Surgery For Obesity And Related Diseases[JOURNAL]
Sun
200 papers
Heart failure as a leading independent predictor for mortality and adverse outcomes after bariatric surgery: analysis using the 2023-2024 MBSAQIP database.
Sebastian R, Zevallos A, Tuesta O … +6 more , Riva A, Biller J, Silvers J, Adrales G, Li C, Schweitzer M
Surg Obes Relat Dis · 2026 Jun · PMID 41864825 · Publisher ↗
BACKGROUND: Heart failure (HF) has been associated with postoperative cardiac events and mortality after bariatric surgery. However, recent data remain scarce. OBJECTIVES: To compare 30-day outcomes after sleeve gastrect...
BACKGROUND: Heart failure (HF) has been associated with postoperative cardiac events and mortality after bariatric surgery. However, recent data remain scarce. OBJECTIVES: To compare 30-day outcomes after sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) in patients with versus without HF and to assess HF as a predictor for adverse outcomes after SG and RYGB. SETTING: 2023-2024 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. METHODS: We analyzed patients with HF who underwent SG and RYGB. A 4:1 propensity score matching analysis was performed, matching 24 preoperative characteristics. We compared 30-day postoperative outcomes in patients with and without HF for both SG and RYGB. Then, 7 multivariate logistic regression analyses were conducted to identify independent predictors for postoperative complications after SG and RYGB. RESULTS: We analyzed 231,243 SG and 96,546 RYGB patients. Outcomes in patients who underwent SG showed that patients with HF had higher rates of mortality, cardiac complications, pulmonary complications, unplanned intensive care unit admissions, readmissions, interventions, nonhome discharge, and postoperative bleeding (P < .05). Outcomes in patients who underwent RYGB had higher rates of mortality, pulmonary complications, renal complications, unplanned intensive care unit admissions, emergency visits, readmissions, and interventions (P < .05). HF was the most significant predictor for 30-day mortality (odds ratio: 4.88; 95% confidence interval: 2.88-8.27; P < .001) following SG and the second most significant predictor (odds ratio: 2.90; 95% confidence interval: 1.37-6.14; P = .005) following RYGB. CONCLUSIONS: Patients with HF have a higher rate of mortality and overall complications compared to patients without HF after either SG or RYGB. HF is the strongest independent predictor for 30-day mortality after SG and the second strongest independent predictor after RYGB. Preoperative cardiac optimization is strongly advised in this population.
Current trends in reoperative bariatric surgery using MBSAQIP database 2020-2023.
Crnkovic CM, Ng MRA, Jordan N … +5 more , Butler L, Davenport D, Steiner J, Inabnet W, Jain V
Surg Obes Relat Dis · 2026 Jun · PMID 41864824 · Publisher ↗
BACKGROUND: Reoperative bariatric surgeries continue to increase every year, and indications and outcomes have changed over time. OBJECTIVE: The aim of this study is to assess trends and 30-day outcomes of elective reope...
BACKGROUND: Reoperative bariatric surgeries continue to increase every year, and indications and outcomes have changed over time. OBJECTIVE: The aim of this study is to assess trends and 30-day outcomes of elective reoperative metabolic and bariatric surgeries (MBS) between 2020 and 2023. SETTING: National database, United States. METHODS: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database from 2020 to 2023 was evaluated. Elective reoperations were included in the analysis while emergent and rare procedures were excluded. Comprehensive descriptive statistics were reported for pooled and stratified data. Preoperative variables and postoperative outcomes were compared. RESULTS: Of 828,481 surgeries, 90,410 elective reoperations occurred (10.9%) between 2020 and 2023. Sleeve gastrectomy (SG) reoperations were the most common. Of these, 39,265 (80.9%) were converted to Roux-en-Y gastric bypass (RYGB), and 5331 (11%) to duodenal switch (DS)/single anastomosis duodenal-ileal bypass (SADI). Common indications for reoperation were weight recurrence/non-responders (53.7%) and gastroesophageal reflux (32.2%). Laparoscopic adjustable gastric band (LAGB) conversion to RYGB had higher complication rates than LAGB to SG (5.9% vs 3.4%). Conversion from SG to RYGB had higher complication rates compared with conversion to SADI or DS (5.9% vs 4.6% and 3.6%); however, SG to RYGB had lower rates of major complication (leak, deep space surgical site infection (SSI), and gastrointestinal bleeding). CONCLUSION: Reoperative bariatric surgery procedures have remained relatively stable over recent years. SG is the most common primary MBS procedure as well as the most frequent requiring re-operation. While complication rates continue to be low for elective re-operative bariatric surgeries, comprehensive evaluation and counseling are vital for informed decision-making with patients. Objective assessment of indication and patient factors are necessary when choosing reoperative procedures.
Bariatric surgery: disposable costs are driven by surgeon variability without measurable benefit.
Giorgi M
Surg Obes Relat Dis · 2026 May · PMID 41862349 · Publisher ↗
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Alcohol consumption patterns up to 10 years after bariatric surgery: using the highly specific biomarker phosphatidylethanol.
Berggren J, Lindqvist A, Isaksson A … +2 more , Hedenbro J, Wierup N
Surg Obes Relat Dis · 2026 Jun · PMID 41862348 · Publisher ↗
BACKGROUND: The increasing prevalence of obesity has led to a rise in bariatric surgery as an effective intervention for weight loss and associated co-morbidities. However, concerns persist regarding increased alcohol co...
BACKGROUND: The increasing prevalence of obesity has led to a rise in bariatric surgery as an effective intervention for weight loss and associated co-morbidities. However, concerns persist regarding increased alcohol consumption after surgery. OBJECTIVES: To objectively assess long-term changes in alcohol use after bariatric surgery, we used the highly specific alcohol biomarker phosphatidylethanol (PEth). SETTING: Kalmar County Hospital, Sweden. METHODS: This longitudinal cohort study included 1238 patients who underwent Roux-en-Y gastric bypass or sleeve gastrectomy at Kalmar County Hospital from 2010 to 2020. Patients were divided into 2 cohorts based on preoperative PEth sampling (n = 327 with, n = 911 without). PEth levels were measured before surgery and at intervals up to 10 years postoperatively, using .30 μmol/L (approximately 210 ng/mL) as the threshold for heavy alcohol use. RESULTS: Mean PEth concentrations increased from .07 to .38 μmol/L (P < .001) in men and from .06 to .11 μmol/L nonsignificantly in women. The proportion of patients that postoperatively exceeded the heavy drinking threshold rose significantly over time. At 5 years, 37.5% of men and 4.8% of women had PEth values above .30 μmol/L (both P < .001). Men were at significantly higher risk (odds ratio: 7.89, 95% confidence interval: 3.76-16.57; P < .001). This pattern remained consistent at the 10-year follow-up. CONCLUSIONS: Alcohol consumption, as measured by PEth, increased significantly after bariatric surgery, particularly in men. These findings support routine postoperative alcohol screening and suggest incorporating PEth testing into long-term follow-up protocols.
Characterization of concurrent bariatric surgery and abdominal wall hernia repair prevalence and outcomes: a multi-centered study of 180,544 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program patients.
Hage K, Wills MV, Mocanu V … +9 more , Barajas-Gamboa JS, Kachornvitaya P, Zhu X, Ghanem OM, Corcelles R, Strong AT, Navarrete S, Kroh M, Dang J
Surg Obes Relat Dis · 2026 Jun · PMID 41832100 · Publisher ↗
BACKGROUND: Abdominal Wall Hernias (AWHs) are common in patients with obesity, yet the optimal management approach and outcomes of concurrent bariatric surgery and hernia repair remain unclear. OBJECTIVES: To compare out...
BACKGROUND: Abdominal Wall Hernias (AWHs) are common in patients with obesity, yet the optimal management approach and outcomes of concurrent bariatric surgery and hernia repair remain unclear. OBJECTIVES: To compare outcomes of patients who underwent concurrent AWH repair and bariatric surgery with those who had bariatric surgery alone. SETTING: National deidentified database. METHODS: We conducted a retrospective analysis of the 2023 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database, which recently incorporated new Current Procedural Terminology codes capturing detailed hernia characteristics. RESULTS: Of 180,544 patients undergoing bariatric surgery, 1.3% (2292) of patients underwent concurrent AWH. These patients were older (47.6 ± 11.4 vs. 42.9 ± 11.9 years; P < .001), had higher body mass index (46.1 ± 11.4 vs. 45.1 ± 7.7 kg/m; P < .001), and more comorbidities. Most repaired hernias were primary (90.1%), reducible (71.4%), and small-to-medium sized (<3 cm) (94.9%). Concurrent procedures had longer operative times (122.2 ± 64.5 vs. 84.1 ± 48.4 min) and hospital stays (1.5 ± 1.8 vs. 1.2 ± 1.1 days). Reoperation (2.1% vs. .8%), readmission (4.8% vs. 2.9%), serious complications (4.1% vs. 2.5%), and mortality (.3% vs. .07%) were significantly higher with concurrent repair (all P < .001). Multivariable logistic regression analysis identified medium hernia size (3-10 cm) (odds ratio [OR] 1.87), increased age (OR 1.10), history of venous thromboembolism (OR 1.49), and Roux-en-Y gastric bypass (RYGB) (OR 1.72) as independent predictors of serious complications. CONCLUSION: This large-scale national analysis demonstrates that concurrent AWH repair during bariatric surgery is uncommon and might be associated with higher short-term morbidity. These findings should be interpreted as descriptive and hypothesis-generating, highlighting patient- and hernia-specific factors that may inform perioperative risk stratification and shared decision-making, particularly in patients with medium-sized hernias (3-10 cm) or those undergoing RYGB.
Does food insecurity elucidate the relationship between food addiction and binge eating among bariatric surgery candidates?
Aylward L, Bartholomay E, Etuk R … +1 more , Cox S
Surg Obes Relat Dis · 2026 Jun · PMID 41832099 · Full text
BACKGROUND: Food addiction symptoms and binge eating symptoms both include the experience of loss of control eating and emotional dysregulation and are prevalent among adult metabolic and bariatric surgery (MBS) candidat...
BACKGROUND: Food addiction symptoms and binge eating symptoms both include the experience of loss of control eating and emotional dysregulation and are prevalent among adult metabolic and bariatric surgery (MBS) candidates. OBJECTIVES: To examine whether food insecurity elucidates the relationship between food addiction symptoms and binge eating symptoms. We hypothesized an indirect effect through food insecurity on the relationship between food addiction symptoms and binge eating symptoms. We also hypothesized that food insecurity moderates the relationship between food addiction symptoms and binge eating symptoms. SETTING: Academic medical center, United States METHODS: Participants were 866 consecutive adult MBS candidates who completed a battery of self-report questionnaires assessing demographic information, food addiction symptoms, food insecurity, and binge eating symptoms prior to MBS during a routine clinic visit. RESULTS: In both statistical models, a strong relationship between food addiction symptoms and binge eating symptoms emerged; however, overall food insecurity did not mediate or moderate this relationship. Exploratory analyses indicated that use of food assistance from family or friends moderated the relationship between food addiction symptoms and binge eating symptoms. CONCLUSIONS: Food insecurity may not be relevant in understanding the relationship food addiction symptoms and binge eating symptoms in presurgical bariatric populations. Food addiction symptoms and binge eating symptoms continue to demonstrate a strong relationship; however, the extent to which they have unique differences requires additional examination.
Airway resistance improves after bariatric surgery.
Guimarães GF, Lorenzetti Branco JH, da Silveira B … +2 more , Nascimento AQ, Matte DL
Surg Obes Relat Dis · 2026 Jun · PMID 41832098 · Publisher ↗
BACKGROUND: Severe obesity is associated with impaired respiratory and lung mechanics, including increased airway resistance. OBJECTIVES: This study aimed to evaluate changes in respiratory system impedance and airway me...
BACKGROUND: Severe obesity is associated with impaired respiratory and lung mechanics, including increased airway resistance. OBJECTIVES: This study aimed to evaluate changes in respiratory system impedance and airway mechanics after bariatric surgery in adults with severe obesity. METHODS: Adults with severe obesity (n = 12) were evaluated before and after bariatric surgery using impulse oscillometry. Anthropometric measures and respiratory system impedance parameters, including airway resistance (R5 and R20), reactance (X5), and resonant frequency (Fres), were assessed and compared between time points. RESULTS: Weight loss after bariatric surgery was associated with significant reductions in airway resistance (R5 and R20) and Fres, indicating improvements in respiratory system mechanics. CONCLUSION: Bariatric surgery improved respiratory system impedance and airway mechanics in adults with severe obesity. Impulse oscillometry detected respiratory mechanical improvements after weight loss and may represent a sensitive tool for evaluating changes in lung mechanics in this population.
Management of obesity in the menopause transition and postmenopausal period.
Allen JT, Zahler-Miller C, Lough M … +1 more , Titus H
Surg Obes Relat Dis · 2026 May · PMID 41826147 · Publisher ↗
BACKGROUND: The menopause transition and postmenopausal period represent inevitable life stages characterized by physiologic changes that can pose significant health risks, primarily through the effects of estrogen decli...
BACKGROUND: The menopause transition and postmenopausal period represent inevitable life stages characterized by physiologic changes that can pose significant health risks, primarily through the effects of estrogen decline on multiple organ systems. The prevalence of obesity during and after menopause is significant. Symptoms derived from menopause, such as poor sleep, sexual dysfunction, and mood changes are often exacerbated in the setting of obesity. Therefore, treating and managing obesity during menopause is essential. OBJECTIVES: The purpose of this review article is to explain the impact obesity bears on midlife and postmenopausal patients, discuss the treatment options available for weight management in this stage of life, including behavioral, medical, and surgical interventions, and review special considerations for hormone therapy in women with increased adiposity experiencing climacteric symptoms. METHODS: A literature review was conducted from February to April 2025. CONCLUSIONS: Many women who seek treatment for obesity and bariatric surgery are perimenopausal or postmenopausal. Raising awareness of the unique considerations in this population can help optimize patient care.
Efficacy and safety of direct oral anticoagulants versus enoxaparin for extended thromboprophylaxis following sleeve gastrectomy.
Brown A, Li ES, Patel S … +10 more , Massie A, Ihunwo P, Schaap A, Alade M, Ren-Fielding CJ, Somoza E, Orandi BJ, Segev D, Parikh M, Chhabra KR
Surg Obes Relat Dis · 2026 May · PMID 41813545 · Publisher ↗
BACKGROUND: Extended-course enoxaparin is increasingly used after bariatric surgery to prevent venous thromboembolism (VTE), the leading cause of death after bariatric surgery. Direct oral anticoagulants are widely used...
BACKGROUND: Extended-course enoxaparin is increasingly used after bariatric surgery to prevent venous thromboembolism (VTE), the leading cause of death after bariatric surgery. Direct oral anticoagulants are widely used for extended thromboprophylaxis outside of bariatric surgery and offered to patients in our program who cannot tolerate or obtain enoxaparin. We evaluated the safety and efficacy of apixaban 2.5 mg twice daily relative to a weight-based dose of enoxaparin 40 mg or 60 mg twice daily for 30 days after discharge following sleeve gastrectomy. METHODS: Patients aged ≥18 years who underwent laparoscopic sleeve gastrectomy from 2019 to 2024 at a single high-volume urban academic center were included. Bleeding and thrombosis outcomes within 30 days were compared between patients receiving enoxaparin 40 mg twice daily or apixaban 2.5 mg twice daily. Weighted modified Poisson analyses were used to obtain covariate balance and assess differences in bleeding and thrombosis events. RESULTS: A total of 5921 patients were included for analysis (5274 enoxaparin 40 mg twice daily, 486 enoxaparin 60 mg twice daily, and 161 apixaban 2.5 mg twice daily). The 30-day thrombosis rate was significantly lower with enoxaparin versus apixaban (.1% versus 1.9%, P < .001). The composite outcome (VTE, portomesenteric venous thrombosis, and major/minor bleeding) was also significantly lower with enoxaparin versus apixaban (1.7% versus 5.6%, P < .01). In adjusted analyses, apixaban was associated with a relative risk of 12.09 for thrombosis (95% confidence interval [CI], 5.71-31.18), 1.93 for bleeding (95% CI, 1.27-3.00), and 2.59 (95% CI, 2.06-3.27) for any adverse outcome relative to enoxaparin. CONCLUSION: Enoxaparin is associated with both lower thrombosis and bleeding rates compared with apixaban for extended thromboprophylaxis after sleeve gastrectomy.
Perioperative cannabis use in metabolic and bariatric surgery: practical guidance in an evolving evidence base.
Vosburg RW, Aylward L, Northup CJ
Surg Obes Relat Dis · 2026 May · PMID 41807184 · Publisher ↗
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Psychosocial factors associated with a positive phosphatidylethanol test during the preoperative evaluation for metabolic and bariatric surgery.
Miller-Matero LR, Killian SJ, Bendit S … +6 more , Martens KM, Hamann A, Snodgrass M, Green S, Genaw J, Carlin AM
Surg Obes Relat Dis · 2026 May · PMID 41794609 · Publisher ↗
BACKGROUND: Patients who undergo metabolic and bariatric surgery (MBS) are at an increased risk for an alcohol use disorder. Preoperative alcohol use is associated with increased postoperative risk, yet patients under-re...
BACKGROUND: Patients who undergo metabolic and bariatric surgery (MBS) are at an increased risk for an alcohol use disorder. Preoperative alcohol use is associated with increased postoperative risk, yet patients under-report their alcohol use during the routine psychosocial evaluation. This results in challenges to accurately identify individuals at risk for postoperative alcohol use disorder. OBJECTIVE: This study investigated whether there are clinical characteristics associated with objective measurement of alcohol use to help guide preoperative assessment. SETTING: Single healthcare system. METHODS: Retrospective medical record reviews were conducted on 85 patients who completed a preoperative psychosocial evaluation and phosphatidylethanol (PEth) testing prior to MBS. Patient demographic and clinical characteristics were collected from the preoperative psychosocial evaluation. RESULTS: Black individuals (37.7%) were more likely to have a positive PEth test compared to White individuals (13.8%, P = .02). Individuals with a positive PEth test had significantly lower depressive symptoms than those with a negative PEth test (P = .03). No other demographic or clinical characteristics were associated with PEth test results. CONCLUSIONS: Few variables were associated with a positive PEth test, and the value of the statistical differences may not be clinically meaningful. As such, it is difficult to use clinical characteristics to assist with identification of individuals with regular alcohol use at the preoperative assessment. There may be benefits to routine use of objective alcohol measurement, such as PEth testing, for patients pursuing MBS to identify individuals who are engaging in regular or heavy alcohol use at the time of the preoperative evaluation.
Five-year comparative outcomes of Nissen sleeve gastrectomy versus standard sleeve gastrectomy in patients with type 2 diabetes.
Savvala NA, Jaussent A, Prelot A … +9 more , de Choudens C, Silvestri M, Joumaa S, Lefebvre P, Debourdeau A, Picot MC, Nocca D, Galtier F, Bariatric surgery study group
Surg Obes Relat Dis · 2026 May · PMID 41791959 · Publisher ↗
BACKGROUND: Patients with type 2 diabetes (T2D) and obesity are prone to gastroesophageal reflux disease (GERD) due not only to obesity itself but also to gastroparesis, digestive neuropathy, and antidiabetic treatment....
BACKGROUND: Patients with type 2 diabetes (T2D) and obesity are prone to gastroesophageal reflux disease (GERD) due not only to obesity itself but also to gastroparesis, digestive neuropathy, and antidiabetic treatment. Nissen sleeve gastrectomy (NSG) achieves satisfactory long-term weight loss and significantly reduces GERD incidence. However, its results in this population remain to be compared with those of standard sleeve gastrectomy (SG) given the potential impact of the Nissen wrap on GERD outcomes. OBJECTIVES: To compare the 5-year results of NSG on patients with T2D and obesity in terms of weight loss, T2D remission, and GERD incidence, with those of SG. SETTING: Montpellier University Hospital, France. METHODS: This is a comparative, nonrandomized, single-center cohort study analyzing prospectively collected data from patients who underwent SG or NSG between January 2017 and December 2019. RESULTS: A total of 105 patients with T2D and obesity underwent either an SG (N = 61) or an NSG (N = 44), with 82 (SG: 44; NSG: 36) completing 5-year follow-up. The groups were comparable for sex, age, and T2D severity. At 5 years, total weight loss was 19.1% versus 19.6% (effect size: -.77, P = .86), mean hemoglobin A1C 6.5% versus 6.3% (effect size: -.43, P = .12), and clinical GERD incidence 57.9% versus 18.8% (effect size: .23 [.07; .73], P = .01) for the SG and NSG groups, respectively. CONCLUSIONS: NSG could be a valuable alternative to SG for patients with T2D and obesity, providing comparable weight loss and diabetes remission at 5 years, with the added benefit of significantly reducing the incidence of GERD.
Prevalence of early marginal ulcer in sleeve to bypass conversions: an analysis of the 2020-2022 MBSAQIP.
Doiron JE, Corpodean F, Kachmar M … +4 more , Danos DM, Cook MW, Schauer PR, Albaugh VL
Surg Obes Relat Dis · 2026 May · PMID 41791958 · Publisher ↗
BACKGROUND: Early marginal ulceration (MU) within 30 days after operation is uncommon after Roux-en-Y gastric bypass (RYGB), yet recent evidence indicates that these rates may be higher than initially thought. We hypothe...
BACKGROUND: Early marginal ulceration (MU) within 30 days after operation is uncommon after Roux-en-Y gastric bypass (RYGB), yet recent evidence indicates that these rates may be higher than initially thought. We hypothesized that the incidence of early MU would be higher in patients undergoing sleeve gastrectomy-RYGB (SG-RYGB) conversion compared with primary RYGB (p-RYGB). SETTING: National quality improvement data from Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP)-accredited sites in the United States, 2020-2022. METHODS: Examination of 610,529 records from the 2020-2022 MBSAQIP data sets noted 136,392 RYGB cases, after exclusions for pediatric cases, nonbinary gender, and records missing body mass index (BMI), operative time, age, and non-SG-RYGB conversions. We compared SG-RYGB and p-RYGB patient characteristics, surgical details, and postoperative outcomes, using rare event logistic regression to model early MU risk based on sleeve conversion status and additional risk factors. RESULTS: Early MU developed in .2% (337 of 136,392) of p-RYGB cases and .4% (109 of 26,333) of SG-RYGB cases (P < .0001). SG-RYGB conversion was a significant predictor of early MU in a multivariable model (odds ratio: 1.42, 95% confidence interval: 1.10-1.84, P = .0069), along with factors such as Black race, BMI <30, chronic obstructive pulmonary disease, prior cardiac catheterization, history of deep vein thrombosis, and active immunosuppression. CONCLUSIONS: Early MU remains a rare event after RYGB. Patients undergoing SG-RYGB face a 42% greater risk of developing early MU compared with those receiving p-RYGB, indicating the necessity for enhanced MU prevention measures in this demographic.
The role and effects of metabolic and bariatric surgery on endometrial cancer care.
El Ghazal N, Abedalqader T, Jawhar N … +3 more , Puvvadi S, Sample JW, Ghanem OM
Surg Obes Relat Dis · 2026 May · PMID 41791957 · Publisher ↗
Obesity has become one of the most prevalent chronic diseases in the United States, contributing to various obesity-related medical conditions and affecting women's health. It has been shown to be a major modifiable risk...
Obesity has become one of the most prevalent chronic diseases in the United States, contributing to various obesity-related medical conditions and affecting women's health. It has been shown to be a major modifiable risk factor in the development of menstrual cycle disorders, anovulation, and infertility. It remains the second leading cause of cancer in general, and its increasing incidence has been associated with an increased risk of female- and hormone-specific cancers, especially endometrial cancer. Various mechanisms have been implicated in the relationship between adiposity and endometrial proliferation, which include but are not limited to hormonal pathway disruptions and hyperinsulinemia. This well-established connection has necessitated interventions that target weight loss. Bariatric surgery remains one of the most sustainable and effective long-term treatments, which not only leads to successful weight loss, but also restores the physiologic hormonal pathways, contributing to improved women's health, fertility and pregnancy outcomes. Most importantly, weight-loss surgery has been proven to reduce the incidence and mortality of endometrial cancer and to mediate other obesity-related medical conditions that impact overall survival in patients with endometrial cancer. With more studies evaluating the effects of bariatric surgery on endometrial cancer over the long-term, it can increasingly be advocated as a potential adjunct treatment in this regard.
Pregnancy after bariatric surgery: persistent obesity and longer time to conception influences peripartum outcomes more than the type of operation.
Bloemhard ME, Schmulbach AA, Koti K … +4 more , Arul C, Ahmed SM, Ali MR, Lyo V
Surg Obes Relat Dis · 2026 May · PMID 41781289 · Full text
BACKGROUND: While women may seek metabolic and bariatric surgery (MBS) to achieve pregnancy, conflicting data exist on how MBS affects pregnancy and fetal outcomes. Additionally, despite existing consensus recommendation...
BACKGROUND: While women may seek metabolic and bariatric surgery (MBS) to achieve pregnancy, conflicting data exist on how MBS affects pregnancy and fetal outcomes. Additionally, despite existing consensus recommendations for micronutrient monitoring, adherence to recommended screening is unknown. OBJECTIVES: Evaluate post-MBS pregnancy outcomes and clinical adherence to micronutrient monitoring recommendations. SETTING: University Hospital, United States. METHODS: A retrospective cohort study of singleton, live-birth pregnancies in post-MBS patients from 2008 to 2023 was performed. Mother and neonate weight, pregnancy comorbidities, peripartum outcomes, and micronutrient results were analyzed using descriptive statistics and Chi-square tests. RESULTS: In 139 patients (99 Roux-en-Y gastric bypass (RYGB)/duodenal switch (DS) and 40 sleeve gastrectomy (SG)/adjustable gastric band (AGB)), we evaluated 169 singleton, live birth pregnancies. Mean body mass index (BMI) at MBS and preconception were 46.5 ± 8.7 and 34.0 ± 7.7 kg/m, respectively. Median time to conception (TTC) was 37.6 months (IQR 50.2). Vaginal deliveries were common (62.1%), but emergency cesarean section was required in 9.5% of pregnancies. SG/AGB compared to RYGB/DS, longer TTC, and preconception obesity were associated with peripartum hypertension (odds ratio [OR] 2.65, 95% confidence interval [CI] 1.19-5.91; OR 6.90, 95% CI 1.55-30.80; OR 2.67, 95% CI 1.16-6.11, respectively). Longer TTC and preconception obesity were also associated with diabetes (OR 2.20, 95% CI 1.0009-4.83; OR 2.57, 95% CI 1.2-5.46, respectively). While prenatal supplementation was common (86.4%), micronutrient monitoring (any vitamin B, 71.6%; any micronutrient, 74.0%; iron, 52%) was subpar. CONCLUSIONS: We found that longer TTC and persistent obesity increased patient risk for peripartum complications. Support to help patients achieve lower preconception weight may reduce peripartum complications.
Risk of magnetic sphincter augmentation erosion following sleeve gastrectomy: a systematic review and meta-analysis.
Noel P, Jacobs M
Surg Obes Relat Dis · 2026 May · PMID 41781288 · Publisher ↗
BACKGROUND: Gastroesophageal reflux disease following laparoscopic sleeve gastrectomy (LSG) affects up to 40% of patients. Magnetic sphincter augmentation (MSA) has emerged as a less invasive alternative to Roux-en-Y gas...
BACKGROUND: Gastroesophageal reflux disease following laparoscopic sleeve gastrectomy (LSG) affects up to 40% of patients. Magnetic sphincter augmentation (MSA) has emerged as a less invasive alternative to Roux-en-Y gastric bypass, but device erosion remains a critical concern in postbariatric populations. OBJECTIVES: To evaluate MSA erosion rates after LSG and compare them with general populations, while identifying risk factors and clinical outcomes. SETTING: Multi-institutional systematic review and meta-analysis. METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, we searched PubMed, Embase, Cochrane Library, Web of Science, and Scopus through September 2025. Primary outcome was device erosion rate. Secondary outcomes included time to erosion, risk factors, clinical presentation, and management. Random-effects meta-analysis with heterogeneity assessment was performed. RESULTS: Analysis of 14 studies encompassing 287 patients with median follow-up of 24 months revealed overall erosion rate of 3.8% (11/287), significantly higher than .1%-.3% in nonbariatric populations (P < .001). Median time to erosion was 18 months. Factors associated with erosion included body mass index > 30 kg/m at MSA (odds ratio [OR]: 3.2), absence of hiatal repair (OR: 4.1), device undersizing (OR: 3.8), and persistent sleeve dilatation (OR: 2.7). Most erosions (72.7%) presented with dysphagia; all required explantation with 90.9% symptom resolution. CONCLUSIONS: MSA erosion risk after LSG is elevated compared to nonbariatric populations but remains below 4% with proper patient selection, and must be weighed against the 7%-8% complication rate of Roux-en-Y gastric bypass conversion. Based on very low to low-certainty evidence, body mass index optimization, adequate hiatal repair, appropriate device sizing, and sleeve evaluation may help minimize erosion risk in this population, although these recommendations require prospective validation.
Long-term study retention of adolescents undergoing metabolic and bariatric surgery: lessons learned from the Teen-Longitudinal Assessment of Bariatric Surgery cohort.
Rode JB, Ogle SB, Khoury JC … +10 more , Allen DL, Black J, Miller R, Michalsky MP, Jenkins TM, Brandt ML, Figueroa A, DeTella M, Ryder JR, Inge TH
Surg Obes Relat Dis · 2026 May · PMID 41763972 · Publisher ↗
BACKGROUND: High participant retention is critical for data quality and generalizability in longitudinal studies. Adolescents, especially after metabolic and bariatric surgery (MBS), are at high risk for attrition. OBJEC...
BACKGROUND: High participant retention is critical for data quality and generalizability in longitudinal studies. Adolescents, especially after metabolic and bariatric surgery (MBS), are at high risk for attrition. OBJECTIVES: To describe long-term retention strategies and visit completion in the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) cohort, and identify participant and caregiver factors associated with missed visits. SETTING: Five academic medical centers in the United States. METHODS: Teen-LABS enrolled 242 adolescents (≤19 years) undergoing MBS between 2007 and 2012. Data were collected through 10 years postoperatively, concluding in 2022. Participant engagement and retention strategies are described herein. Visit attendance was grouped as: no missed visits, 1-2 missed visits, or >2 missed visits. Baseline participant and caregiver clinical and demographic variables were analyzed using chi-square and general linear models to identify predictors of visit attendance. RESULTS: In-person visit attendance averaged 86% (95% confidence interval [CI]: 85%-87%), with 88% (95% CI: 87%-90%) remaining engaged at 10 years. Baseline characteristics associated with greater missed visits included sleep apnea, public insurance, psychiatric medication use, and caregiver race and employment status. Body mass index trajectory, comorbidity status, independence, and lifestyle factors over time did not differ significantly by visit attendance group. CONCLUSIONS: Retention strategies used by study staff to maintain the Teen-LABS research cohort engagement during transition into young adulthood were powerfully effective in maintaining high cohort retention since visit completion rates of 88% were achieved for the decade-long study.
What we know and where to go: a scoping review of the psychosocial literature in youth undergoing metabolic and bariatric surgery.
Ley SL, Browne NT, Gillette MD … +5 more , Mackey E, Sogg S, Beck AR, Santos M, Clinical Issues Committee of the American Society for Metabolic and Bariatric Surgery
Surg Obes Relat Dis · 2026 May · PMID 41763971 · Publisher ↗
There is a paucity of research summarizing the impact of psychosocial factors on youth metabolic and bariatric surgery (MBS) outcomes and the impact of MBS on youth psychosocial health. This scoping review provides a com...
There is a paucity of research summarizing the impact of psychosocial factors on youth metabolic and bariatric surgery (MBS) outcomes and the impact of MBS on youth psychosocial health. This scoping review provides a comprehensive characterization of the state of the literature regarding psychosocial care for youth undergoing MBS to identify implications for practice and define knowledge gaps to inform future research. A search of articles published between 2010 and March 2025 was conducted focusing on study objectives from all peer-reviewed evidence sources except for review articles, commentaries, protocol papers, meta-analyses, editorials, and guidelines. One hundred forty-three articles were included for review. Frequency counts were utilized to provide narrative description of study findings which were also mapped in tabular form to demonstrate the state of the literature. Youth seeking MBS have high rates of psychosocial complexity which maintain or improve (at least in the short term) following MBS, with a subset experiencing symptom worsening, highlighting the importance of monitoring and support postoperatively. More research is needed in larger and diverse (e.g., age, race/ethnicity, gender, and neurodivergent) populations as well as in the areas of family relationships and social determinants of health to ensure that assessment, treatment, and informed consent processes allow families to make the most informed decisions for care.
Transversus abdominis plane blocks during primary bariatric surgery reduce length of stay without increasing complication rates: an Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program analysis of 511,981 patients.
Barajas-Gamboa JS, Mocanu V, Wills MV … +11 more , Restrepo-Rodas G, Shin TH, Romero-Velez G, Allemang M, Strong AT, Navarrete S, Corcelles R, Guerron AD, Rodriguez J, Kroh M, Dang JT
Surg Obes Relat Dis · 2026 May · PMID 41748368 · Publisher ↗
BACKGROUND: Transversus abdominis plane (TAP) block is an effective strategy to improve recovery after bariatric surgery, but its large-scale clinical impact remains uncertain. OBJECTIVES: To evaluate the effect of conco...
BACKGROUND: Transversus abdominis plane (TAP) block is an effective strategy to improve recovery after bariatric surgery, but its large-scale clinical impact remains uncertain. OBJECTIVES: To evaluate the effect of concomitant TAP block on length of stay (LOS) and complication rates in bariatric surgery patients. SETTING: Multi-institutional analysis of 902 accredited bariatric surgery centers across the United States and Canada. METHODS: Retrospective analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Participant Use Data File (2020-2022) comparing patients undergoing primary Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) with or without concomitant TAP block. Primary outcomes were prolonged LOS (>2 standard deviations above mean) and 30-day serious complications. Multivariable logistic regression determined the independent predictive value of TAP block. RESULTS: Of 511,981 patients, 43,146 (8.4%) received concomitant TAP block. The distribution of procedures was similar between groups: SG (75.7% TAP versus 72.8% no TAP, P < .001) and RYGB (24.3% TAP versus 27.2% no TAP). TAP block patients had slightly more favorable clinical profiles, with lower rates of diabetes (21.8% versus 23.1%, P < .001) and hyperlipidemia (21.4% versus 22.4%, P < .001). Operative time was longer in the TAP block group (89.3 versus 83.8 min, P < .001). Prolonged LOS occurred in 5.6% of TAP block patients versus 5.9% in the no TAP block group. The TAP block group exhibited a statistically significant but clinically modest reduction in prolonged LOS (unadjusted odds ratio [OR] .89, 95% confidence interval [CI] .82-.97, P = .01) with no difference in serious complications (2.7% versus 2.7%, P = .993). Multivariable analysis confirmed TAP block was independently associated with reduced odds of prolonged LOS (adjusted OR .89, 95% CI .82-.97, P = .01). CONCLUSIONS: Concomitant TAP block during bariatric surgery was independently associated with a statistically significant but modest reduction in odds of prolonged LOS, with an absolute difference of .3%, and no increased risk of serious complications. While the absolute effect size is small, at a population level this may translate to meaningful reductions in health care utilization. These findings suggest TAP block may be a safe adjunct for optimizing recovery in bariatric surgery, though the modest magnitude of benefit should be weighed against costs and resource utilization when considering implementation.
Beyond pooled averages: technical nuance and evidence gaps in revisional SADI-S.
Mehta K
Surg Obes Relat Dis · 2026 May · PMID 41723031 · Publisher ↗
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