Advanced machine learning techniques, particularly random forest, demonstrated superior performance in predicting 30-day complications in metabolic bariatric surgery compared to the established MBSAQIP risk score. The random forest model achieved an area under the receiver operating characteristic curve (AUROC) of 0.94 in training and 0.88 in validation. Key predictive features included serum alkaline phosphatase, platelet […]
Category: Metabolic and Bariatric Surgery
Preoperative anticoagulation increases postoperative morbidity in bariatric patients
A recent analysis of 1,178,090 patients reveals that those undergoing sleeve gastrectomy or Roux-en-Y gastric bypass with preoperative therapeutic anticoagulation face significantly higher risks of postoperative complications. Specifically, these patients exhibited increased rates of anastomotic leaks, deep vein thrombosis, and gastrointestinal bleeding, as well as longer operative times and hospital stays. Moreover, sleeve gastrectomy patients […]
Probiotics enhance weight loss and eating behavior after surgery
Participants receiving probiotic supplementation alongside a weight loss program and cognitive behavioral therapy experienced significantly greater reductions in weight, body mass index, and fat mass compared to the placebo group (p
Metabolic and bariatric surgery significantly reduces insulin dependency in diabetes.
In a study of 287 patients with insulin-treated type 2 diabetes, metabolic and bariatric surgery (MBS) showed remarkable efficacy. At five years post-surgery, insulin dependence dropped from complete dependency to 36.2%, and the use of non-insulin antidiabetic drugs decreased from 79.4% to 26.1%. Additionally, type 2 diabetes remission rates were highest after biliopancreatic diversion with […]
Endoscopic sleeve gastroplasty shows cost-effectiveness for obesity treatment
Endoscopic sleeve gastroplasty (ESG) demonstrated cost-effectiveness compared to lifestyle modification in adults with class I/II obesity within a five-year horizon, achieving an incremental cost-effectiveness ratio of $23,432 per quality-adjusted life year (QALY). ESG remained cost-effective across sensitivity analyses and was dominant over longer timeframes. The findings suggest ESG as a viable treatment alternative for individuals […]
Laparoscopic Roux-en-Y gastric bypass offers superior weight loss
At five years post-surgery, laparoscopic Roux-en-Y gastric bypass (LRYGB) achieved significantly greater weight loss compared to laparoscopic sleeve gastrectomy (LSG) with a mean difference of -7.65 kg/m² (p=0.0001). The LRYGB group also exhibited better resolution rates for type 2 diabetes mellitus (T2D) and dyslipidemia. Although both procedures showed no difference in quality of life or […]
Barbed sutures significantly reduce suturing time in bariatric surgery
Researchers found barbed sutures significantly reduce suturing time in bariatric surgery. Analyzing 11 studies with 27,442 patients, including 3,516 using barbed sutures, they observed a mean reduction of 4.87 minutes in suturing time (95% CI -8.43 to -1.30; p
Routine preoperative endoscopy reveals significant pathologies in obesity patients.
A study analyzed preoperative endoscopic findings in 405 patients undergoing bariatric surgery, revealing chronic superficial gastritis (80.5%) and reflux esophagitis (20.2%) as the most common conditions. Higher rates of reflux esophagitis were associated with older age, male gender, elevated BMI, smoking, and drinking. Risk factors differed by gender, with morbid obesity and H. pylori common […]
Duodeno-ileal diversion with SNAP is feasible and safe.
A pilot study involving 27 participants demonstrates that duodeno-ileal diversion using the sutureless neodymium anastomosis procedure (SNAP) is both technically feasible and relatively safe. Patients achieved progressive, clinically meaningful weight loss within 9 months post-procedure, with all presenting widely patent anastomoses at the 3-month mark. These findings suggest potential for SNAP as an effective approach […]
Guidelines for Metabolic and Bariatric Surgeons
A consensus was achieved among 89 international metabolic and bariatric surgeons on 29 of 30 statements regarding the prerequisites for practicing metabolic and bariatric surgery (MBS). Key criteria include holding a general surgery degree, completing a dedicated fellowship, and proficiency in managing postoperative complications. The learning curve for various MBS procedures was defined, ranging from […]