric surgery and the prevalence of postoperative mineral deficiency, with subgroup analyses of different surgical procedures, study regions, and follow-up time. METHODS CENTRAL, PubMed, and EMBASE were searched for related articles. Meta-analysis, subgroup analysis, and sensitivity analysis were performed if necessary. RESULTS A total of 107 articles with 47,432 patients were included. The most severe mineral deficiency after bariatric surgery was iron (20.1%), followed by zinc (18.3%), copper (14.4%), chlorine (12.2%), phosphorus (7.5%), and calcium (7.4%). Serum concentrations of potassium, sodium, selenium, manganese, and molybdenum showed no significant change before and after surgery. Subgroup analyses revealed that SG had fewer deficiencies in serum iron, calcium, zinc, magnesium, phosphorus, copper, and selenium than RYGB. OAGB showed a higher incidence of serum iron and zinc deficiencies than RYGB. Studies conducted in different regions also found various mineral statuses after surgery. Studies with follow-up ≥ 5 years had a lower prevalence of zinc, copper, and selenium deficiencies than follow-up < 5 years. CONCLUSION A high deficiency rate of serum iron, zinc, copper, chlorine, phosphorus, and calcium was seen after bariatric surgery. The difference in surgical procedures, study regions, and follow-up time may affect postoperative mineral status; more targeted mineral supplement programs are needed considering these influencing factors.
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Affiliation(s)
- Li Cao
- College of Nursing, Jinan University, Guangzhou, 510632, China
| | - Sihua Liang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Xuefen Yu
- Comprehensive Special Diagnosis Department, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Bingsheng Guan
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
| | - Qiaohong Yang
- College of Nursing, Jinan University, Guangzhou, 510632, China.
| | - Wai-Kit Ming
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, 999077, China.
| | - Yanya Chen
- College of Nursing, Jinan University, Guangzhou, 510632, China.
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, 999077, China.
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Chang YC, Hsu CN, Chong K, Yang PJ, Ser KH, Lee PC, Chen SC, Hsuan CF, Lee YC, Hsu CC, Lee HL, Liao KCW, Hsieh ML, Chuang GT, Yang WS, Chu SL, Li WY, Chuang LM, Lee WJ. Roux-en-Y and One-Anastomosis Gastric Bypass Surgery Are Superior to Sleeve Gastrectomy in Lowering Glucose and Cholesterol Levels Independent of Weight Loss: a Propensity-Score Weighting Analysis. Obes Surg 2023; 33:3035-3050. [PMID: 37612578 DOI: 10.1007/s11695-023-06656-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/17/2023] [Accepted: 05/17/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND The superior effects of gastric bypass surgery in preventing cardiovascular diseases compared with sleeve gastrectomy are well-established. However, whether these effects are independent of weight loss is not known. METHODS In this retrospective cohort study, we compared the change in cardiometabolic risks of 1073 diabetic patients undergoing Roux-en-Y gastric bypass (RYGB) (n = 265), one-anastomosis gastric bypass (OAGB) (n = 619), and sleeve gastrectomy (SG) (n = 189) with equivalent weight loss from the Min-Shen General Hospital. Propensity score-weighting, multivariate regression, and matching were performed to adjust for baseline differences. RESULTS After 12 months, OAGB and, to a lesser extent, RYGB exhibited superior effects on glycemic control compared with SG in patients with equivalent weight loss. The effect was significant in patients with mild-to-modest BMI reduction but diminished in patients with severe BMI reduction. RYGB and OAGB had significantly greater effects in lowering total and low-density lipoprotein cholesterol than SG, regardless of weight loss. The results of matching patients with equivalent weight loss yielded similar results. The longer length of bypassed biliopancreatic (BP) limbs was correlated with a greater decrease in glycemic levels, insulin resistance index, lipids, C-reactive protein (CRP) levels, and creatinine levels in patients receiving RYBG. It was correlated with greater decreases in BMI, fasting insulin, insulin resistance index, and C-reactive protein levels in patients receiving OAGB. CONCLUSION Diabetic patients receiving OAGB and RYGB had lower glucose and cholesterol levels compared with SG independent of weight loss. Our results suggest diabetic patients with cardiovascular risk factors such as hypercholesterolemia to receive bypass surgery.
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Affiliation(s)
- Yi-Cheng Chang
- Graduate Institute of Medical Genomics and Proteomics, National Taiwan University, Taipei, 100, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, 100, Taiwan
- Institute of Biomedical Sciences, Academia Sinica, Taipei, 115, Taiwan
- Center for Obesity, Lifestyle, and Metabolic Surgery, National Taiwan University Hospital, Taipei, 100, Taiwan
- Graduate Institute of Molecular Medicine, National Taiwan University, Taipei, 100, Taiwan
| | - Chih-Neng Hsu
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, 640, Taiwan
| | - Keong Chong
- Department of Medicine, Min-Sheng General Hospital, Taoyuan, 330, Taiwan
| | - Po-Jen Yang
- Center for Obesity, Lifestyle, and Metabolic Surgery, National Taiwan University Hospital, Taipei, 100, Taiwan
- Department of Surgery, National Taiwan University Hospital, Taipei, 100, Taiwan
- Department of Surgery, College of Medicine, National Taiwan University, Taipei, 100, Taiwan
| | - Kong-Han Ser
- Department of Surgery, Ten-Chen General Hospital, Taoyuan, 326, Taiwan
| | - Po-Chu Lee
- Department of Surgery, National Taiwan University Hospital, Taipei, 100, Taiwan
| | - Shu-Chun Chen
- Department of Nursing, Ming-Sheng General Hospital, Taoyuan, 330, Taiwan
| | - Chin-Feng Hsuan
- Department of Internal Medicine, Division of Cardiology, E-Da Hospital, Kaohsiung, 824, Taiwan
- Department of Internal Medicine, Division of Cardiology, E-Da Dachang Hospital, Kaohsiung, 824, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 840, Taiwan
| | - Yi-Chih Lee
- Department of International Business, Chien Hsin University of Science and Technology, Taoyuan, 320, Taiwan
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, 350, Taiwan
| | - Hsiao-Lin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, 100, Taiwan
| | - Karen Chia-Wen Liao
- Biological Sciences Division, University of Chicago, Chicago, IL, 60637, USA
| | - Meng-Lun Hsieh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, 100, Taiwan
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, 32610, USA
| | - Gwo-Tsann Chuang
- Graduate Institute of Medical Genomics and Proteomics, National Taiwan University, Taipei, 100, Taiwan
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, 100, Taiwan
| | - Wei-Shun Yang
- Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu, 302, Taiwan
| | - Shao-Lun Chu
- Department of Medicine, College of Medicine, National Taiwan University, Taipei, 100, Taiwan
| | - Wen-Yi Li
- Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, 640, Taiwan
| | - Lee-Ming Chuang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, 100, Taiwan.
- Graduate Institute of Molecular Medicine, National Taiwan University, Taipei, 100, Taiwan.
- Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, 100, Taiwan.
| | - Wei-Jei Lee
- Department of Medicine, Min-Sheng General Hospital, Taoyuan, 330, Taiwan.
- Department of Surgery, Min-Sheng General Hospital, Taoyuan, 330, Taiwan.
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Eagleston J, Nimeri A. Optimal Small Bowel Limb Lengths of Roux-en-Y Gastric Bypass. Curr Obes Rep 2023; 12:345-354. [PMID: 37466789 DOI: 10.1007/s13679-023-00513-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/18/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE OF REVIEW Gastric bypass and biliopancreatic diversion (BPD) have come full circle, from a loop configuration to a Roux-en-Y and finally back to a loop configuration as one anastomosis gastric bypass and single-anastomosis duodenal switch. Most surgeons performing Roux-en-Y gastric bypass (RYGB) do not measure the common channel (CC) length and most surgeons performing BPD do not measure the biliopancreatic limb length (BPL). RECENT FINDINGS The small bowel length in humans is variable from as short as < 400 cm to as long as > 1000 cm. The combination of these two facts means that even if surgeons keep the limb lengths constant, surgeons will get variable limb length due to the variability of small bowel length in patients. Hence, outcomes of weight loss, resolution of medical problems, or developing nutritional deficiencies which are related to limb length are variable. In this article, we evaluate the published literature related to the effect of varying the Roux limb, BPL, CC, and total alimentary limb lengths on the outcomes of RYGB. We have focused on historical and current randomized controlled trials as well as systematic reviews and meta-analysis to outline the current literature and our interpretation of this literature.
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Affiliation(s)
- Justin Eagleston
- Bariatric Surgery, Department of Surgery, Atrium Health, Charlotte, USA
| | - Abdelrahman Nimeri
- Wake Forest School of Medicine, Bariatric Surgery, Atrium Health, Charlotte, NC, USA.
- Director, of Bariatric Surgery, Brigham and Womens Hospital, Harvard Medical School, 75 Francis, MA, 02115, Boston, USA.
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Saeidi S, Nooghabi MJ, Jangjoo A, Dalili A. Are the Common Statistics Used in the Bariatric Surgery Always Valid to Be Relied on? Obes Surg 2023:10.1007/s11695-023-06615-1. [PMID: 37093507 DOI: 10.1007/s11695-023-06615-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 03/11/2023] [Accepted: 03/28/2023] [Indexed: 04/25/2023]
Affiliation(s)
- Sara Saeidi
- Minimally Invasive Research Center, Division of Minimally Invasive and Bariatric Surgery, Mashhad University of Medical Sciences, Mashhad, Iran.
| | | | - Ali Jangjoo
- Minimally Invasive Research Center, Division of Minimally Invasive and Bariatric Surgery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amin Dalili
- Minimally Invasive Research Center, Division of Minimally Invasive and Bariatric Surgery, Mashhad University of Medical Sciences, Mashhad, Iran
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