The history of metabolic and bariatric surgery: Development of standards for patient safety and efficacy

Phillips, Blaine T.; Shikora, Scott A.

doi:10.1016/j.metabol.2017.12.010

Cited by 108 publications

(66 citation statements)

References 61 publications

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“…Surgical procedures for the treatment of obesity were introduced as early as 1952. 60 In the following years, a multitude of surgical procedures were introduced; many of which carried the risk of treatment failure, high mortality rates, and unacceptable complications. Historically, the surgical procedures have been categorized according to their presumed mechanisms of action.…”

Section: Obesity Surgerymentioning

confidence: 99%

Effects of Obesity Surgery on Blood Coagulation and Fibrinolysis: A Literature Review

2020

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Objective Obesity is characterized by a disturbed hemostatic balance with increased coagulation and impaired fibrinolysis. This increases the risk of thrombosis, and the risk is lowered after obesity surgery. Over the past 25 years, several studies have contributed to understand the mechanisms behind the antithrombotic effect of obesity surgery, and this literature review summarizes the results of these studies. Methods A detailed literature search on the effects of obesity surgery on the hemostatic balance was conducted. Results The 25 relevant studies reviewed demonstrated that obesity surgery has favorable effects on many biomarkers of coagulation and fibrinolysis. The evidence is substantial for fibrinogen and plasminogen activator inhibitor type 1 with average reductions from 1 to 24 months after obesity surgery of 17 and 48%, respectively. For most other biomarkers, the evidence is moderate or weak with average effect sizes varying from 2% for fiber mass length ratio to 70% for prothrombin fragment 1 + 2 and with a large variation between studies. Many studies are small and of short duration, and the surgical techniques differ. Also, studies are confounded by changes in medication, comorbidity, diet, and exercise. It is unknown whether the hemostatic changes are mediated by weight loss alone or by the accompanying metabolic improvements. Conclusion Despite issues of confounding, this review suggests that obesity surgery shifts the hemostatic balance in the antithrombotic direction, thereby reducing the thrombotic potential of people with obesity, but more studies are needed for most of the biomarkers.

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Section: Obesity Surgerymentioning

confidence: 99%

Effects of Obesity Surgery on Blood Coagulation and Fibrinolysis: A Literature Review

2020

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“…VSG removes approximately 80% of the stomach along the side of the greater curvature, leaving a tube-like remnant stomach. In this regard, VSG was initially considered a restrictive surgery 4 . However, a growing body of evidence suggests that the restriction of food intake is not the primary mechanism driving metabolic improvements after VSG 5 .…”

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confidence: 99%

Vertical sleeve gastrectomy induces distinctive transcriptomic responses in liver, fat and muscle

Ahn

Choi

Lee

et al. 2021

Sci Rep

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Vertical sleeve gastrectomy (VSG) is the most commonly performed bariatric/metabolic surgery, exhibiting a high rate of diabetes remission in humans. To elucidate the molecular mechanisms of VSG, we performed transcriptomic analysis of the liver, fat, and muscle in VSG mice. C57BL/6 mice fed a high-fat diet were randomly assigned to sham or VSG surgery. The sham-operated mice were fed ad libitum (sham group) or pair-fed (sham-PF group) matching their food intake to the VSG-operated mice. Comparative transcriptomic analysis of the liver, fat, and muscle using RNA sequencing was performed. VSG reduced body weight and improved glucose tolerance compared to the sham group, but not more than the sham-PF group. Improvement in fatty liver and adipose tissue inflammation was comparable between VSG and sham-PF. However, global gene expression profiles showed distinctive changes in the liver, fat, and muscle of the VSG group compared to both the sham or sham-PF groups. The liver showed the most prominent gene expression changes. Immune response-related pathways were commonly upregulated in the three organs of the VSG group compared to the sham or sham-PF. VSG induces organ-specific gene expression changes in the liver, fat, and muscle, which may play critical roles in metabolic improvements after VSG.

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“…The mid‐twentieth century birthed the beginning of a myriad of metabolic procedures that would be modified, adapted and refined to treat obesity effectively and safely. In 1953, Dr. Richard Varco performed the first intestinal bypass in humans by anastomozing the proximal jejunum to the distal ileum, and Dr. Kremen performed a similar procedure for obesity in 1954 10 . While these intestinal bypass procedures produced significant weight loss, they were fraught with unacceptably high rates of complications including diarrhoea and secondary dehydration, protein malnutrition, liver failure, myalgia, arthralgia, vitamin and electrolyte derangements, and metabolic bone disease.…”

Section: A Historical Perspectivementioning

confidence: 99%

“…The advent of minimally invasive surgical techniques have improved the perioperative experience for patients including recovery, wound healing, postoperative pain, length of hospital stay, rate of incisional hernias, cosmesis and mortality 10 . Enhanced recovery pathways have helped to streamline the postoperative course even further to allow for safe and efficient recovery.…”

Section: A Historical Perspectivementioning

confidence: 99%

Metabolic surgery: A clinical update

Wilson

Aminian

Tahrani

2021

Diabetes Obesity Metabolism

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Metabolic and bariatric surgery has grown beyond ‘experimental’ weight‐loss surgery. As techniques have advanced over the last few decades, so has the growing body of research and evidence, proving that both weight‐loss and metabolic health improvement are induced. Metabolic surgery has become the more appropriate term for weight‐loss surgery because of the altered gastrointestinal anatomy and subsequent beneficial metabolic effects. Although the tool of metabolic surgery has been well refined, a large portion of the global population does not have adequate access to it. This clinical update aims to (a) inform healthcare providers from all disciplines about the myriad of benefits of metabolic surgery and (b) equip them with the necessary knowledge to bridge the gap between patients in need of metabolic treatment and the therapies in metabolic surgery available to them.

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The history of metabolic and bariatric surgery: Development of standards for patient safety and efficacy

Cited by 108 publications

References 61 publications

Effects of Obesity Surgery on Blood Coagulation and Fibrinolysis: A Literature Review

Effects of Obesity Surgery on Blood Coagulation and Fibrinolysis: A Literature Review

Vertical sleeve gastrectomy induces distinctive transcriptomic responses in liver, fat and muscle

Metabolic surgery: A clinical update

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