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Medicina
Special Issues
Obesity and Bariatric Surgery: Updates and Challenges
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Obesity and Bariatric Surgery: Updates and Challenges

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: closed (20 October 2023) | Viewed by 9117

Special Issue Editors

Dr. Natalia Dowgiałło-Gornowicz

E-Mail Website
Guest Editor
Department of General, Minimally Invasive and Elderly Surgery, Collegium Medicum, University of Warmia and Mazury, Niepodległosci 44 St., 10-045 Olsztyn, Poland
Interests: bariatric surgery; metabolic surgery; UGI surgery
Special Issues, Collections and Topics in MDPI journals
Dr. Paweł Lech

E-Mail Website
Guest Editor
Department of General, Minimally Invasive and Elderly Surgery, Collegium Medicum, University of Warmia and Mazury, Niepodległosci 44 St., 10-045 Olsztyn, Poland
Interests: bariatric surgery; metabolic surgery; UGI surgery
Prof. Dr. Piotr Major

E-Mail Website
Guest Editor
2nd Department of General Surgery, Jagiellonian University Medical College, Cracow, Poland
Interests: surgery for obesity; hemicolectomy; gastric bypass

Special Issue Information

Dear Colleagues,

In order to achieve not only effective weight loss, but also remission of comorbidities, various surgical methods for the treatment of obesity are used. In addition to the most common procedures, newer surgical methods are common. Roux-en-Y gastric bypass (RYGB), one anastomosis gastric bypass (OAGB) or sleeve gastrectomy (SG) is followed by single anastomosis duodenal-Ileal bypass with sleeve (SADI-S), single anastomosis sleeve ileal (SASI) or BariClip.

We would like to propose a Special Issue where authors can present the results of their latest research in the field of bariatric and metabolic surgery. In addition, we encourage authors to present the challenges faced by bariatric surgeons.

Dr. Natalia Dowgiałło-Gornowicz
Dr. Paweł Lech
Prof. Dr. Piotr Major
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • bariatric surgery
  • metabolic surgery
  • obesity surgery
  • obesity
  • diabetes remission
  • hypertension remission

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Published Papers (4 papers)

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Research

11 pages, 725 KiB  
Article
Indications for Sleeve Gastrectomy—Is It Worth Waiting for Comorbidities to Develop?
by Zsuzsanna Németh, Miklós Siptár, Natália Tóth, Krisztina Tóth, Csaba Csontos, Zoltán Kovács-Ábrahám, Alexandra Csongor, Ferenc Molnár, Zsombor Márton and Sándor Márton
Medicina 2023, 59(12), 2092; https://doi.org/10.3390/medicina59122092 - 29 Nov 2023
Cited by 1 | Viewed by 1798
Abstract
(1) Background and Objectives: Morbid obesity significantly increases the prevalence of comorbidities, such as heart disease, restrictive lung disease, stroke, diabetes mellitus and more. (2) Methods: Patients undergoing gastric sleeve surgery were divided into three groups with BMI between 30–34.9 kg/m2 [...] Read more.
(1) Background and Objectives: Morbid obesity significantly increases the prevalence of comorbidities, such as heart disease, restrictive lung disease, stroke, diabetes mellitus and more. (2) Methods: Patients undergoing gastric sleeve surgery were divided into three groups with BMI between 30–34.9 kg/m2 (Group I), 35–39.9 kg/m2 (Group II), and over 40 kg/m2 (Group III). Preoperative examinations included cardiac ultrasound, respiratory function and laboratory tests, and preoperative comorbidities were also recorded. Following a one-year follow-up, we compared the rate of weight loss in the three groups at six months and one year following surgery, specifically, the effect of surgery on preoperative comorbidities at one year. (3) Results: The weight loss surgeries performed were successful in all three groups. Preoperative laboratory examinations, an echocardiogram and respiratory function results showed no clinically significant difference, except moderate elevations in blood lipid levels. Hypertension was the most common comorbidity. (4) Conclusions: In our patient population, hypertension and diabetes were the only comorbidities with a high prevalence. It can be explained by the relatively younger age among the patients (mean age 44.5 years) and the fact that they had not yet developed the pathological consequences of severe obesity. Consequently, while performing the surgery at a relatively younger age, it seems far more likely that the patient will return to a more active and productive life and enjoy a better quality of life. Additionally, the perioperative risk is lower, and the burden upon health systems and health expenditure is reduced by preventing comorbidities, in particular, multimorbidity. On this basis, it may be advisable to direct patients who do not exhaust the classical indications for bariatric surgery toward the surgical solution at a younger age. Our results suggest it is not worth waiting for comorbidities, especially multimorbidity, to appear. Full article
(This article belongs to the Special Issue Obesity and Bariatric Surgery: Updates and Challenges)
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11 pages, 2178 KiB  
Article
The Impact of COVID-19 Pandemic on Weight Loss, Eating Behaviour and Quality of Life after Roux-en-Y Gastric Bypass
by Karolina Bauraitė, Rita Gudaitytė and Almantas Maleckas
Medicina 2023, 59(9), 1597; https://doi.org/10.3390/medicina59091597 - 4 Sep 2023
Viewed by 1615
Abstract
Background and Objectives: The global pandemic of coronavirus disease (COVID-19), declared on 11 March 2020, had an extensive impact on bariatric patients. The aim of this study was to evaluate short-term weight loss outcomes, changes in eating behaviour, and health-related quality of [...] Read more.
Background and Objectives: The global pandemic of coronavirus disease (COVID-19), declared on 11 March 2020, had an extensive impact on bariatric patients. The aim of this study was to evaluate short-term weight loss outcomes, changes in eating behaviour, and health-related quality of life (HRQoL) among patients who had Roux-en-Y gastric bypass (RYGB) before and during the COVID-19 pandemic. Materials and Methods: This cohort study included 72 patients (Group S) who underwent RYGB surgery in the Surgery Department of the Lithuanian University of Health Sciences during the COVID-19 pandemic in the years 2020–2022. Data for the control group (Group C) of 87 patients (operated on in 2010–2012) were collected from a prospective study. The data referred to the period before and a year after the RYGB. The information about patients’ weight changes, hunger, satiety, fullness sensations, appetite, diet, and eating patterns was queried. Eating behaviour and HRQoL evaluation were conducted by the Three-Factor Eating Questionnaire (TFEQ-R18) and the medical outcomes study Short-Form-36 (SF-36), respectively. Results: One year after the surgery, % excess body mass index loss (%EBMIL) was 77.88 (26.33) in Group S, 76.21 (19.98) in Group C, p = 0.663. Patients in Group S tended more to choose snacks between main meals: 79.2% versus 28.7%, p < 0.0001. Cognitive restraint significantly increased in Group S from 45.93 (13.37) up to 54.48 (13.76), p = 0.001; additionally, significantly worse overall health status was found in Group S compared to Group C, 53.27 (24.61) versus 70.11 (31.63), p < 0.0001. Mental HRQoL (50.76 versus 60.52 score, p < 0.0001) and social functioning (44.79 versus 57.90, p < 0.0001) were worse in Group S. Conclusions: In this study, the COVID-19 pandemic had no impact on short-term weight loss after RYGB. However, one year after, RYGB patients tended to snack more, and mental HRQoL and social functioning were worse in the study group. Full article
(This article belongs to the Special Issue Obesity and Bariatric Surgery: Updates and Challenges)
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11 pages, 946 KiB  
Article
Differences in Technical Aspects of Primary Sleeve Gastrectomy Prior to Redo Bariatric Surgery—A Multicenter Cohort Study (PROSS Study)
by Piotr Zarzycki, Justyna Rymarowicz, Piotr Małczak, Magdalena Pisarska-Adamczyk, Rafał Mulek, Artur Binda, Natalia Dowgiałło-Gornowicz, Piotr Major and PROSS Collaborative Study Group
Medicina 2023, 59(4), 799; https://doi.org/10.3390/medicina59040799 - 20 Apr 2023
Cited by 4 | Viewed by 2520
Abstract
Background and Objectives: Although the technical simplicity of laparoscopic sleeve gastrectomy is relatively well understood, many parts of the procedure differ according to bariatric surgeons. These technical variations may impact postoperative weight loss or the treatment of comorbidities and lead to qualification for [...] Read more.
Background and Objectives: Although the technical simplicity of laparoscopic sleeve gastrectomy is relatively well understood, many parts of the procedure differ according to bariatric surgeons. These technical variations may impact postoperative weight loss or the treatment of comorbidities and lead to qualification for redo procedures. Materials and Methods: A multicenter, observational, retrospective study was conducted among patients undergoing revision procedures. Patients were divided into three groups based on the indications for revisional surgery (insufficient weight loss or obesity-related comorbidities treatment, weight regain and development of complications). Results: The median bougie size was 36 (32–40) with significant difference (p = 0.04). In 246 (51.57%) patients, the resection part of sleeve gastrectomy was started 4 cm from the pylorus without significant difference (p = 0.065). The number of stapler cartridges used during the SG procedure was six staplers in group C (p = 0.529). The number of procedures in which the staple line was reinforced was the highest in group A (29.63%) with a significant difference (0.002). Cruroplasty was performed in 13 patients (p = 0.549). Conclusions: There were no differences between indications to redo surgery in terms of primary surgery parameters such as the number of staplers used or the length from the pylorus to begin resection. The bougie size was smaller in the group of patients with weight regain. Patients who had revision for insufficient weight loss were significantly more likely to have had their staple line oversewn. A potential cause could be a difference in the size of the removed portion of the stomach, but it is difficult to draw unequivocal conclusions within the limitations of our study. Full article
(This article belongs to the Special Issue Obesity and Bariatric Surgery: Updates and Challenges)
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12 pages, 705 KiB  
Article
Inflammatory Cytokines, Redox Status, and Cardiovascular Diseases Risk after Weight Loss via Bariatric Surgery and Lifestyle Intervention
by Mahmoud M. A. Abulmeaty, Hazem K. Ghneim, Abdulaziz Alkhathaami, Khalid Alnumair, Mohamed Al Zaben, Suhail Razak and Yazeed A. Al-Sheikh
Medicina 2023, 59(4), 751; https://doi.org/10.3390/medicina59040751 - 12 Apr 2023
Cited by 7 | Viewed by 2141
Abstract
Background and Objectives: Obesity is a chronic inflammatory condition and is considered a major risk factor for cardiovascular disease (CVD). The effects of obesity management via sleeve gastrectomy (SG) and lifestyle intervention (LS) on inflammatory cytokines, redox status, and CVD risk were [...] Read more.
Background and Objectives: Obesity is a chronic inflammatory condition and is considered a major risk factor for cardiovascular disease (CVD). The effects of obesity management via sleeve gastrectomy (SG) and lifestyle intervention (LS) on inflammatory cytokines, redox status, and CVD risk were studied in this work. Materials and Methods: A total of 92 participants (18 to 60 years old) with obesity (BMI ≥ 35 kg/m2 were divided into two groups: the bariatric surgery (BS) group (n = 30), and the LS group (n = 62). According to the achievement of 7% weight loss after 6 months, the participants were allocated to either the BS group, the weight loss (WL) group, or the weight resistance (WR) group. Assessments were performed for body composition (by bioelectric impedance), inflammatory markers (by ELISA kits), oxidative stress (OS), antioxidants (by spectrophotometry), and CVD risk (by the Framingham risk score (FRS) and lifetime atherosclerotic cardiovascular disease risk (ASCVD)). Measurements were taken before and after six months of either SG or LS (500 kcal deficit balanced diet, physical activity, and behavioral modification). Results: At the final assessment, only 18 participants in the BS group, 14 participants in the WL group, and 24 participants in the WR group remained. The loss in fat mass (FM) and weight loss were greatest in the BS group (p < 0.0001). Levels of IL-6, TNF-a, MCP-1, CRP, and OS indicators were significantly reduced in the BS and WL groups. The WR group had significant change only in MCP-1 and CRP. Significant reductions in the CVD risk in the WL and BS groups were detected only when using FRS rather than ASCVD. The FM loss correlated inversely with FRS-BMI and ASCVD in the BS group, whereas in the WL group, FM loss correlated only with ASCVD. Conclusions: BS produced superior weight and fat mass loss. However, both BS and LS produced a similar reduction in the inflammatory cytokines, relief of OS indicators, and enhancement of antioxidant capacity, and consequently reduced the CVD risk. Full article
(This article belongs to the Special Issue Obesity and Bariatric Surgery: Updates and Challenges)
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