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Demirpolat MT, İslam MM. Development and Validation of the GAASThyriC Model for Predicting Patients with Suboptimal Clinical Response After Laparoscopic Sleeve Gastrectomy and a Practical Calculator: A Retrospective Cohort Study. Surg Laparosc Endosc Percutan Tech 2024:00129689-990000000-00242. [PMID: 38898798 DOI: 10.1097/sle.0000000000001300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND It might not be possible to achieve the desired outcome in every patient following bariatric surgery, even though every patient is thoroughly examined before surgery. This study aimed to develop a regression model based on parameters that affect weight loss success in patients scheduled for laparoscopic sleeve gastrectomy (LSG) and thus preoperatively predict whether the patients will have an optimal clinical response in terms of weight loss at the end of the first year. MATERIALS AND METHODS Between January 2018 and August 2022, patients who underwent LSG were analyzed retrospectively. Age, sex, comorbidities, smoking status, alcohol use status, preoperative weight, preoperative body mass index (BMI), preoperative laboratory data, weight, and total weight loss (TWL)% values at the end of the first year were recorded. At the end of the first year following LSG, patients with TWL% above 20% were defined as having an optimal clinical response in terms of weight loss. This study is designed, conducted, and reported regarding the "transparent reporting of a multivariable prediction model for individual prognosis or diagnosis" (TRIPOD) statement. The final model was used to construct an Excel-based calculator. RESULTS Four hundred thirty-eight patients underwent the sleeve gastrectomy procedure, and 38 of them were excluded from the study because of a lack of 1-year follow-up information, resulting in 400 eligible patients for our study. Age, glucose, thyroid stimulating hormone (TSH), alcohol consumption, systemic immune inflammation index (SII), and tobacco were the independent predictors of optimal clinical response (P<0.001, P<0.001, P<0.001, P=0.011, P=0.039, P=0.045, respectively). The model was called the GAASThyriC score. When the final model was tested in the validation cohort, the AUC was 0.875 (95% CI, 0.742-0.999), the sensitivity was 83.3% (95% CI, 51.6-97.9), specificity was 86.4% (95% CI, 77.4-92.8), negative likelihood ratio was 0.19 (95% CI, 0.05-0.68), and accuracy was 86% (95% CI, 77.6-92.1) when the cutoff value was set to the optimal threshold (logit = 0.8451). CONCLUSION The GAASThyriC score can be used as an effective auxiliary tool to predict the patient population with suboptimal clinical response in terms of TWL% at the end of the first year after LSG.
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Affiliation(s)
| | - Mehmet Muzaffer İslam
- Department of Emergency Medicine, University of Health Sciences, Umraniye Education and Research Hospital, Istanbul, Turkey
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Chen G, Li Z, Wang L, Wuyun Q, Sang Q, Wang J, Wang Z, Tian C, Yu C, Amin B, Zhang N, Fan Q. Analysis of correlation between BMI and TWL% outcome following metabolic and bariatric surgery: a retrospective study using restricted cubic spline. BMC Surg 2024; 24:178. [PMID: 38849774 PMCID: PMC11157919 DOI: 10.1186/s12893-024-02455-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 05/16/2024] [Indexed: 06/09/2024] Open
Abstract
OBJECTIVE This study aimed to examine the correlation between preoperative body mass index (BMI) and adequate percentage of total weight loss (TWL%) outcome and present evidence of tiered treatment for patients with obesity in different preoperative BMI. METHODS We included patients with complete follow-up data who underwent metabolic and bariatric surgery (BMS). We termed optimal clinical response as TWL% >20% at one year following MBS. To investigate dose-response association between preoperative BMI and optimal clinical response, preoperative BMI was analyzed in three ways: (1) as quartiles; (2) per 2.5 kg/m2 units (3) using RCS, with 3 knots as recommended. RESULTS A total of 291 patients with obesity were included in our study. The corresponding quartile odds ratios associated with optimal clinical response and adjusted for potential confounders were 1.00 (reference), 1.434 [95% confidence interval (95%CI) = 0.589-3.495], 4.926 (95%CI = 1.538-15.772), and 2.084 (95%CI = 0.941-1.005), respectively. RCS analysis showed a non-linear inverted U-shaped association between preoperative BMI and optimal clinical response (Nonlinear P = 0.009). In spline analysis, when preoperative BMI was no less than 42.9 kg/m2, the possibility of optimal clinical response raised as preoperative BMI increased. When preoperative BMI was greater than 42.9 kg/m2, the possibility of optimal clinical response had a tendency to decline as preoperative BMI increased. CONCLUSION Our research indicated the non-linear inverted U-shaped correlation between preoperative BMI and adequate weight loss. Setting a preoperative BMI threshold of 42.9 is critical to predicting optimal clinical outcomes.
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Affiliation(s)
- Guanyang Chen
- Department of General Surgery, Peking University Ninth School of Clinical Medicine, Beijing, China
- Department of Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Zhehong Li
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Liang Wang
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Qiqige Wuyun
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Qing Sang
- Department of General Surgery, Peking University Ninth School of Clinical Medicine, Beijing, China
| | - Jing Wang
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Zheng Wang
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Chenxu Tian
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Chengyuan Yu
- Department of General Surgery, Peking University Ninth School of Clinical Medicine, Beijing, China
| | - Buhe Amin
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Nengwei Zhang
- Department of General Surgery, Peking University Ninth School of Clinical Medicine, Beijing, China.
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
| | - Qing Fan
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
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Wong J, Li X, Arterburn DE, Li D, Messenger-Jones E, Wang R, Toh S. Using Claims Data to Predict Pre-Operative BMI Among Bariatric Surgery Patients: Development of the BMI Before Bariatric Surgery Scoring System (B3S3). Pragmat Obs Res 2024; 15:65-78. [PMID: 38559704 PMCID: PMC10981874 DOI: 10.2147/por.s450229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/19/2024] [Indexed: 04/04/2024] Open
Abstract
Background Lack of body mass index (BMI) measurements limits the utility of claims data for bariatric surgery research, but pre-operative BMI may be imputed due to existence of weight-related diagnosis codes and BMI-related reimbursement requirements. We used a machine learning pipeline to create a claims-based scoring system to predict pre-operative BMI, as documented in the electronic health record (EHR), among patients undergoing a new bariatric surgery. Methods Using the Optum Labs Data Warehouse, containing linked de-identified claims and EHR data for commercial or Medicare Advantage enrollees, we identified adults undergoing a new bariatric surgery between January 2011 and June 2018 with a BMI measurement in linked EHR data ≤30 days before the index surgery (n=3226). We constructed predictors from claims data and applied a machine learning pipeline to create a scoring system for pre-operative BMI, the B3S3. We evaluated the B3S3 and a simple linear regression model (benchmark) in test patients whose index surgery occurred concurrent (2011-2017) or prospective (2018) to the training data. Results The machine learning pipeline yielded a final scoring system that included weight-related diagnosis codes, age, and number of days hospitalized and distinct drugs dispensed in the past 6 months. In concurrent test data, the B3S3 had excellent performance (R2 0.862, 95% confidence interval [CI] 0.815-0.898) and calibration. The benchmark algorithm had good performance (R2 0.750, 95% CI 0.686-0.799) and calibration but both aspects were inferior to the B3S3. Findings in prospective test data were similar. Conclusion The B3S3 is an accessible tool that researchers can use with claims data to obtain granular and accurate predicted values of pre-operative BMI, which may enhance confounding control and investigation of effect modification by baseline obesity levels in bariatric surgery studies utilizing claims data.
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Affiliation(s)
- Jenna Wong
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Department of Population Medicine, Harvard Medical School, Boston, MA, USA
- Optum Labs Visiting Fellow, Eden Prairie, MN, USA
| | - Xiaojuan Li
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Department of Population Medicine, Harvard Medical School, Boston, MA, USA
| | - David E Arterburn
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Dongdong Li
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Department of Population Medicine, Harvard Medical School, Boston, MA, USA
| | | | - Rui Wang
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Department of Population Medicine, Harvard Medical School, Boston, MA, USA
| | - Sengwee Toh
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Department of Population Medicine, Harvard Medical School, Boston, MA, USA
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Khattab MH, Said SM, Fayez MA, Elaguizy MM, Mohamed AAA, Ghobashy AM. The Association Between Preoperative Insulin-Like Growth Factor 1 Levels and the Total Body Weight Loss in Women Post Laparoscopic Sleeve Gastrectomy. Obes Surg 2024; 34:874-881. [PMID: 38285303 PMCID: PMC10899394 DOI: 10.1007/s11695-024-07077-9] [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: 12/12/2023] [Revised: 01/21/2024] [Accepted: 01/22/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Despite the well-described optimal initial clinical response of sleeve gastrectomy (SG) in the treatment of obesity, some patients do not achieve optimal initial clinical response. Insulin-like growth factor-1 (IGF-1) has currently shown an association with post-bariatric surgery weight loss. This study aimed to assess the IGF-1 levels in female patients with obesity, the change after surgery, and their association with the metabolic profile and weight loss after surgery. PATIENTS AND METHODS This was a prospective study that was conducted on adult female patients who were recruited for SG. The patients underwent clinical and laboratory investigations that included the IGF-1 measurement. At the 1-year follow-up, the same clinical and laboratory measures were repeated. RESULTS This study included 100 female patients. At the 1-year follow-up, there was a statistically significant reduction in body mass index (BMI) (p < 0.001), fasting HbA1C levels (p < 0.001), and triglycerides (p < 0.001), as well as a statistically significant increase in HDL (p < 0.001) and IGF-1 (p < 0.001). Multiple regression analysis revealed that, among the patients baseline characteristics, the significant predictors for the percentage of total weight loss (%TWL) were the patients' BMI (p < 0.001) and IGF-1 levels (p < 0.001). The ROC curve showed that an IGF1 cutoff value of ≤ 23 ng/ml detected suboptimal initial clinical response, with a sensitivity of 95.35% and a specificity of 100%. CONCLUSION This study underscores the significant impact of SG on weight loss and metabolic improvements in female patients. Baseline IGF-1 levels emerged as a crucial predictor of optimal initial clinical response.
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Affiliation(s)
| | - Sami M Said
- Department of General Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
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Mackenzie RM, Ali A, Bruce D, Bruce J, Ford I, Greenlaw N, Grieve E, Lean M, Lindsay RS, O'Donnell J, Sattar N, Stewart S, Logue J. Clinical outcomes and adverse events of bariatric surgery in adults with severe obesity in Scotland: the SCOTS observational cohort study. Health Technol Assess 2024; 28:1-115. [PMID: 38343107 PMCID: PMC11017628 DOI: 10.3310/unaw6331] [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] [Indexed: 02/15/2024] Open
Abstract
Background Bariatric surgery is a common procedure worldwide for the treatment of severe obesity and associated comorbid conditions but there is a lack of evidence as to medium-term safety and effectiveness outcomes in a United Kingdom setting. Objective To establish the clinical outcomes and adverse events of different bariatric surgical procedures, their impact on quality of life and the effect on comorbidities. Design Prospective observational cohort study. Setting National Health Service secondary care and private practice in Scotland, United Kingdom. Participants Adults (age >16 years) undergoing their first bariatric surgery procedure. Main outcome measures Change in weight, hospital length of stay, readmission and reoperation rate, mortality, diabetes outcomes (HbA1c, medications), quality of life, anxiety, depression. Data sources Patient-reported outcome measures, hospital records, national electronic health records (Scottish Morbidity Record 01, Scottish Care Information Diabetes, National Records Scotland, Prescription Information System). Results Between December 2013 and February 2017, 548 eligible patients were approached and 445 participants were enrolled in the study. Of those, 335 had bariatric surgery and 1 withdrew from the study. Mean age was 46.0 (9.2) years, 74.7% were female and the median body mass index was 46.4 (42.4; 52.0) kg/m2. Weight was available for 128 participants at 3 years: mean change was -19.0% (±14.1) from the operation and -24.2% (±12.8) from the start of the preoperative weight-management programme. One hundred and thirty-nine (41.4%) participants were readmitted to hospital in the same or subsequent 35 months post surgery, 18 (5.4% of the operated cohort) had a reoperation or procedure considered to be related to bariatric surgery gastrointestinal complications or revisions. Fewer than five participants (<2%) died during follow-up. HbA1c was available for 93/182 and diabetes medications for 139/182 participants who had type 2 diabetes prior to surgery; HbA1c mean change was -5.72 (±16.71) (p = 0.001) mmol/mol and 65.5% required no diabetes medications (p < 0.001) at 3 years post surgery. Physical quality of life, available for 101/335 participants, improved in the 3 years post surgery, mean change in Rand 12-item Short Form Survey physical component score 8.32 (±8.95) (p < 0.001); however, there was no change in the prevalence of anxiety or depression. Limitations Due to low numbers of bariatric surgery procedures in Scotland, recruitment was stopped before achieving the intended 2000 participants and follow-up was reduced from 10 years to 3 years. Conclusions Bariatric surgery is a safe and effective treatment for obesity. Patients in Scotland, UK, appear to be older and have higher body mass than international comparators, which may be due to the small number of procedures performed. Future work Intervention studies are required to identify the optimal pre- and post surgery pathway to maximise safety and cost-effectiveness. Study registration This study is registered as ISRCTN47072588. Funding details This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 10/42/02) and is published in full in Health Technology Assessment; Vol. 28, No. 7. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Ruth M Mackenzie
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Abdulmajid Ali
- University Hospital Ayr, NHS Ayrshire and Arran, Ayr, UK
| | | | - Julie Bruce
- Clinical Trials Unit, University of Warwick, Warwick, UK
| | - Ian Ford
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - Nicola Greenlaw
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - Eleanor Grieve
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Mike Lean
- School of Medicine, University of Glasgow, Glasgow, UK
| | - Robert S Lindsay
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Joanne O'Donnell
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Sally Stewart
- Department of Nursing and Community Health, Glasgow Caledonian University, Glasgow, UK
| | - Jennifer Logue
- Lancaster Medical School, Lancaster University, Lancaster, UK
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Li Z, Chen G, Wang L, Wuyun Q, Sang Q, Wang J, Tian C, Shang M, Wang Z, Du D, Zhang N. Analysis of Correlation between Age and Satisfied Total Weight Loss Percentage Outcome at 1 Year after Bariatric Surgery using the Restricted Cubic Spline Function: A Retrospective Study in China. Obes Surg 2023; 33:3133-3140. [PMID: 37624490 DOI: 10.1007/s11695-023-06691-3] [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: 01/24/2023] [Revised: 06/12/2023] [Accepted: 06/16/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVE This study aims to explore the relationship between age and whether the percentage of total weight loss (TWL%) is ≥ 25% or not at 1 year after bariatric surgery (BS). We aimed to provide evidence for the stratified treatment of spatients with obesity at different ages. METHODS The primary outcome evaluated was whether TWL% was no less than 25% at 1 year after BS. A TWL% ≥ 25% was defined as a satisfied TWL% outcome. Logistic regression analysis and the restricted cubic spline (RCS) function were used to analyze the relationship between age and the satisfied TWL% outcome at 1 year after BS. RESULTS Two hundred and ninety-one patients were included in our study. After adjusting for potential confounders, the odds ratios (ORs) of the corresponding quartiles of age associated with satisfied TWL% outcome were 1.00 (reference), 1.117 [95% confidence interval (95% CI) = 0.540-2.311], 1.378 (95% CI = 0.647-2.935), and 0.406 (95% CI = 0.184-0.895). RCS analysis revealed a non-linear inverted L-shaped association between age and satisfied TWL% outcome at 1 year after BS (non-linear P = 0.033). CONCLUSION Age was an independent predictor of satisfied TWL% outcome one year following BS, and our study considered 32 years as a potential cut-off point. For Chinese patients over the age of 32 who are eligible for BS, it may be beneficial to do BS earlier as the probability of achieving a satisfied TWL% outcome may decrease with age.
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Affiliation(s)
- Zhehong Li
- Surgery Centre of Diabetes Mellitus, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Guanyang Chen
- Department of General Surgery, Peking University Ninth School of Clinical Medicine, Beijing, China
| | - Liang Wang
- Surgery Centre of Diabetes Mellitus, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Qiqige Wuyun
- Surgery Centre of Diabetes Mellitus, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Qing Sang
- Department of General Surgery, Peking University Ninth School of Clinical Medicine, Beijing, China
| | - Jing Wang
- Surgery Centre of Diabetes Mellitus, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Chenxu Tian
- Surgery Centre of Diabetes Mellitus, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Mingyue Shang
- Surgery Centre of Diabetes Mellitus, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Zheng Wang
- Surgery Centre of Diabetes Mellitus, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Dexiao Du
- Surgery Centre of Diabetes Mellitus, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
| | - Nengwei Zhang
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
- Department of General Surgery, Peking University Ninth School of Clinical Medicine, Beijing, China.
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Thaher O, Driouch J, Hukauf M, Stroh C. One-stage versus two-stage Roux-Y gastric bypass as redo surgery of failed adjustable gastric banding. Ann R Coll Surg Engl 2023; 105:614-622. [PMID: 36250224 PMCID: PMC10471435 DOI: 10.1308/rcsann.2022.0085] [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] [Accepted: 03/30/2022] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION The study focussed on whether a one-stage Roux-Y gastric bypass (OS-RYGB) or a two-stage RYGB (TS-RYGB) has a significant advantage in terms of perioperative risk in patients after failed adjustable gastric banding (AGB). METHODS Data collection included patients who underwent OS-RYGB or TS-RYGB after AGB between 2005 and 2019 and whose outcomes were compared with those after primary RYGB (P-RYGB). Outcome criteria were perioperative complications, comorbidities, 30-day mortality and operating time. RESULTS The study analysed data from patients who underwent OS-RYGB (N = 525), TS-RYGB (N = 382) and P-RYGB (N = 26,445). Intraoperative and postoperative complication rates were significantly lower for P-RYGB (p < 0.001). Total intraoperative and specific postoperative complication rates were significantly lower in TS-RYGB than in OS-RYGB (p = 0.048 and p < 0.001, respectively). In contrast, the total general postoperative complication rate was lower in OS-RYGB than in TS-RYGB (p < 0.001). The mean operating time differed significantly among the three groups (P-RYGB 96.5min, OS-RYGB 141.2min and TS-RYGB 190.9min; p < 0.001). The mortality rate was not significantly different between the three groups. CONCLUSIONS Based on the significant difference between the two groups in revision surgery and the slight difference with the results of primary RYGB, this study concludes that removal of a failed AGB is safe and feasible with either the OS- or TS-RYGB procedure. However, we cannot directly recommend either procedure in our study. Proper patient selection and surgeon experience are critical to avoid potential adverse effects.
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Affiliation(s)
- O Thaher
- Marien Hospital Herne, Ruhr-Universität Bochum, Germany
| | - J Driouch
- Marien Hospital Herne, Ruhr-Universität Bochum, Germany
| | - M Hukauf
- StatConsult Society for Clinical and Health Services Research GmbH, Magdeburg, Germany
| | - C Stroh
- Municipal Hospital, Gera, Germany
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Seifert G, Fagnocchi L, Edozie M, Herrmann S, Baumann H, Panzeri I, Mewes S, Aicher D, Runkel M, Lässle C, Fink J, Marjanovic G, Fichtner-Feigl S, Pospisilik JA. The DECON pilot project investigates predictive markers for successful bariatric surgery. Sci Rep 2023; 13:13401. [PMID: 37591977 PMCID: PMC10435485 DOI: 10.1038/s41598-023-40452-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 08/10/2023] [Indexed: 08/19/2023] Open
Abstract
Obesity is a chronic, multifactorial disease which is linked to a number of adverse endocrinological and metabolic conditions. Currently, bariatric surgery is one of the most effective treatments for individuals diagnosed with severe obesity. However, the current indications for bariatric surgery are based on inadequate metrics (i.e., BMI) which do not account for the complexity of the disease, nor the heterogeneity among the patient population. Moreover, there is a lack of understanding with respect to the biological underpinnings that influence successful and sustained weight loss post-bariatric surgery. Studies have implicated age and pre-surgery body weight as two factors that are associated with favorable patient outcomes. Still, there is an urgent medical need to identify other potential factors that could improve the specificity of candidate selection and better inform the treatment plan of patients with obesity. In this report, we present and describe the cohort of the DECON pilot project, a multicenter study which aims to identify predictive biomarkers of successful weight loss after bariatric surgery.
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Affiliation(s)
- Gabriel Seifert
- Department of General and Visceral Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg,, Germany.
| | | | | | - Stephan Herrmann
- Department of General and Visceral Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg,, Germany
| | - Hannah Baumann
- Department of General and Visceral Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg,, Germany
| | - Ilaria Panzeri
- Van Andel Institute, Grand Rapids, MI, 49503, USA
- Max Planck Institute of Immunobiology and Epigenetics, 79108, Freiburg, Germany
| | - Stephanie Mewes
- Department of General and Visceral Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg,, Germany
| | - David Aicher
- Department of General and Visceral Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg,, Germany
| | - Mira Runkel
- Department of General and Visceral Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg,, Germany
| | - Claudia Lässle
- Department of General and Visceral Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg,, Germany
| | - Jodok Fink
- Department of General and Visceral Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg,, Germany
| | - Goran Marjanovic
- Department of General and Visceral Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg,, Germany
| | - Stephan Fichtner-Feigl
- Department of General and Visceral Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg,, Germany
| | - J Andrew Pospisilik
- Van Andel Institute, Grand Rapids, MI, 49503, USA.
- Max Planck Institute of Immunobiology and Epigenetics, 79108, Freiburg, Germany.
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Barbuti M, Carignani G, Weiss F, Calderone A, Fierabracci P, Salvetti G, Menculini G, Tortorella A, Santini F, Perugi G. Eating disorders and emotional dysregulation are associated with insufficient weight loss after bariatric surgery: a 1-year observational follow-up study. Eat Weight Disord 2023; 28:49. [PMID: 37266717 DOI: 10.1007/s40519-023-01574-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/14/2023] [Indexed: 06/03/2023] Open
Abstract
PURPOSE Subjects with obesity, especially those seeking bariatric surgery, exhibit high rates of mental disorders and marked psychopathological traits. The primary objective of this prospective, non-interventional study was to investigate whether the presence of different psychiatric disorders, attention deficit/hyperactivity disorder (ADHD) symptomatology and emotional dysregulation influenced weight loss at 1-year follow-up after surgery. METHODS Subjects consecutively referred for pre-surgical evaluation at the Obesity Center of Pisa University Hospital were recruited. Psychiatric diagnoses were made through the Mini-International Neuropsychiatric Interview (MINI) and ADHD symptomatology was assessed with the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS). Emotional dysregulation was investigated through the WRAADDS and self-report questionnaires. After surgery, weight and obesity-related comorbidities were monitored during follow-up. RESULTS Of the 99 participants recruited, 76 underwent surgery and 65 could be reevaluated 1 year after surgery. Subjects with insufficient weight loss (excess body mass index loss ≤ 53%, n = 15) had more frequent lifetime binge eating disorder (BED) and BED-mood disorders comorbidity than subjects with favorable post-surgical outcome. Additionally, they scored higher on both physician-administered and self-report scales assessing emotional dysregulation, which represents a nuclear symptom of ADHD in adults. At the logistic regression analysis, older age, higher preoperative excess body mass index and greater affective instability were predictors of reduced weight loss at 1-year follow-up. CONCLUSION Emotional dysregulation seems to be associated with a worse outcome after bariatric surgery. Further studies with larger samples and longer follow-up are needed to confirm the influence of different psychiatric disorders and psychopathological traits on post-surgical outcome. LEVEL OF EVIDENCE V, prospective descriptive study.
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Affiliation(s)
- Margherita Barbuti
- 2nd Psychiatry Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Via Savi 10, 56126, Pisa, Italy
| | - Giulia Carignani
- 2nd Psychiatry Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Via Savi 10, 56126, Pisa, Italy
| | - Francesco Weiss
- 2nd Psychiatry Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Via Savi 10, 56126, Pisa, Italy
| | - Alba Calderone
- 1st Endocrinology Unit, Department of Clinical and Experimental Medicine, Obesity and Lipodystrophy Research Center, University Hospital of Pisa, Via Paradisa, 2, 56124, Pisa, Italy
| | - Paola Fierabracci
- 1st Endocrinology Unit, Department of Clinical and Experimental Medicine, Obesity and Lipodystrophy Research Center, University Hospital of Pisa, Via Paradisa, 2, 56124, Pisa, Italy
| | - Guido Salvetti
- 1st Endocrinology Unit, Department of Clinical and Experimental Medicine, Obesity and Lipodystrophy Research Center, University Hospital of Pisa, Via Paradisa, 2, 56124, Pisa, Italy
| | - Giulia Menculini
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Piazza Lucio Severi 1, 06132, Perugia, Italy
| | - Alfonso Tortorella
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Piazza Lucio Severi 1, 06132, Perugia, Italy
| | - Ferruccio Santini
- 1st Endocrinology Unit, Department of Clinical and Experimental Medicine, Obesity and Lipodystrophy Research Center, University Hospital of Pisa, Via Paradisa, 2, 56124, Pisa, Italy
| | - Giulio Perugi
- 2nd Psychiatry Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Via Savi 10, 56126, Pisa, Italy.
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10
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Preoperative Serum Cortisol Level Is Predictive of Weight Loss After Laparoscopic Sleeve Gastrectomy in Men with Severe Obesity but Not Women. Obes Surg 2023; 33:851-859. [PMID: 36626105 PMCID: PMC9988780 DOI: 10.1007/s11695-022-06415-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 11/30/2022] [Accepted: 12/09/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Bariatric surgery is an effective treatment for severe obesity and its associated medical problems. Preoperative factors that predict postoperative weight loss remain to be fully characterized, however. METHODS Anthropometric and laboratory data were collected retrospectively for severely obese patients who underwent laparoscopic sleeve gastrectomy (LSG) between April 2016 and July 2019 at our hospital. Preoperative factors that predicted weight loss at 1 year after LSG were investigated. RESULTS A total of 122 subjects (45 men and 77 women) underwent LSG. The mean ± SD age and body mass index at surgery were 44.4 ± 10.4 years and 40.7 ± 6.7 kg/m2. The percent total weight loss (%TWL) was 27.0 ± 8.6 among all subjects, 26.4 ± 8.0 among men, and 27.4 ± 8.9 among women, with no significant difference between the sexes. The %TWL showed a significant inverse correlation with serum cortisol level in men and with age and the visceral/subcutaneous fat area ratio in women. Multivariable regression analysis revealed the presence of type 2 diabetes and the serum cortisol concentration to be negatively associated with %TWL among all subjects and men, respectively. Receiver operating characteristic curve analysis identified an optimal cutoff of 10 µg/dL for prediction of a %TWL of ≥ 25 in men by serum cortisol level. CONCLUSIONS Serum cortisol concentration was identified as a predictor for postoperative weight loss in men. Our results may thus help inform the decision to perform LSG or more effective surgical procedures in men with severe obesity.
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11
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Drewnowski A, Hong BD, Shen E, Ji M, Paz SR, Bhakta BB, Macias M, Crawford CL, Lewis KH, Liu J, Moore DD, Murali SB, Young DR, Coleman KJ. Neighborhood deprivation and residential property values do not affect weight loss at 1 or 3 years after bariatric surgery. Obesity (Silver Spring) 2023; 31:545-552. [PMID: 36627742 PMCID: PMC9877110 DOI: 10.1002/oby.23623] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 09/21/2022] [Accepted: 09/28/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE This study examined the association between individual- and neighborhood-level sociodemographic factors and surgical weight loss at 1 year (short term) and 3 years (long term). METHODS Data were obtained from the baseline survey of the BELONG (Bariatric Experience Long Term) prospective longitudinal cohort study. Individual-level self-reported data on sex, race and ethnicity, education, and household income were obtained by survey. Data from the 2010 US Census were used to calculate area Neighborhood Deprivation Index score and median value of owner-occupied housing units at the census tract level. RESULTS Patients (N = 1341) had a mean age of 43.4 (SD 11.3) years, were mostly female (86%), were mostly Black or Hispanic (52%), had some college education (83%), and had annual household incomes ≥$51,000 (55%). Percentage total weight loss was 25.8% (SD 9.0%) at year 1 and 22.2% (SD 10.5%) at year 3. Race and ethnicity and age were significant predictors of weight loss at 1 and 3 years with a small effect of self-reported household income at year 1. There were no significant associations between census tract-level Neighborhood Deprivation Index score or value of owner-occupied housing units and weight loss at either time point. CONCLUSIONS Health systems could improve the chances of weight-loss maintenance after surgery by addressing factors related to racial and ethnic disparities and to income disparities.
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Affiliation(s)
- Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA
| | - Benjamin D. Hong
- Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA
| | - Ernest Shen
- Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA
| | - Ming Ji
- College of Nursing, University of South Florida, Tampa, FL
| | - Silvia R. Paz
- Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA
| | - Bhumi B. Bhakta
- Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA
| | - Mayra Macias
- Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA
| | - Cecelia L. Crawford
- Regional Nursing Research Program, Kaiser Permanente Southern California, Pasadena, CA
| | - Kristina H. Lewis
- Division of Public Health Sciences, Department of Epidemiology & Prevention, Wake Forest University Health Sciences, Winston-Salem, NC
| | - Jialuo Liu
- Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA
| | - Darren D. Moore
- Marriage and Family Therapy Program, The Family Institute, Northwestern University, Evanston, IL
| | - Sameer B. Murali
- Center for Obesity Medicine & Metabolic Performance, Department of Surgery, University of Texas McGovern Medical School, Houston, Texas
| | - Deborah R. Young
- Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA
| | - Karen J. Coleman
- Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA
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12
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Grannell A. Reframing the need for exercise therapy in the clinical management of people living with obesity. Clin Obes 2022; 12:e12554. [PMID: 36161706 DOI: 10.1111/cob.12554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/01/2022] [Accepted: 09/04/2022] [Indexed: 01/06/2023]
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13
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New Insights on the Association Between Socioeconomic Status and Weight Loss After Bariatric Surgery: a Systematic Review and Meta-analysis. Obes Surg 2022; 32:3752-3770. [DOI: 10.1007/s11695-022-06269-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/01/2022] [Accepted: 09/01/2022] [Indexed: 10/14/2022]
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14
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Barski K, Binda A, Jaworski P, Gonciarska A, Kudlicka E, Żurkowska J, Wawiernia K, Tałałaj M, Wąsowski M, Tarnowski W. Influence of preoperative weight loss on gastric wall thickness-analysis of laparoscopic sleeve gastrectomy histological material. Langenbecks Arch Surg 2022; 407:3315-3322. [PMID: 36074187 DOI: 10.1007/s00423-022-02668-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 08/26/2022] [Indexed: 01/09/2023]
Abstract
PURPOSE The variables possibly enabling the prediction of gastric wall thickness during laparoscopic sleeve gastrectomy remain undetermined. The aim of the study was to identify preoperative factors affecting gastric wall thickness in patients undergoing laparoscopic sleeve gastrectomy. METHODS The measurements of the double-wall thickness of gastric specimen excised during sleeve gastrectomy were taken at three locations after 15 s of compression with an applied pressure of 8 g/mm2. Statistical calculations were used to determine the influence of preoperative weight loss and other perioperative parameters on gastric wall thickness. RESULTS The study involved one hundred patients (78 female; 22 male). The thickest tissue was observed at the antrum with the mean value 2.55 mm (range 1.77-4.0 mm), followed by the midbody, mean 2.13 mm (range 1.34-3.20 mm), and the fundus, mean 1.69 mm (range 0.99-2.69 mm). Positive relationships were found between gastric wall thickness and both preoperative weight loss and age in all three measured locations; p < 0.05. In a linear regression model, age and preoperative weight loss were found to be statistically significant and positive predictors of higher gastric wall thickness only at the antrum. Male patients were observed to have thicker gastric wall at all three locations as compared to female patients. CONCLUSION Preoperative weight loss should be considered an important factor influencing gastric wall thickness. Age and gender can also be helpful in predicting the varying tissue thickness. Anatomical region is a key factor determining thickness of the stomach walls.
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Affiliation(s)
- Krzysztof Barski
- Department of General, Oncological and Digestive Tract Surgery, Centre of Postgraduate Medical Education, Orlowski Hospital, Czerniakowska 231, 00-416, Warsaw, Poland
| | - Artur Binda
- Department of General, Oncological and Digestive Tract Surgery, Centre of Postgraduate Medical Education, Orlowski Hospital, Czerniakowska 231, 00-416, Warsaw, Poland.
| | - Paweł Jaworski
- Department of General, Oncological and Digestive Tract Surgery, Centre of Postgraduate Medical Education, Orlowski Hospital, Czerniakowska 231, 00-416, Warsaw, Poland
| | - Agnieszka Gonciarska
- Department of General, Oncological and Digestive Tract Surgery, Centre of Postgraduate Medical Education, Orlowski Hospital, Czerniakowska 231, 00-416, Warsaw, Poland
| | - Emilia Kudlicka
- Department of General, Oncological and Digestive Tract Surgery, Centre of Postgraduate Medical Education, Orlowski Hospital, Czerniakowska 231, 00-416, Warsaw, Poland
| | - Joanna Żurkowska
- Department of General, Oncological and Digestive Tract Surgery, Centre of Postgraduate Medical Education, Orlowski Hospital, Czerniakowska 231, 00-416, Warsaw, Poland
| | - Karolina Wawiernia
- Department of General, Oncological and Digestive Tract Surgery, Centre of Postgraduate Medical Education, Orlowski Hospital, Czerniakowska 231, 00-416, Warsaw, Poland
| | - Marek Tałałaj
- Geriatrics, Internal Medicine and Metabolic Bone Diseases Department, Centre of Postgraduate Medical Education, Orlowski Hospital, Czerniakowska 231, 00-416, Warsaw, Poland
| | - Michał Wąsowski
- Geriatrics, Internal Medicine and Metabolic Bone Diseases Department, Centre of Postgraduate Medical Education, Orlowski Hospital, Czerniakowska 231, 00-416, Warsaw, Poland
| | - Wiesław Tarnowski
- Department of General, Oncological and Digestive Tract Surgery, Centre of Postgraduate Medical Education, Orlowski Hospital, Czerniakowska 231, 00-416, Warsaw, Poland
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15
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Pineda-García G, Serrano-Medina A, Cornejo-Bravo JM, Andrade-Soto VH, Armenta-Rojas E, González-Sánchez DL. Self-care model and body image in adults after a bariatric surgery. Rev Lat Am Enfermagem 2022; 30:e3586. [PMID: 35830125 DOI: 10.1590/1518-8345.5592.3587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/13/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE the aim of the present article was to test a self-care model explained by the relationship between self-efficacy, body image, obsessive-compulsive disorder, and depression in people with bariatric surgery in the city of Tijuana, Baja California, Mexico. METHOD this was a correlational cross-sectional study carried out between August and December 2020. Validated instruments were administered to 102 participants to measure their self-care capacity, general self-efficacy, psychopathological symptoms, and body image perception and satisfaction. The variables of interest were analyzed using descriptive statistics and the Pearson and Spearman correlation coefficients were used to develop a model using path analysis. RESULT a significant model was obtained with adequate goodness-of-fit indicators (chi-square χ2 (8) = 11.451, p = .177; root mean square error of approximation (RMSEA)= 0.000; goodness-of-fit index (GFI)= 0.965; comparative fit index (CFI)= 0.985; parsimonious normed fit index (PNFI)= 0.509, and Akaike information criterion (AIC)= 37.451). Self-efficacy (Zβ=0.294) and body image dissatisfaction (So= -0.376) were shown to influence self-care abilities while psychopathological symptoms influenced body dissatisfaction: obsessive-compulsive disorder (Zβ=0.370) and depression (Zβ=0.320). CONCLUSION adequate levels of self-efficacy and body satisfaction predict a high capacity for self-care.
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Affiliation(s)
- Gisela Pineda-García
- Universidad Autónoma de Baja Califonia, Facultad de Medicina y Psicología, Tijuana, Baja California, México
| | - Aracely Serrano-Medina
- Universidad Autónoma de Baja Califonia, Facultad de Medicina y Psicología, Tijuana, Baja California, México
| | - José Manuel Cornejo-Bravo
- Universidad Autónoma de Baja Califonia, Facultad de Ciencias Químicas e Ingeniería, Tijuana, Baja California, México
| | - Víctor Hugo Andrade-Soto
- Universidad Autónoma de Baja Califonia, Facultad de Ciencias de la Salud, Tijuana, Baja California, México
| | - Efraín Armenta-Rojas
- Universidad Autónoma de Baja Califonia, Facultad de Ciencias Químicas e Ingeniería, Tijuana, Baja California, México.,Bolsista do Consejo Nacional de Ciencia y Tecnología, México
| | - Daniela Lilian González-Sánchez
- Universidad Autónoma de Baja Califonia, Facultad de Medicina y Psicología, Tijuana, Baja California, México.,Bolsista do Sindicato de Profesores Superación Universitaria de la Universidad Autónoma de Baja California, México
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16
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Voglino C, Badalucco S, Tirone A, Ciuoli C, Cantara S, Benenati N, Bufano A, Formichi C, Croce F, Gaggelli I, Vuolo ML, Vuolo G. Follow-up after bariatric surgery: is it time to tailor it? Analysis of early predictive factors of 3-year weight loss predictors of unsuccess in bariatric patients. Updates Surg 2022; 74:1389-1398. [PMID: 35780262 PMCID: PMC9338161 DOI: 10.1007/s13304-022-01314-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 06/14/2022] [Indexed: 12/03/2022]
Abstract
Bariatric surgery (BS) is the most effective treatment strategy for obesity. Nevertheless, a subset of patients does not reach a successful weight loss or experience long-term weight regain. Conflicting evidence exists regarding predictors of BS outcomes. We aimed to define the early factors linked to 3 year unsuccessful weight loss in order to promote a tailored close follow-up. We enrolled 443 patients who underwent BS from January 2014 to December 2018 with a 3 year follow-up. An unsuccessful BS outcome was defined as a percentage of total weight loss (%TWL) < 20. We compared the characteristics between successful and unsuccessful patients in order to identify predictor factors of unsuccess after surgery. We found that the proportion of patients with unsuccessful weight loss progressively increased from one to three years after BS. In a multiple regression model, only 1 month %TWL and sleeve gastrectomy (SG) were significantly associated with 3 year unsuccessful weight loss. We stratified our cohort in four groups according to the risk of BS unsuccess, in terms of 1 month %TWL and type of surgery (SG vs gastric bypass). Interestingly, groups showed a significant difference in terms of %TWL at each follow-up point. Patients submitted to SG with lower 1 month %TWL must be considered at higher risk of future weight regain; consequently, they require a tailored and closer follow-up.
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Affiliation(s)
- Costantino Voglino
- Department of General and Specialized Surgery, Unit of Bariatric Surgery, University of Siena, Policlinico "Le Scotte", Viale Bracci 14, 53100, Siena, Italy
| | - Simona Badalucco
- Department of General and Specialized Surgery, Unit of Bariatric Surgery, University of Siena, Policlinico "Le Scotte", Viale Bracci 14, 53100, Siena, Italy.
| | - Andrea Tirone
- Department of General and Specialized Surgery, Unit of Bariatric Surgery, University of Siena, Policlinico "Le Scotte", Viale Bracci 14, 53100, Siena, Italy
| | - Cristina Ciuoli
- Department of Medicine, Surgery and Neurosciences, Unit of Endocrinology, University of Siena, Viale Bracci, Policlinico "Le Scotte", 53100, Siena, Italy
| | - Silvia Cantara
- Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci, Policlinico "Le Scotte", 53100, Siena, Italy
| | - Nicoletta Benenati
- Department of Medicine, Surgery and Neurosciences, Unit of Endocrinology, University of Siena, Viale Bracci, Policlinico "Le Scotte", 53100, Siena, Italy
| | - Annalisa Bufano
- Department of Medicine, Surgery and Neurosciences, Unit of Endocrinology, University of Siena, Viale Bracci, Policlinico "Le Scotte", 53100, Siena, Italy
| | - Caterina Formichi
- Department of Medicine, Surgery and Neurosciences, Unit of Endocrinology, University of Siena, Viale Bracci, Policlinico "Le Scotte", 53100, Siena, Italy
| | - Federica Croce
- Department of Diagnostic Imaging, Hospital Campostaggia, Campostaggia, 53036, Poggibonsi, SI, Italy
| | - Ilaria Gaggelli
- Department of General and Specialized Surgery, Unit of Bariatric Surgery, University of Siena, Policlinico "Le Scotte", Viale Bracci 14, 53100, Siena, Italy
| | - Maria Laura Vuolo
- Department of General and Specialized Surgery, Unit of Bariatric Surgery, University of Siena, Policlinico "Le Scotte", Viale Bracci 14, 53100, Siena, Italy
| | - Giuseppe Vuolo
- Department of General and Specialized Surgery, Unit of Bariatric Surgery, University of Siena, Policlinico "Le Scotte", Viale Bracci 14, 53100, Siena, Italy
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17
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Nymo S, Børresen Skjølsvold O, Aukan M, Finlayson G, Græslie H, Mårvik R, Kulseng B, Sandvik J, Martins C. Suboptimal Weight Loss 13 Years After Roux-en-Y Gastric Bypass: Is Hedonic Hunger, Eating Behaviour and Food Reward to Blame? Obes Surg 2022; 32:2263-2271. [PMID: 35505168 PMCID: PMC9276719 DOI: 10.1007/s11695-022-06075-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 04/16/2022] [Accepted: 04/20/2022] [Indexed: 11/28/2022]
Abstract
Purpose Suboptimal weight loss (SWL) and weight regain (WR) following bariatric surgery are common. The exact reasons for this phenomenon remain to be fully elucidated. To compare hedonic hunger, food preferences, food reward and eating behaviour traits between participants with SWL and optimal weight loss (OWL) 13 years after Roux-en-Y gastric bypass (RYGB). Materials and Method Cross-sectional case control study where participants experiencing SWL or OWL (< or ≥ 50% of excess weight, respectively) post-RYGB were compared to a non-surgical control group matched for pre-operative body mass index. Hedonic hunger (Power of Food Scale), implicit and explicit liking and wanting for high-fat and low-fat savoury and sweet food (Leeds Food Preference Questionnaire) and eating behaviour (Dutch Eating Behavior Questionnaire, Three-Factor Eating Questionnaire and the Food Cravings Questionnaires State and Trait-reduced) were assessed. Results In total, 75 participants were recruited from the bariatric surgery observation study (BAROBS). Disinhibition, hunger, emotional, external and restrained eating, frequency of cravings and hedonic hunger were lower in the OWL, compared with the SWL and/or control groups. Implicit wanting and explicit liking and wanting for high-fat savoury and high-fat sweet food were lower, and implicit wanting for low-fat savoury food higher, in the OWL, compared with the SWL and/or control groups. Conclusion SWL 13 years after RYGB is associated with dysfunctional eating behaviours, increased preference and reward for high-fat food and increased hedonic hunger. Future longitudinal studies are needed to establish the cause-effect relationship between these variables. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s11695-022-06075-z.
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Affiliation(s)
- Siren Nymo
- Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Prinsesse Kristinas gate 5, 7030, Forsyningssenteret, Trondheim, Norway. .,Centre for Obesity and Innovation (ObeCe), Clinic of Surgery, St. Olav University Hospital, Trondheim, Norway. .,Clinic of Surgery, Namsos Hospital, Nord-Trøndelag Hospital Trust, Namsos, Norway. .,Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Oda Børresen Skjølsvold
- Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Prinsesse Kristinas gate 5, 7030, Forsyningssenteret, Trondheim, Norway.,Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Marthe Aukan
- Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Prinsesse Kristinas gate 5, 7030, Forsyningssenteret, Trondheim, Norway.,Centre for Obesity and Innovation (ObeCe), Clinic of Surgery, St. Olav University Hospital, Trondheim, Norway.,Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Graham Finlayson
- School of Psychology, University of Leeds, Leeds, UK.,Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hallvard Græslie
- Clinic of Surgery, Namsos Hospital, Nord-Trøndelag Hospital Trust, Namsos, Norway.,Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ronald Mårvik
- Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Prinsesse Kristinas gate 5, 7030, Forsyningssenteret, Trondheim, Norway.,Centre for Obesity and Innovation (ObeCe), Clinic of Surgery, St. Olav University Hospital, Trondheim, Norway.,Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Bård Kulseng
- Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Prinsesse Kristinas gate 5, 7030, Forsyningssenteret, Trondheim, Norway.,Centre for Obesity and Innovation (ObeCe), Clinic of Surgery, St. Olav University Hospital, Trondheim, Norway.,Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jorunn Sandvik
- Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Prinsesse Kristinas gate 5, 7030, Forsyningssenteret, Trondheim, Norway.,Centre for Obesity and Innovation (ObeCe), Clinic of Surgery, St. Olav University Hospital, Trondheim, Norway.,Clinic of Surgery, Ålesund Hospital, Møre- og Romsdal Hospital Trust, Ålesund, Norway.,Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Catia Martins
- Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Prinsesse Kristinas gate 5, 7030, Forsyningssenteret, Trondheim, Norway.,Centre for Obesity and Innovation (ObeCe), Clinic of Surgery, St. Olav University Hospital, Trondheim, Norway.,Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
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18
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Guo L, Luo W, Tan T, Gong F, Liu X, Rao S, Lian F, Liu J, Chen X, Li G, Yang Z, Mei M, Hu J, Li Q, Wang Z, Zhang J, Zeng M, Gong L. Early phase insulin hypersecretion associated with weight loss outcome after LSG: A prospective cohort study in Asian patients with BMI ≥ 28 kg/m2. Surg Obes Relat Dis 2022; 18:1209-1217. [DOI: 10.1016/j.soard.2022.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 04/27/2022] [Accepted: 05/10/2022] [Indexed: 11/26/2022]
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19
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Relationship between the Levels of lncRNA H19 in Plasma and Different Adipose Tissue Depots with Patients’ Response to Bariatric Surgery. Life (Basel) 2022; 12:life12050633. [PMID: 35629301 PMCID: PMC9147957 DOI: 10.3390/life12050633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/20/2022] [Accepted: 04/22/2022] [Indexed: 11/17/2022] Open
Abstract
Bariatric surgery represents a widespread approach to treating morbid obesity. The search for biomarkers to identify patients to whom this type of treatment will be most effective is needed. Our aim was to characterize the relationship of levels of lncRNA H19 in plasma and different adipose tissue depots with patients’ response to bariatric surgery. The study includes control subjects, patients with obesity and patients with obesity accompanied by impaired carbohydrate metabolism (ICM). Quantitative analysis of lncRNA H19 levels has been performed using qPCR in plasma and subcutaneous (SAT) and visceral adipose tissue (VAT). Patients with obesity without ICM have higher levels of lncRNA H19 in VAT compared to SAT, and higher levels of lncRNA H19 in SAT compared to SAT of control individuals. One year after the intervention, levels of lncRNA H19 decreased in SAT of patients with obesity without ICM. The preoperative level of lncRNA H19 in VAT demonstrates a positive correlation with excess weight loss and a negative correlation with initial BMI. In conclusion, ICM affects expression of lncRNA H19 in SAT of patients with obesity. The preoperative level of lncRNA H19 in VAT can be used to predict excess weight loss in patients with obesity after bariatric surgery.
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20
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Alotaibi AA, Almutairy AN, Alsaab AS. Post-Bariatric Surgery Patients: A Quality of Life Assessment in Saudi Arabia. Cureus 2022; 14:e24273. [PMID: 35602806 PMCID: PMC9119020 DOI: 10.7759/cureus.24273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 11/05/2022] Open
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21
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Glycemic control and BMI changes after endoscopic implantation of a duodenojejunal bypass liner compared with laparoscopic Roux-en-Y gastric bypass surgery: a propensity score matching analysis. Surg Endosc 2022; 36:5979-5985. [PMID: 35378626 DOI: 10.1007/s00464-022-09177-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 02/25/2022] [Indexed: 10/18/2022]
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Singhal R, Cardoso VR, Wiggins T, Super J, Ludwig C, Gkoutos GV, Mahawar K. 30-day morbidity and mortality of sleeve gastrectomy, Roux-en-Y gastric bypass and one anastomosis gastric bypass: a propensity score-matched analysis of the GENEVA data. Int J Obes (Lond) 2022; 46:750-757. [PMID: 34912046 PMCID: PMC8671878 DOI: 10.1038/s41366-021-01048-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/29/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND There is a paucity of data comparing 30-day morbidity and mortality of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one anastomosis gastric bypass (OAGB). This study aimed to compare the 30-day safety of SG, RYGB, and OAGB in propensity score-matched cohorts. MATERIALS AND METHODS This analysis utilised data collected from the GENEVA study which was a multicentre observational cohort study of bariatric and metabolic surgery (BMS) in 185 centres across 42 countries between 01/05/2022 and 31/10/2020 during the Coronavirus Disease-2019 (COVID-19) pandemic. 30-day complications were categorised according to the Clavien-Dindo classification. Patients receiving SG, RYGB, or OAGB were propensity-matched according to baseline characteristics and 30-day complications were compared between groups. RESULTS In total, 6770 patients (SG 3983; OAGB 702; RYGB 2085) were included in this analysis. Prior to matching, RYGB was associated with highest 30-day complication rate (SG 5.8%; OAGB 7.5%; RYGB 8.0% (p = 0.006)). On multivariate regression modelling, Insulin-dependent type 2 diabetes mellitus and hypercholesterolaemia were associated with increased 30-day complications. Being a non-smoker was associated with reduced complication rates. When compared to SG as a reference category, RYGB, but not OAGB, was associated with an increased rate of 30-day complications. A total of 702 pairs of SG and OAGB were propensity score-matched. The complication rate in the SG group was 7.3% (n = 51) as compared to 7.5% (n = 53) in the OAGB group (p = 0.68). Similarly, 2085 pairs of SG and RYGB were propensity score-matched. The complication rate in the SG group was 6.1% (n = 127) as compared to 7.9% (n = 166) in the RYGB group (p = 0.09). And, 702 pairs of OAGB and RYGB were matched. The complication rate in both groups was the same at 7.5 % (n = 53; p = 0.07). CONCLUSIONS This global study found no significant difference in the 30-day morbidity and mortality of SG, RYGB, and OAGB in propensity score-matched cohorts.
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Affiliation(s)
- Rishi Singhal
- Upper GI Unit, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
| | - Victor Roth Cardoso
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- Health Data Research UK Midlands, Birmingham, UK
| | - Tom Wiggins
- Upper GI Unit, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | - Jonathan Super
- General Surgery Department, Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells, UK
| | - Christian Ludwig
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Georgios V Gkoutos
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- Health Data Research UK Midlands, Birmingham, UK
- NIHR Experimental Cancer Medicine Centre, Birmingham, B15 2TT, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, Birmingham, B15 2TT, UK
| | - Kamal Mahawar
- Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK
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Khajeh E, Aminizadeh E, Eslami P, Ramouz A, Kulu Y, Billeter AT, Nickel F, Müller-Stich BP, Mehrabi A. Outcomes of Bariatric Surgery in Obese Patients with Compensated Liver Cirrhosis. Surg Obes Relat Dis 2022; 18:727-737. [DOI: 10.1016/j.soard.2022.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/10/2022] [Accepted: 03/13/2022] [Indexed: 12/21/2022]
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Edwards MA, Terhaar H, Spaulding A. Resident first assistance in bariatric surgery: do patients pay a price? Surg Obes Relat Dis 2022; 18:738-746. [DOI: 10.1016/j.soard.2022.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/13/2022] [Accepted: 02/18/2022] [Indexed: 10/18/2022]
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Five Year Trends in the Utilization of Robotic Bariatric Surgery Procedures, United States 2015-2019. Obes Surg 2022; 32:1539-1545. [PMID: 35169953 DOI: 10.1007/s11695-022-05964-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/07/2022] [Accepted: 02/07/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE Robotic approaches have been steadily replacing laparoscopic approaches in metabolic and bariatric surgeries (MBS); however, their superiority has not been rigorously evaluated. The main goal of the study was to evaluate the 5-year utilization trends of robotic MBS and to compare to laparoscopic outcomes. METHODS Retrospective analysis of 2015-2019 MBSAQIP data. Kruskal-Wallis test/Wilcoxon and Fisher's exact/chi-square were used to compare continuous and categorical variables, respectively. Generalized linear models were used to compare surgery outcomes. RESULTS The use of robotic MBS increased from 6.2% in 2015 to 13.5% in 2019 (N= 775,258). Robotic MBS patients had significantly higher age, BMI, and likelihood of 12 diseases compared to laparoscopic patients. After adjustment, robotic MBS patients showed higher 30-day interventions and 30-day readmissions alongside longer surgery time (26-38 min). CONCLUSION Robotic MBS shows higher intervention and readmission even after controlling for cofounding variables.
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Is Adherence to Follow-Up After Bariatric Surgery Necessary? A Systematic Review and Meta-Analysis. Obes Surg 2022; 32:904-911. [PMID: 35020125 PMCID: PMC8866276 DOI: 10.1007/s11695-021-05857-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 11/15/2022]
Abstract
The association of adherence to follow-up (FU) after laparoscopic gastric bypass — and gastric sleeve with weight loss (WL) is unclear. The aim of this study was to evaluate this association. Fourteen full text articles were included in the systematic review. Eight studies were included in the meta-analysis concerning FU up to 3 years postoperatively and 3 for the FU between 3 and 10 years postoperatively. Results showed a significant association between adherence to FU 0.5 to 3 years postoperatively and percentage excess WL (%EWL) but did not demonstrate a significant association between FU > 3 years postoperatively and total WL (%TWL). In conclusion, adherence to FU may not be associated with WL and therefore stringent lifelong FU in its current form should be evaluated.
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Rodríguez F, Herrera A, Sepúlveda EM, Guilbert L, Hernández LA, Peñuñuri LF, Rodríguez FM, Zerrweck C. Weight loss before bariatric surgery and its impact on poor versus excellent outcomes at 2 years. Langenbecks Arch Surg 2022; 407:1047-1053. [PMID: 35013797 DOI: 10.1007/s00423-021-02399-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 12/06/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To identify preoperative factors that influence the outcomes of gastric bypass surgery, in terms of excess weight loss at 24 months. METHODS This retrospective study included two groups of patients who underwent laparoscopic gastric bypass surgery. Group A (poor outcomes) had ≤ 50%EWL or BMI ≥ 30 kg/m2; group B (excellent outcomes) had ≥ 80%EWL at 24 months. A comparative analysis of demography, anthropometry, comorbidities, and metabolic status was performed. A linear regression model was used to evaluate %EWL association; the number of preoperative and postoperative consultations were also compared. RESULTS A total of 202 patients completed follow-up; 71 (35.1%) and 78 (38%) had poor and excellent outcomes (%EWL 44.1 ± 9.4% vs. 92 ± 10.9%), respectively. Mean age was 40.4 ± 8.9 years. Patients with poor outcomes had higher weight and BMI, lesser preoperative %EWL, higher dyslipidemia and diabetes rates with longer periods of evolution, and increased HbA1c% levels. In the linear regression analysis, preoperative %EWL and initial and preoperative BMI were statistically significant determinants of %EWL at 24 months Diabetes remission was 46.2% (group A) vs. 66.6% (group B). Group A had higher non-attendance rates after surgery. CONCLUSION The factors independently associated with greater %EWL at 24 months between groups were higher preoperative %EWL, and lower initial and preoperative BMI.
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Affiliation(s)
- Fernando Rodríguez
- The Obesity Clinic at Hospital General Tláhuac, Avenida la Turba # 655, Col. Villa Centroamericana y del Caribe, Delegación Tláhuac, 13250, México City, Mexico
| | - Antonio Herrera
- The Obesity Clinic at Hospital General Tláhuac, Avenida la Turba # 655, Col. Villa Centroamericana y del Caribe, Delegación Tláhuac, 13250, México City, Mexico
| | - Elisa M Sepúlveda
- The Obesity Clinic at Hospital General Tláhuac, Avenida la Turba # 655, Col. Villa Centroamericana y del Caribe, Delegación Tláhuac, 13250, México City, Mexico
| | - Lizbeth Guilbert
- The Obesity Clinic at Hospital General Tláhuac, Avenida la Turba # 655, Col. Villa Centroamericana y del Caribe, Delegación Tláhuac, 13250, México City, Mexico
| | - Louis A Hernández
- The Obesity Clinic at Hospital General Tláhuac, Avenida la Turba # 655, Col. Villa Centroamericana y del Caribe, Delegación Tláhuac, 13250, México City, Mexico
| | - Luis F Peñuñuri
- The Obesity Clinic at Hospital General Tláhuac, Avenida la Turba # 655, Col. Villa Centroamericana y del Caribe, Delegación Tláhuac, 13250, México City, Mexico
| | - Fátima M Rodríguez
- The Obesity Clinic at Hospital General Tláhuac, Avenida la Turba # 655, Col. Villa Centroamericana y del Caribe, Delegación Tláhuac, 13250, México City, Mexico
| | - Carlos Zerrweck
- The Obesity Clinic at Hospital General Tláhuac, Avenida la Turba # 655, Col. Villa Centroamericana y del Caribe, Delegación Tláhuac, 13250, México City, Mexico.
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Pineda-García G, Serrano-Medina A, Cornejo-Bravo JM, Andrade-Soto VH, Armenta-Rojas E, González-Sánchez DL. Self-care model and body image in adults after a bariatric surgery. Rev Lat Am Enfermagem 2022. [PMID: 35830125 PMCID: PMC9264863 DOI: 10.1590/1518-8345.5592.3536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: the aim of the present article was to test a self-care model explained by the relationship between self-efficacy, body image, obsessive-compulsive disorder, and depression in people with bariatric surgery in the city of Tijuana, Baja California, Mexico. Method: this was a correlational cross-sectional study carried out between August and December 2020. Validated instruments were administered to 102 participants to measure their self-care capacity, general self-efficacy, psychopathological symptoms, and body image perception and satisfaction. The variables of interest were analyzed using descriptive statistics and the Pearson and Spearman correlation coefficients were used to develop a model using path analysis. Result: a significant model was obtained with adequate goodness-of-fit indicators (chi-square χ2 (8) = 11.451, p = .177; root mean square error of approximation (RMSEA)= 0.000; goodness-of-fit index (GFI)= 0.965; comparative fit index (CFI)= 0.985; parsimonious normed fit index (PNFI)= 0.509, and Akaike information criterion (AIC)= 37.451). Self-efficacy (Zβ=0.294) and body image dissatisfaction (So= -0.376) were shown to influence self-care abilities while psychopathological symptoms influenced body dissatisfaction: obsessive-compulsive disorder (Zβ=0.370) and depression (Zβ=0.320). Conclusion: adequate levels of self-efficacy and body satisfaction predict a high capacity for self-care.
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Affiliation(s)
| | | | | | | | - Efraín Armenta-Rojas
- Universidad Autónoma de Baja Califonia, Mexico; Consejo Nacional de Ciencia y Tecnología, México
| | - Daniela Lilian González-Sánchez
- Universidad Autónoma de Baja Califonia, Mexico; Sindicato de Profesores Superación Universitaria de la Universidad Autónoma de Baja California, México
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Bahadori E, Esfehani AJ, Bahrami LS, Shadmand Foumani Moghadam MR, Jangjoo A, Nematy M, Roghani A, Rezvani R. Identifying the Predictors of Short Term Weight Loss Failure after Roux-En-Y Gastric Bypass. Int J Clin Pract 2022; 2022:2685292. [PMID: 36349055 PMCID: PMC9629942 DOI: 10.1155/2022/2685292] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 10/17/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Gastric bypass surgery is a gold standard therapy for severe obesity. This study aimed to evaluate anthropometric predictors for short-term excess weight loss (EWL) after Roux-en-Y gastric bypass surgery (RYGB) in a sample of severely obese patients. MATERIALS AND METHODS This cohort study was conducted on severely obese candidates for RYGB bariatric surgery in Mashhad, Iran. Indirect calorimetry, anthropometric measurements, and body composition data were collected before, one, and six months after RYGB. RESULTS Fifty-four participants (43, 79.6% women and 11, 20.4% men) with a mean age of 39.63 ± 9.66 years participated in this study. The mean total weight and BMI loss within six months were 32.89 ± 20.22 kg and 12.37 ± 7.34 kg/m2, respectively. The mean reduction in adipose tissue and fat-free mass was 24.49 kg and 7.46 kg, respectively. The mean resting metabolism rate (RMR) reduction at one and six months after RYGB was 260.49 kcal and 396.07 kcal, respectively. There was a significant difference in mean RMR between the baseline and one and six months after RYGB (p < 0.001). There was no significant gender difference in mean weight and BMI loss percentage at six months post-RYGB (p > 0.05). Baseline skeletal muscle mass (SMM), excess BMI loss (EBMIL) at first month after surgery, and baseline neck circumference (NC) could predict EWL six months after surgery. CONCLUSION Reduced RMR shortly after RYGB may be due to FFM reduction. Some anthropometric and their acute changes after RYGB may predict the short-term EWL in RYGB patients.
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Affiliation(s)
- Effat Bahadori
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Leila Sadat Bahrami
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Ali Jangjoo
- Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Nematy
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Afshin Roghani
- Institute for Sustainable Horticulture (ISH), 20901 Langley Bypass, Langley, BC V3A 8G9, Canada
| | - Reza Rezvani
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Pineda-García G, Serrano-Medina A, Cornejo-Bravo JM, Andrade-Soto VH, Armenta-Rojas E, González-Sánchez DL. Modelo de autocuidado e imagen corporal en adultos post-cirugía bariátrica. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5592.3586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumen Objetivo: probar un modelo de autocuidado explicado por la relación entre autoeficacia, imagen corporal, obsesión-compulsión y depresión en personas con cirugía bariátrica de la ciudad de Tijuana, B.C. Método: estudio transversal correlacional realizado entre agosto y diciembre de 2020. Se aplicaron instrumentos validados a 102 participantes para medir su capacidad de autocuidado, autoeficacia general, síntomas psicopatológicos, percepción y satisfacción de la imagen corporal. Las variables de interés fueron analizadas mediante estadística descriptiva y correlaciones de Pearson y Spearman para finalmente elaborar un modelo mediante análisis de ruta (Path Analysis). Resultados: se obtuvo un modelo significativo con buenos indicadores de bondad de ajuste (chi-cuadrado χ 2 (8)= 11.451, p = .177; error de aproximación raíz-media-cuadrada (RMSEA)= 0.000; índice de bondad de ajuste (GFI)= 0.965; índice de ajuste comparativo (CFI)= 0.985; índice de ajuste normado parsimonioso (PNFI)= 0.509 y criterio de información de Akaike (AIC)= 37.451). Se demostró que la autoeficacia (Zβ= 0.294) y la insatisfacción de la imagen corporal (Zβ= -0.376) tienen un efecto sobre las capacidades de autocuidado mientras que los síntomas psicopatológicos influyen sobre la insatisfacción corporal: obsesión-compulsión (Zβ= 0.370) y depresión (Zβ= 0.320). Conclusión: los niveles adecuados de autoeficacia y satisfacción corporal predicen una alta capacidad de autocuidado.
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Affiliation(s)
| | | | | | | | - Efraín Armenta-Rojas
- Universidad Autónoma de Baja Califonia, Mexico; Consejo Nacional de Ciencia y Tecnología, México
| | - Daniela Lilian González-Sánchez
- Universidad Autónoma de Baja Califonia, Mexico; Sindicato de Profesores Superación Universitaria de la Universidad Autónoma de Baja California, México
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Wang L, Tian C, Xu G, Sang Q, Chen G, Yu C, Wuyun Q, Wang Z, Chen W, Amin B, Wang D, Lian D, Zhang N. Long-Term Weight Loss Outcome of Laparoscopic Sleeve Gastrectomy Predicted by the Percentage of Excess Weight Loss at 6 Months in Chinese Patients with Body Mass Index ≥ 32.5 Kg/m 2. Diabetes Metab Syndr Obes 2022; 15:2235-2247. [PMID: 35936054 PMCID: PMC9346418 DOI: 10.2147/dmso.s371017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/16/2022] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To evaluate the predictive effect of the initial weight loss on the long-term weight loss in Chinese patients with a body mass index (BMI) ≥ 32.5 kg/m2 who underwent LSG. PATIENTS AND METHODS The follow-up was completed via phone or WeChat for outpatients and at the hospital for inpatients. We evaluated the BMI, percentage of excess weight loss (%EWL), and type 2 diabetes mellitus, hypertension, and hyperlipidemia statuses. Linear and logistic regression analyses were performed on the relationship between the initial and long-term weight loss. The optimal cut-off value was determined by receiver operating characteristic (ROC) curve analysis. RESULTS We enrolled 307 patients, with a median preoperative BMI of 39.68 (35.68, 45.47) kg/m2. %EWL ≥ 50% was regarded as successful weight loss, and 76.55% of the patients lost their weight successfully. (Reviewer #1, comment #4) %EWL at 6 months and 5 years were positively correlated (P < 0.001). Further, the following linear equation could express the relationship: (%EWL5 years = 29.193 + 0.526 × %EWL6 months). %EWL ≥ 58.57% at 6 months was the best predictor of successful weight loss at 5 years after LSG (Reviewer #1, comment #5) (sensitivity, 73.62%; specificity, 73.61%; AUC value, 0.780). Internal verification of the prediction model revealed satisfactory results in terms of discrimination and calibration. CONCLUSION In Chinese patients with BMI ≥ 32.5 kg/m2 who underwent LSG, %EWL at 6 months and 5 years were correlated. %EWL ≥ 58.57% at 6 months was a predictor of successful long-term weight loss.
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Affiliation(s)
- Liang Wang
- Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, People’s Republic of China
| | - Chenxu Tian
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, People’s Republic of China
| | - Guangzhong Xu
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, People’s Republic of China
| | - Qing Sang
- Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, People’s Republic of China
| | - Guanyang Chen
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, People’s Republic of China
| | - Chengyuan Yu
- Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, People’s Republic of China
| | - Qiqige Wuyun
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, People’s Republic of China
| | - Zheng Wang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, People’s Republic of China
| | - Weijian Chen
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, People’s Republic of China
| | - Buhe Amin
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, People’s Republic of China
| | - Dezhong Wang
- General Surgery, Aerospace Center Hospital, Beijing, People’s Republic of China
| | - Dongbo Lian
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, People’s Republic of China
- Correspondence: Dongbo Lian; Nengwei Zhang, Email ;
| | - Nengwei Zhang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, People’s Republic of China
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The efficacy and safety of auriculotherapy for weight loss: A systematic review and meta-analysis. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2021.101402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Loo JH, Lim YH, Seah HL, Chong AZQ, Tay KV. Intragastric Balloon as Bridging Therapy Prior to Bariatric Surgery for Patients with Severe Obesity (BMI ≥ 50 kg/m 2): a Systematic Review and Meta-analysis. Obes Surg 2021; 32:489-502. [PMID: 34787766 DOI: 10.1007/s11695-021-05772-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 10/15/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022]
Abstract
Bariatric surgery for patients with severe obesity (body mass index (BMI) ≥ 50kg/m2) is technically challenging. Intragastric balloon (IGB) has been proposed for weight loss before bariatric surgery to reduce surgical risks but its efficacy remains unclear. We conducted a systematic review and meta-analysis of the effectiveness of IGB as bridging therapy and assess potential complications. Amongst 2419 citations, 13 studies were included. IGB resulted in a BMI reduction of 6.60 kg/m2 (MD=6.60, 95% CI: 5.06-8.15; I2=72%). The total post-procedural complication rate was 8.13% (95% CI: 4.04-13.17%), with majority being balloon intolerance. Overall, IGB is effective as a bridging therapy with adequate procedural safety profile, but further study is needed to evaluate the risk reduction for bariatric surgery and long-term weight-loss outcomes.
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Affiliation(s)
- Jing Hong Loo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
| | - Yao Hui Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Hwee Ling Seah
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Kon Voi Tay
- Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore.,Department of General Surgery, Woodlands Health Campus, Singapore, Singapore
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Impact of Preoperative Weight Loss on Postoperative Weight Loss Revealed from a Large Nationwide Quality Registry. Obes Surg 2021; 32:26-32. [PMID: 34713382 DOI: 10.1007/s11695-021-05760-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/07/2021] [Accepted: 10/11/2021] [Indexed: 01/19/2023]
Abstract
PURPOSE Weight loss before bariatric surgery is not mandatory, but questions remain as to whether preoperative weight loss has an impact on weight loss after surgery. Most studies have small sample sizes. The objective was to evaluate the relationship between preoperative and successful postoperative weight loss defined as ≥25% total weight loss (TWL) at 1 and 2 years after primary bariatric surgery with regard to the obesity-related comorbidities. MATERIALS AND METHODS Data were extracted from a large nationwide quality registry of patients who underwent a sleeve gastrectomy (SG) or gastric bypass (GBP) between January 2015 and January 2018. Patients with completed screening and preoperative and postoperative data were included. A multivariate logistic regression analysis was performed for each technique and follow-up years separately. RESULTS In total, 8751 were included in the analysis. Patients with preoperative weight loss were more likely to achieve ≥25% postoperative TWL in both procedures. Patients with higher preoperative weight loss of 5-10% had an increased likelihood for achieving 25% TWL compared to 0-5%, OR 1.79 (CI (1.42-2.25), p < 0.001) vs 1.25 (CI (1.08-1.46), p < 0.004) for the GBP group for year 2 postoperative. This was the same for the SG group at year 2, OR 1.30 (CI (1.03-1.64), p < 0.029) vs 1.14 (CI (0.94-1.38), p < 0.198). CONCLUSION Patients with preoperative weight loss were more likely to achieve ≥25% postoperative TWL at 1 and 2 years after surgery in both procedures; moreover, the extent of preoperative weight loss contributes to the significance and odds of this success.
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Swaleh R, McGuckin T, Myroniuk TW, Manca D, Lee K, Sharma AM, Campbell-Scherer D, Yeung RO. Using the Edmonton Obesity Staging System in the real world: a feasibility study based on cross-sectional data. CMAJ Open 2021; 9:E1141-E1148. [PMID: 34876416 PMCID: PMC8673483 DOI: 10.9778/cmajo.20200231] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The Edmonton Obesity Staging System (EOSS) combined with body mass index (BMI) enables improved functional and prognostic assessment for patients. To facilitate application of the EOSS in practice, we aimed to create tools for capturing comorbidity assessments in electronic medical records and for automating the calculation of a patient's EOSS stage. METHODS In this feasibility study, we used cross-sectional data to create a clinical dashboard to calculate and display the relation between BMI and EOSS and the prevalence of related comorbidities. We obtained data from the Northern Alberta Primary Care Research Network and the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). We included patients at least 18 years of age with BMI between 30 and 60 who visited a network clinic between July 2016 and July 2019. We calculated descriptive statistics and used stepwise ordinary least squares regression to assess the contributions of age, sex and BMI to EOSS variation. RESULTS We created a clinical dashboard using the CPCSSN data presentation tool. Of the total 31 496 patients included in the study, 23 460 had a BMI of at least 30; BMI was unavailable for 8036 patients. Within each EOSS disease severity stage, there were similar proportions of patients from each BMI class (e.g., patients with EOSS stage 2 included 51.8% of those with BMI class I, 55.3% of those with BMI class II and 58.8% of those with BMI class III). INTERPRETATION Using data from primary care electronic medical records, it was feasible to create a clinical dashboard for obesity that highlighted the severity and stage of obesity. Making this information easily accessible for individual clinical care and practice-level quality improvement may advance obesity care.
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Affiliation(s)
- Rukia Swaleh
- Division of Endocrinology and Metabolism, Department of Medicine (Swaleh, Yeung), Edmonton Physician Learning Program (McGuckin, Myroniuk, Manca, Campbell-Scherer, Yeung), Department of Family Medicine (Manca, Campbell-Scherer), Division of Preventive Medicine, Department of Medicine (Lee), and Department of Medicine (Sharma), Faculty of Medicine and Dentistry; School of Public Health (Lee); School of Urban and Regional Planning (Lee); and Alberta Diabetes Institute (Sharma, Campbell-Scherer, Yeung), University of Alberta, Edmonton, Alta.; and Department of Public Health (Myroniuk), University of Missouri-Columbia, Columbia, Mo
| | - Taylor McGuckin
- Division of Endocrinology and Metabolism, Department of Medicine (Swaleh, Yeung), Edmonton Physician Learning Program (McGuckin, Myroniuk, Manca, Campbell-Scherer, Yeung), Department of Family Medicine (Manca, Campbell-Scherer), Division of Preventive Medicine, Department of Medicine (Lee), and Department of Medicine (Sharma), Faculty of Medicine and Dentistry; School of Public Health (Lee); School of Urban and Regional Planning (Lee); and Alberta Diabetes Institute (Sharma, Campbell-Scherer, Yeung), University of Alberta, Edmonton, Alta.; and Department of Public Health (Myroniuk), University of Missouri-Columbia, Columbia, Mo
| | - Tyler W Myroniuk
- Division of Endocrinology and Metabolism, Department of Medicine (Swaleh, Yeung), Edmonton Physician Learning Program (McGuckin, Myroniuk, Manca, Campbell-Scherer, Yeung), Department of Family Medicine (Manca, Campbell-Scherer), Division of Preventive Medicine, Department of Medicine (Lee), and Department of Medicine (Sharma), Faculty of Medicine and Dentistry; School of Public Health (Lee); School of Urban and Regional Planning (Lee); and Alberta Diabetes Institute (Sharma, Campbell-Scherer, Yeung), University of Alberta, Edmonton, Alta.; and Department of Public Health (Myroniuk), University of Missouri-Columbia, Columbia, Mo
| | - Donna Manca
- Division of Endocrinology and Metabolism, Department of Medicine (Swaleh, Yeung), Edmonton Physician Learning Program (McGuckin, Myroniuk, Manca, Campbell-Scherer, Yeung), Department of Family Medicine (Manca, Campbell-Scherer), Division of Preventive Medicine, Department of Medicine (Lee), and Department of Medicine (Sharma), Faculty of Medicine and Dentistry; School of Public Health (Lee); School of Urban and Regional Planning (Lee); and Alberta Diabetes Institute (Sharma, Campbell-Scherer, Yeung), University of Alberta, Edmonton, Alta.; and Department of Public Health (Myroniuk), University of Missouri-Columbia, Columbia, Mo
| | - Karen Lee
- Division of Endocrinology and Metabolism, Department of Medicine (Swaleh, Yeung), Edmonton Physician Learning Program (McGuckin, Myroniuk, Manca, Campbell-Scherer, Yeung), Department of Family Medicine (Manca, Campbell-Scherer), Division of Preventive Medicine, Department of Medicine (Lee), and Department of Medicine (Sharma), Faculty of Medicine and Dentistry; School of Public Health (Lee); School of Urban and Regional Planning (Lee); and Alberta Diabetes Institute (Sharma, Campbell-Scherer, Yeung), University of Alberta, Edmonton, Alta.; and Department of Public Health (Myroniuk), University of Missouri-Columbia, Columbia, Mo
| | - Arya M Sharma
- Division of Endocrinology and Metabolism, Department of Medicine (Swaleh, Yeung), Edmonton Physician Learning Program (McGuckin, Myroniuk, Manca, Campbell-Scherer, Yeung), Department of Family Medicine (Manca, Campbell-Scherer), Division of Preventive Medicine, Department of Medicine (Lee), and Department of Medicine (Sharma), Faculty of Medicine and Dentistry; School of Public Health (Lee); School of Urban and Regional Planning (Lee); and Alberta Diabetes Institute (Sharma, Campbell-Scherer, Yeung), University of Alberta, Edmonton, Alta.; and Department of Public Health (Myroniuk), University of Missouri-Columbia, Columbia, Mo
| | - Denise Campbell-Scherer
- Division of Endocrinology and Metabolism, Department of Medicine (Swaleh, Yeung), Edmonton Physician Learning Program (McGuckin, Myroniuk, Manca, Campbell-Scherer, Yeung), Department of Family Medicine (Manca, Campbell-Scherer), Division of Preventive Medicine, Department of Medicine (Lee), and Department of Medicine (Sharma), Faculty of Medicine and Dentistry; School of Public Health (Lee); School of Urban and Regional Planning (Lee); and Alberta Diabetes Institute (Sharma, Campbell-Scherer, Yeung), University of Alberta, Edmonton, Alta.; and Department of Public Health (Myroniuk), University of Missouri-Columbia, Columbia, Mo
| | - Roseanne O Yeung
- Division of Endocrinology and Metabolism, Department of Medicine (Swaleh, Yeung), Edmonton Physician Learning Program (McGuckin, Myroniuk, Manca, Campbell-Scherer, Yeung), Department of Family Medicine (Manca, Campbell-Scherer), Division of Preventive Medicine, Department of Medicine (Lee), and Department of Medicine (Sharma), Faculty of Medicine and Dentistry; School of Public Health (Lee); School of Urban and Regional Planning (Lee); and Alberta Diabetes Institute (Sharma, Campbell-Scherer, Yeung), University of Alberta, Edmonton, Alta.; and Department of Public Health (Myroniuk), University of Missouri-Columbia, Columbia, Mo
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Athanasiadis DI, Hernandez E, Dirks RC, Stefanidis D, Banerjee A. Postoperative 4-Year Outcomes in Septuagenarians Following Bariatric Surgery. Obes Surg 2021; 31:5127-5131. [PMID: 34476727 DOI: 10.1007/s11695-021-05694-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 08/26/2021] [Accepted: 08/29/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Bariatric surgery is the most effective treatment for obesity; however, its utilization in older patients remains low. There is a dearth of literature on long-term effectiveness and safety of bariatric surgery in septuagenarian patients. The aim of this study was to compare the short- and long-term outcomes of bariatric surgery in this population. METHODS Patients who underwent primary laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) at our institution between 2011 and 2015 were included. Patients were divided into two age groups: < 70 and ≥ 70 years. Outcomes included postoperative hospital length of stay (LOS), 30-day complications, up to 4-year complications, 90-day mortality, comorbidity resolution, and 4-year weight loss (BMI change-ΔΒΜΙ). The groups were also compared using multivariable analyses adjusting for potential confounders (gender, preoperative BMI, and type of procedure). RESULTS Twenty-nine septuagenarians who underwent 21 LRYGB (72.4%) and 8 LSG (27.6%) were compared to 1016 patients aged < 70 years operated on during the same time period. Additionally, following the multivariable analyses, the septuagenarians had higher LOS (3 vs 2.3 days, p = 0.01), 4-year complications (38% vs 23%, p = 0.012), and less comorbidities' resolution but similar 4-year ΔBMI (- 8.6 vs - 10, p = 0.421), and 30-day complications (10% vs 6%, p = 0.316). CONCLUSION Bariatric surgery in carefully selected septuagenarians can be accomplished with acceptable safety and comparable postoperative weight loss at 4 years. Surgeons may consider broadening their selection criteria to include this patient subgroup but may allow the patients to reap its benefits if offered earlier in life.
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Affiliation(s)
| | - Edward Hernandez
- Department of Surgery, Indiana University School of Medicine Indiana, Indianapolis, IN, USA
| | - Rebecca C Dirks
- Department of Surgery, Indiana University School of Medicine Indiana, Indianapolis, IN, USA
| | - Dimitrios Stefanidis
- Department of Surgery, Indiana University School of Medicine Indiana, Indianapolis, IN, USA.,Section of Minimally Invasive and Bariatric Surgery, Indiana University Health North Hospital, 11725 N Illinois St, Suite 350, Carmel, Indianapolis, IN, 46032, USA
| | - Ambar Banerjee
- Department of Surgery, Indiana University School of Medicine Indiana, Indianapolis, IN, USA. .,Section of Minimally Invasive and Bariatric Surgery, Indiana University Health North Hospital, 11725 N Illinois St, Suite 350, Carmel, Indianapolis, IN, 46032, USA.
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37
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Mackenzie RM, Greenlaw N, Ali A, Bruce D, Bruce J, Grieve E, Lean M, Lindsay R, Sattar N, Stewart S, Ford I, Logue J. SurgiCal Obesity Treatment Study (SCOTS): a prospective, observational cohort study on health and socioeconomic burden in treatment-seeking individuals with severe obesity in Scotland, UK. BMJ Open 2021; 11:e046441. [PMID: 34446484 PMCID: PMC8395268 DOI: 10.1136/bmjopen-2020-046441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES There is a lack of evidence to inform the delivery and follow-up of bariatric surgery for people with severe obesity. The SurgiCal Obesity Treatment Study (SCOTS) is a national longitudinal cohort of people undergoing bariatric surgery. Here, we describe characteristics of the recruited SCOTS cohort, and the relationship between health and socioeconomic status with body mass index (BMI) and age. PARTICIPANTS/METHODS 445 participants scheduled for bariatric surgery at any of 14 centres in Scotland, UK, were recruited between 2013 and 2016 for this longitudinal cohort study (1 withdrawal); 249 completed health-related preoperative patient-reported outcome measures. Regression models were used to estimate the effect of a 10-unit increase in age or BMI, adjusting for sex, smoking and socioeconomic status. RESULTS Mean age was 46 years and median BMI was 47 kg/m2. For each 10 kg/m2 higher BMI, there was a change of -5.2 (95% CI -6.9 to -3.5; p<0.0001) in Rand 12-item Short Form Survey Physical Component Summary (SF-12 PCS), -0.1 (95% CI -0.2 to -0.1; p<0.0001) in EuroQoL 5-level EQ-5D version index score and 14.2 (95% CI 10.7 to 17.7; p<0.0001) in Impact of Weight on Quality of Life-Lite Physical Function Score. We observed a 3.1 times higher use of specialist aids and equipment at home (OR: 3.1, 95% CI 1.9 to 5.0; p<0.0001). Broadly, similar results were seen for each 10-year higher age, including a change of -2.1 (95% CI -3.7 to -0.5; p<0.01) in SF-12 PCS. CONCLUSIONS A higher BMI combined with older age is associated with poor physical functioning and quality of life in people seeking bariatric surgery treatment. Policy-makers must consider the health and care needs of these individuals and invest to provide increased access to effective weight management. TRIAL REGISTRATION NUMBER ISRCTN47072588.
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Affiliation(s)
- Ruth M Mackenzie
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Nicola Greenlaw
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | | | | | - Julie Bruce
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Eleanor Grieve
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Mike Lean
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Robert Lindsay
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Sally Stewart
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Ian Ford
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - Jennifer Logue
- Lancaster Medical School, Lancaster University, Lancaster, UK
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La Sala L, Tagliabue E, Vieira E, Pontiroli AE, Folli F. High plasma renin activity associates with obesity-related diabetes and arterial hypertension, and predicts persistent hypertension after bariatric surgery. Cardiovasc Diabetol 2021; 20:118. [PMID: 34107965 PMCID: PMC8191118 DOI: 10.1186/s12933-021-01310-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 06/02/2021] [Indexed: 02/07/2023] Open
Abstract
Background Information about the renin–angiotensin–aldosterone system (RAAS) in obese individuals before and after bariatric surgery is scarce. Aim of this study was to analyze the RAAS in severely obese subjects, in relation to anthropometric and metabolic variables, with special reference to glucose tolerance. Methods 239 subjects were evaluated at baseline, and 181 one year after bariatric surgery [laparoscopic gastric banding (LAGB)]. Results At baseline, renin (plasma renin activity, PRA) was increased from normal to glucose tolerance and more in diabetes, also correlating with ferritin. After LAGB, the decrease of PRA and aldosterone was significant in hypertensive, but not in normotensive subjects, and correlatied with decrease of ferritin. PRA and glucose levels were predictive of persistent hypertension 1 year after LAGB. Conclusions These data support the role of RAAS in the pathophysiology of glucose homeostasis, and in the regulation of blood pressure in obesity. Ferritin, as a proxy of subclinical inflammation, could be another factor contributing to the cross-talk between RAAS and glucose metabolism.
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Affiliation(s)
- Lucia La Sala
- Lab. of Cardiovascular and Dysmetabolic Disease, IRCCS MultiMedica, 20138, Milan, Italy.
| | - Elena Tagliabue
- Value-based Healthcare Unit, IRCCS MultiMedica, Milan, Italy
| | - Elaine Vieira
- Postgraduate Program on Physical Education, Universidade Católica de Brasília, Taguatinga, DF, 71966-700, Brazil
| | - Antonio E Pontiroli
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142, Milan, Italy.
| | - Franco Folli
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142, Milan, Italy.,Unità di Endocrinologia, Ospedale San Paolo, ASST Santi Paolo e Carlo, Milan, Italy
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Masrur M, Bustos R, Sanchez-Johnsen L, Gonzalez-Ciccarelli L, Mangano A, Gonzalez-Heredia R, Patel R, Danielson KK, Gangemi A, Elli EF. Factors Associated with Weight Loss After Metabolic Surgery in a Multiethnic Sample of 1012 Patients. Obes Surg 2021; 30:975-981. [PMID: 31848986 DOI: 10.1007/s11695-019-04338-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Metabolic surgery is the most effective method for weight loss in the long-term treatment of morbid obesity and its comorbidities. The primary aim of this study was to examine factors associated with percent total weight loss (%TWL) after metabolic surgery among an ethnically diverse sample of patients. METHODS A retrospective review was performed on 1012 patients who underwent either a sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) at our institution between January 2008 and June 2015. RESULTS African Americans had a lower %TWL than non-Hispanic/Latino Whites at 6, 9, 12, 18, and 48 months. At all timeframes, there was a negative association between pre-surgery TWL and %TWL after surgery. Female sex was negatively associated with %TWL at 3 months only. Higher initial BMI was also associated with greater post-operative %TWL at 18, 24 and 36 months. Older patients had lower %TWL at 6, 9, 12 and 24 months post-surgery. Patients who received RYGB had greater %TWL than those who received SG at 3, 6, 9, 12, 24 and 36 months. CONCLUSIONS African Americans had a lower %TWL than non-Hispanic/Latino Whites at most time points; there were no other significant race/ethnicity or sex differences. BMI (greater initial BMI), age (lower) and RYGB were associated with a greater post-operative %TWL at certain post-surgery follow-up time points. A limitation of this study is that there was missing data at a number of time points due to lack of attendance at certain follow-up visits.
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Affiliation(s)
- Mario Masrur
- Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, 840 S. Wood Street, Suite 435E (MC 958), Chicago, IL, 60612, USA
| | - Roberto Bustos
- Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, 840 S. Wood Street, Suite 435E (MC 958), Chicago, IL, 60612, USA.
| | - Lisa Sanchez-Johnsen
- Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, 840 S. Wood Street, Suite 435E (MC 958), Chicago, IL, 60612, USA.,Departments of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Luis Gonzalez-Ciccarelli
- Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, 840 S. Wood Street, Suite 435E (MC 958), Chicago, IL, 60612, USA
| | - Alberto Mangano
- Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, 840 S. Wood Street, Suite 435E (MC 958), Chicago, IL, 60612, USA
| | | | - Ronak Patel
- Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, 840 S. Wood Street, Suite 435E (MC 958), Chicago, IL, 60612, USA
| | - Kirstie K Danielson
- Division of Endocrinology, Department of Medicine, University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Antonio Gangemi
- Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, 840 S. Wood Street, Suite 435E (MC 958), Chicago, IL, 60612, USA
| | - Enrique Fernando Elli
- Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, 840 S. Wood Street, Suite 435E (MC 958), Chicago, IL, 60612, USA.,Department of Surgery, Mayo Clinic Jacksonville, Jacksonville, FL, USA
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40
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Ogle SB, Dewberry LC, Jenkins TM, Inge TH, Kelsey M, Bruzoni M, Pratt JS. Outcomes of Bariatric Surgery in Older Versus Younger Adolescents. Pediatrics 2021; 147:peds.2020-024182. [PMID: 33526606 PMCID: PMC7919111 DOI: 10.1542/peds.2020-024182] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2020] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES In this report, we compare weight loss, comorbidity resolution, nutritional abnormalities, and quality of life between younger and older adolescents after metabolic and bariatric surgery. METHODS From March 2007 to December 2011, 242 adolescents (≤19 years of age) who underwent bariatric surgery at 5 clinical centers in the United States were enrolled in the prospective, multicenter, long-term outcome study Teen-Longitudinal Assessment of Bariatric Surgery. Outcome data from younger (13-15 years; n = 66) and older (16-19 years; n = 162) study participants were compared. Outcomes included percent BMI change, comorbidity outcomes (hypertension, dyslipidemia, and type 2 diabetes mellitus), nutritional abnormalities, and quality of life over 5 years post surgery. RESULTS Baseline characteristics, except for age, between the 2 cohorts were similar. No significant differences in frequency of remission of hypertension (P = .84) or dyslipidemia (P = .74) were observed between age groups. Remission of type 2 diabetes mellitus was high in both groups, although statistically higher in older adolescents (relative risk 0.86; P = .046). Weight loss and quality of life were similar in the 2 age groups. Younger adolescents were less likely to develop elevated transferrin (prevalence ratio 0.52; P = .048) and low vitamin D levels (prevalence ratio 0.8; P = .034). CONCLUSIONS The differences in outcome of metabolic and bariatric surgery between younger and older adolescents were few. These data suggest that younger adolescents with severe obesity should not be denied consideration for surgical therapy on the basis of age alone and that providers should consider adolescents of all ages for surgical therapy for obesity when clinically indicated.
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Affiliation(s)
- Sarah B. Ogle
- Children’s Hospital Colorado and School of Medicine, University of Colorado, Aurora, Colorado
| | - Lindel C. Dewberry
- Children’s Hospital Colorado and School of Medicine, University of Colorado, Aurora, Colorado
| | - Todd M. Jenkins
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; and
| | - Thomas H. Inge
- Children’s Hospital Colorado and School of Medicine, University of Colorado, Aurora, Colorado
| | - Megan Kelsey
- Children’s Hospital Colorado and School of Medicine, University of Colorado, Aurora, Colorado
| | - Matias Bruzoni
- Lucile Packard Children’s Hospital Stanford, Palo Alto, California
| | - Janey S.A. Pratt
- Lucile Packard Children’s Hospital Stanford, Palo Alto, California
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Keshavjee SH, Schwenger KJP, Yadav J, Jackson TD, Okrainec A, Allard JP. Factors Affecting Metabolic Outcomes Post Bariatric Surgery: Role of Adipose Tissue. J Clin Med 2021; 10:714. [PMID: 33670215 PMCID: PMC7916950 DOI: 10.3390/jcm10040714] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/07/2021] [Accepted: 02/09/2021] [Indexed: 02/07/2023] Open
Abstract
Obesity is an ever-growing public health crisis, and bariatric surgery (BS) has become a valuable tool in ameliorating obesity, along with comorbid conditions such as diabetes, dyslipidemia and hypertension. BS techniques have come a long way, leading to impressive improvements in the health of the majority of patients. Unfortunately, not every patient responds optimally to BS and there is no method that is sufficient to pre-operatively predict who will receive maximum benefit from this surgical intervention. This review focuses on the adipose tissue characteristics and related parameters that may affect outcomes, as well as the potential influences of insulin resistance, BMI, age, psychologic and genetic factors. Understanding the role of these factors may help predict who will benefit the most from BS.
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Affiliation(s)
- Sara H. Keshavjee
- Vagelos College of Physicians & Surgeons, Columbia University, New York, NY 10032, USA;
| | - Katherine J. P. Schwenger
- Division of Gastroenterology, Toronto General Hospital, University Health Network, Toronto, ON M5G 2N2, Canada;
| | - Jitender Yadav
- Department of Immunology, University of Toronto, Toronto, ON M5S 1A8, Canada;
| | - Timothy D. Jackson
- Division of General Surgery, University Health Network, University of Toronto, Toronto, ON M5T 2S8, Canada; (T.D.J.); (A.O.)
| | - Allan Okrainec
- Division of General Surgery, University Health Network, University of Toronto, Toronto, ON M5T 2S8, Canada; (T.D.J.); (A.O.)
| | - Johane P. Allard
- Division of Gastroenterology, Toronto General Hospital, University Health Network, Toronto, ON M5G 2N2, Canada;
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Nickel F, Felinska EA, Billeter AT, Müller-Stich BP. Comment on: Esophageal cancer after sleeve gastrectomy: a population-based comparative cohort study. Surg Obes Relat Dis 2021; 17:887-888. [PMID: 33685805 DOI: 10.1016/j.soard.2021.01.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 01/24/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Felix Nickel
- Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany
| | - Eleni Amelia Felinska
- Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany
| | - Adrian Theophil Billeter
- Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany
| | - Beat Peter Müller-Stich
- Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany
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Mao R, Guo P, Lin Z, Yang H, Jayachandran M, Xu C, Zhang T, Qu S, Liu Y. Nomograms for Predicting Non-remission in Patients Who Underwent Bariatric Surgery: A Multicenter Retrospective Study in China. Obes Surg 2021; 31:1967-1978. [PMID: 33415611 DOI: 10.1007/s11695-020-05206-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 12/23/2020] [Accepted: 12/29/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND As a reflection of the increasing global incidence of obesity, there is a corresponding increase in the proportion of obese patients undergoing bariatric surgery. This study reviewed the factors and outcomes of patients who underwent bariatric surgical procedures and determined the relationships and developed a nomogram to calculate individualized patient risk. METHODS The nomogram was based on a retrospective study on 259 patients who underwent bariatric surgery at the Chengdu Third People's Hospital from June 2017 to June 2019. The predictive accuracy and discriminative ability of the nomogram were determined by the ROC curve and C-index, respectively. The results were validated using bootstrap resampling and a retrospective study on 121 patients operated on from May 2015 to May 2019 at the Tenth People's Hospital of Shanghai. RESULTS The predictors contained in the prediction nomogram included age, sex, surgical approach, hyperlipidemia, blood pressure (BP), hyperuricemia, body mass index (BMI), and waist circumference (WC). The 6-month model displayed good discrimination with a C-index of 0.765 (95% CI: 0.756 to 0.774) and good calibration. The 1-year model reached a C-index of 0.768 (95% CI, 0.759 to 0.777) in the training cohort. CONCLUSIONS The proposed nomogram resulted in more accurate non-remission prediction for patients with obesity after bariatric surgery and may provide a reference for the preoperative choice of surgical methods.
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Affiliation(s)
- Rui Mao
- Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610036, China
| | - Pengsen Guo
- Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610036, China
| | - Ziwei Lin
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, No. 301 Middle Yanchang Road, Shanghai, 200072, China
| | - Huawu Yang
- The Center of Gastrointestinal and Minimally Invasive Surgery, The Third People's Hospital of Chengdu; Affiliated Hospital of Southwest Jiaotong University, Qinglong Road, Chengdu, 610031, China
| | - Muthukumaran Jayachandran
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, No. 301 Middle Yanchang Road, Shanghai, 200072, China
| | - Chenxin Xu
- Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610036, China
| | - Tongtong Zhang
- Medical Research Center, The Third People's Hospital of Chengdu, The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Sichuan Province, Chengdu, 610031, China. .,Medical Research Center, The Third People's Hospital of Chengdu, 82 Qinglong street, Qingyang District, Chengdu, 610031, Sichuan Province, China.
| | - Shen Qu
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, No. 301 Middle Yanchang Road, Shanghai, 200072, China.
| | - Yanjun Liu
- Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610036, China. .,The Center of Gastrointestinal and Minimally Invasive Surgery, The Third People's Hospital of Chengdu; Affiliated Hospital of Southwest Jiaotong University, Qinglong Road, Chengdu, 610031, China.
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Borges-Canha M, Neves JS, Mendonça F, Silva MM, Costa C, M. Cabral P, Guerreiro V, Lourenço R, Meira P, Salazar D, Ferreira MJ, Pedro J, Barkoudah E, Sande A, Lau E, B. Souto S, Preto J, Freitas P, Carvalho D. Beta Cell Function as a Baseline Predictor of Weight Loss After Bariatric Surgery. Front Endocrinol (Lausanne) 2021; 12:714173. [PMID: 34456871 PMCID: PMC8387593 DOI: 10.3389/fendo.2021.714173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/22/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Obesity is a multifactorial disease, which is strongly associated to other metabolic disorders. Bariatric surgery is the most effective treatment of morbid obesity. The role of beta cell function in weight loss after bariatric surgery is uncertain. AIM To evaluate the association between beta cell function and percentage of total body weight loss (TBWL%) 1, 2, 3, and 4 years after bariatric surgery in patients with morbid obesity. METHODS Retrospective longitudinal study in patients with morbid obesity followed in our center between January 2010 and July 2018. Patients were excluded if they had diabetes at baseline or missing data on the needed parameters. We evaluated baseline Homeostatic Model Assessment of IR, Homeostatic Model Assessment of β-cell function (HOMA-beta), Quantitative Insulin Sensitivity Check Index, and Matsuda and DeFronzo index, and TBWL% at years 1 to 4. Linear regression models were used to evaluate the association of indexes of insulin resistance with TBWL% (unadjusted and adjusted for age, sex, BMI, and type of surgery). RESULTS There were 1,561 patients included in this analysis. HOMA-beta was negatively associated with TBWL% at second, third, and fourth years post-surgery (β = -1.04 [-1.82 to -0.26], p<0.01; β = -1.16 [-2.13 to -0.19], p=0.02; β = -1.29 [-2.64 to 0.06], p=0.061, respectively). This was not observed in the first year post-surgery nor for the other indexes. Glycemia at baseline was positively associated to EWL% at second and third years post-surgery. CONCLUSION β-cell function at baseline seems to be associated to long-term weight loss, explicitly after the first year post bariatric surgery. This might be a helpful predictor of weight loss in clinical practice.
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Affiliation(s)
- Marta Borges-Canha
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- *Correspondence: Marta Borges-Canha, ; orcid.org/0000-0003-2929-3751
| | - João Sérgio Neves
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Fernando Mendonça
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Maria Manuel Silva
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Cláudia Costa
- Serviço de Endocrinologia do Instituto Português de Oncologia do Porto, Francisco Gentil, EPE, Porto, Portugal
| | - Pedro M. Cabral
- Serviço de Patologia Clínica do Centro Hospitalar Universitário Cova da Beira, EPE, Covilhã, Portugal
| | - Vanessa Guerreiro
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Rita Lourenço
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
| | - Patrícia Meira
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
| | - Daniela Salazar
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Maria João Ferreira
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Jorge Pedro
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Ebrahim Barkoudah
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Ana Sande
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Eva Lau
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Selma B. Souto
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - John Preto
- Serviço de Cirurgia Geral do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Paula Freitas
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
- Investigação e Inovação em Saúde (i3s), Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Davide Carvalho
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
- Investigação e Inovação em Saúde (i3s), Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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Ohira M, Watanabe Y, Yamaguchi T, Onda H, Yamaoka S, Abe K, Nakamura S, Tanaka S, Kawagoe N, Nabekura T, Saiki A, Oshiro T, Nagayama D, Tatsuno I. The Relationship between Serum Insulin-Like Growth Factor-1 Levels and Body Composition Changes after Sleeve Gastrectomy. Obes Facts 2021; 14:641-649. [PMID: 34649248 PMCID: PMC8740143 DOI: 10.1159/000519610] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 09/07/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION We previously reported that preoperative serum insulin-like growth factor-1 (IGF-1) is a predictor of total weight loss percentage (%TWL) after laparoscopic sleeve gastrectomy (LSG). IGF-1 may suppress muscle loss after surgery. IGF-1 almost accurately reflects the growth hormone (GH) secretion status, and GH has lipolytic effects. Therefore, IGF-1 may influence both the maintenance of skeletal muscle and the reduction of adipose tissue after LSG. The identification of the relationship between preoperative serum IGF-1 and body composition changes after LSG can help in understanding the pathophysiology of obesity. METHODS We retrospectively reviewed 72 patients with obesity who underwent LSG and were followed up for 12 months. We analyzed the relationship between preoperative serum IGF-1 levels and body composition changes after LSG. A multiple regression model was used. RESULTS LSG led to a significant reduction in body weight. Both body fat mass and skeletal muscle mass decreased after LSG. Preoperative serum IGF-1 levels significantly correlated with %TWL, changes in skeletal muscle mass, and body fat mass after LSG. The multiple regression model showed that preoperative serum IGF-1 levels were related to decreased body fat mass and maintaining skeletal muscle mass after LSG. DISCUSSION/CONCLUSION Preoperative IGF-1 measurement helps predict not only successful weight loss but also decreases body fat mass and maintains skeletal muscle mass after LSG.
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Affiliation(s)
- Masahiro Ohira
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
- *Masahiro Ohira,
| | - Yasuhiro Watanabe
- Center for Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Takashi Yamaguchi
- Center for Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Hiroki Onda
- Center for Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Shuhei Yamaoka
- Center for Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Kazuki Abe
- Center for Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Shoko Nakamura
- Center for Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Shou Tanaka
- Center for Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Naoyuki Kawagoe
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Taiki Nabekura
- Department of Surgery, Toho University Sakura Medical Center, Chiba, Japan
| | - Atsuhito Saiki
- Center for Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Takashi Oshiro
- Department of Surgery, Toho University Sakura Medical Center, Chiba, Japan
| | - Daiji Nagayama
- Department of Internal Medicine, Nagayama Clinic, Tochigi, Japan
| | - Ichiro Tatsuno
- Center for Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
- Chiba Prefectural University of Health Sciences, Chiba, Japan
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Tapking C, Benner L, Hackbusch M, Schüler S, Tran D, Ottawa GB, Krug K, Müller-Stich BP, Fischer L, Nickel F. Influence of Body Mass Index and Gender on Stigmatization of Obesity. Obes Surg 2020; 30:4926-4934. [PMID: 32772227 PMCID: PMC7719108 DOI: 10.1007/s11695-020-04895-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 11/01/2022]
Abstract
BACKGROUND Stigmatization and discrimination of people with obesity due to their weight are a common problem that may lead to additional weight gain. This study evaluated the influence of different parameters on the stigmatization of obesity. MATERIAL AND METHODS Participants of six groups (general population, patients with obesity, medical students, physicians, nurses in training and nurses; n = 490) answered the short-form fat phobia scale (FPS) between August 2016 and July 2017. The influence of body mass index (BMI), gender and other factors on total scores and single adjective pairs was analyzed. RESULTS A total of 490 participants were evaluated. The total mean FPS rating was 3.5 ± 0.6. FPS was significantly lower (more positive) in participants with obesity (3.2 ± 0.7) compared with participants without obesity (3.5 ± 0.5, p < 0.001). Individuals with obesity and diabetes rated the FPS significantly lower (more positive), whereas age and gender did not have a significant influence. Participants with obesity linked obesity more often with good self-control (p < 0.001), being shapely (p = 0.002), industrious (p < 0.001), attractive (p < 0.001), active (p < 0.001), self-sacrificing (p < 0.001) and having more willpower (p < 0.001) than the participants without obesity. Females rated more positive in shapely versus shapeless (p = 0.038) and attractive versus non-attractive (p < 0.001) than males. CONCLUSIONS The present study shows that stigmatization of obesity is present in medical professionals as well as the general population. People affected by obesity characterized other people with obesity more positively (e.g. attractive or active), whereas people without obesity linked negative characteristics with obesity. Gender had an influence only on single items of FPS but did not affect overall stigmatization of obesity.
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Affiliation(s)
- Christian Tapking
- Department of General, Visceral and Transplant Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Trauma Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwig-Guttmann-Strasse 13, 67071 Ludwigshafen on the Rhine, Germany
| | - Laura Benner
- Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Matthes Hackbusch
- Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Svenja Schüler
- Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Danny Tran
- School of Medicine, University of Texas Medical Branch, Galveston, TX USA
| | - Gregor B. Ottawa
- Coordination Centre of Clinical Trials, University Hospital of Heidelberg, Im Neuenheimer Feld 110, Heidelberg, Germany
| | - Katja Krug
- Department of General Practice and Health Services Research, University Hospital of Heidelberg, Vossstr. 2, 69115 Heidelberg, Germany
| | - Beat P. Müller-Stich
- Department of General, Visceral and Transplant Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
| | - Lars Fischer
- Department of Surgery, Hospital Mittelbaden, Balger Strasse 50, 76532 Baden-Baden, Germany
| | - Felix Nickel
- Department of General, Visceral and Transplant Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
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Atlantis E, Sahebolamri M, Cheema BS, Williams K. Usefulness of the Edmonton Obesity Staging System for stratifying the presence and severity of weight-related health problems in clinical and community settings: A rapid review of observational studies. Obes Rev 2020; 21:e13120. [PMID: 32812345 DOI: 10.1111/obr.13120] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/19/2020] [Accepted: 07/20/2020] [Indexed: 12/12/2022]
Abstract
This rapid review aimed to examine the usefulness of the Edmonton Obesity Staging System (EOSS) for stratifying the presence and severity of weight-related health problems in clinical and community settings. We searched PubMed, CINAHL and ProQuest for records from 2009 to May 2020. We considered observational studies in participants with overweight or obesity that investigated the risk of any clinical outcome associated with increasing EOSS. We reviewed and appraised 20 observational studies (cohort = 4, case series = 7, cross-sectional = 9) published between 2011 and 2020. Of 12 studies in clinical populations, the EOSS was most consistently associated with an increased risk of postoperative complications following bariatric surgery, especially for EOSS 3-4, and inversely associated with weight loss, treatment time and resolution of hypertension following bariatric surgery and clinical weight management. Of eight studies in community populations, the EOSS most consistently predicted mortality outcomes, especially for EOSS 3, and was associated with polypharmacy, service use and poorer work outcomes. Studies reported diverse EOSS definitions and outcomes, which slightly weakens the overall evidence base. The EOSS should be routinely used for predicting risks and benefits of surgical and nonsurgical weight management, but it should be applied with caution for population health planning.
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Affiliation(s)
- Evan Atlantis
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia.,School of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Mehdi Sahebolamri
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia.,Department of Endocrinology (Obesity), Nepean Hospital, Nepean Blue Mountains Local Health District, Kingswood, New South Wales, Australia
| | - Birinder S Cheema
- School of Health Sciences and the National Institute of Complementary Medicine, Western Sydney University, Penrith, New South Wales, Australia
| | - Kathryn Williams
- Department of Endocrinology (Obesity), Nepean Hospital, Nepean Blue Mountains Local Health District, Kingswood, New South Wales, Australia.,Charles Perkins Centre-Nepean, The University of Sydney, Kingswood, New South Wales, Australia
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Third bariatric procedure for insufficient weight loss or weight regain: how far should we go? Surg Obes Relat Dis 2020; 17:96-103. [PMID: 33097448 DOI: 10.1016/j.soard.2020.08.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/28/2020] [Accepted: 08/20/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Revisional procedures in bariatric surgery are increasing with several debated failure risk factors, such as super obesity and old age. No study has yet evaluated the outcomes and risks of a third bariatric procedure indicated for weight loss failure or weight regain. OBJECTIVES To assess failure risks of a third bariatric procedure according to Reinhold's criteria (percentage excess weight loss [%EWL] ≤50% and/or body mass index [BMI] ≥35 kg/m2). SETTING A university-affiliated tertiary care center, France. METHODS From 2009 to 2019, clinical data and weight loss results of patients who benefited from 3 bariatric procedures for weight loss failure or weight regain were collected prospectively and analyzed using a binary logistic regression. Weight loss failure was defined according to Reinhold's criteria. RESULTS Among 1401 bariatric procedures performed, 336 patients benefited from 2 or more procedures, and 45 had a third surgery. Eleven patients that were reoperated on because of malnutrition or gastroesophageal reflux disease were excluded from the final analysis. Among 34 patients with 3 procedures because of weight loss failure or regain, mean BMI was 48.3 ± 8.3 kg/m2, and mean age was 30 ± 10.7 years. Three out of 34 patients (9%) presented a severe complication (Dindo-Clavien IIIb) and 2 (6%) had a minor one. Achieving Reinhold's weight loss criteria after the second bariatric procedure was a significant predictor of success of the third procedure (β = 2.9 ± 1.3 S.E.). CONCLUSION Not reaching Reinhold's criteria after a second bariatric procedure was identified as a significant risk factor of failure of a third procedure. A third surgery should be carefully discussed especially in case of primary failure of previous procedures.
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Wang L, Sang Q, Zheng X, Du D, Zhang N, Lian D. Early Weight Loss Following Laparoscopic Sleeve Gastrectomy Is Predictive of Long-Term Weight Loss in Morbidly Obese Chinese. Obes Surg 2020; 31:820-828. [PMID: 33057884 DOI: 10.1007/s11695-020-05037-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/30/2020] [Accepted: 10/06/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Laparoscopic sleeve gastrectomy (LSG) is a bariatric surgical approach often used to treat Chinese individuals suffering from morbid obesity. OBJECTIVES To verify the long-term safety and efficiency of LSG and to evaluate the predictive effect of initial weight loss on long-term weight maintenance after LSG in morbidly obese Chinese. METHODS Follow-up was conducted by telephone or in hospital. We measured the body mass index (BMI), percentage of total body weight loss (%TWL), and excess weight loss (%EWL), and assessed patients for the alleviation of co-morbidities. Relationships between initial weight loss and successful weight maintenance were assessed via linear regression analyses, while optimal cutoff values were determined based on receiver operative characteristic (ROC) curves. RESULTS We included 384 patients in this study. Before surgery, these patients had median weight and BMI values of 110 (91.00-130.75) kg and 38.49 (32.82-44.12) kg/m2, respectively. Successful weight loss of > 50% EWL was accomplished in 91.21%, 82.69%, and 79.37% of patients at 1, 3, and 5 years after surgery. In addition, the %EWL at 6 months was significantly correlated with the %EWL up to 5 years (P < 0.001) in morbidly obese Chinese. Based on the ROC curve, the EWL of 56.54% at 6 months was the best predictor of successful weight loss at 5 years (sensitivity 72.38%, specificity 82.69%) in morbidly obese Chinese. CONCLUSION LSG has long-term safety and efficacy for morbidly obese Chinese patients. The %EWL at 6 months can be used to predict weight maintenance up to 5 years after LSG.
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Affiliation(s)
- Liang Wang
- Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, 100038, China
| | - Qing Sang
- Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, 100038, China
| | - Xuejing Zheng
- Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, 100038, China
| | - Dexiao Du
- Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, 100038, China
| | - Nengwei Zhang
- Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, 100038, China.
| | - Dongbo Lian
- Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, 100038, China.
- Shijitan Hospital, Tieyi Road, Haidian District, Beijing, China.
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Correlating actual one-year weight loss with predicted weight loss by the MBSAQIP: bariatric surgical risk/benefit calculator. Surg Endosc 2020; 35:5705-5708. [DOI: 10.1007/s00464-020-08030-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 09/16/2020] [Indexed: 12/23/2022]
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