Weight loss specific to indication, remission of diabetes, and short-term complications after sleeve gastrectomy conversion to Roux-en-Y gastric bypass: a systematic review and meta-analysis

Fehervari, Matyas; Banh, Serena; Varma, Piyush; Das, Bibek; Alyaqout, Khaled; Al-Sabah, Suleiman; Khwaja, Haris A.; Efthimiou, Evangelos; Ashrafian, Hutan

doi:10.1016/j.soard.2022.11.004

Cited by 16 publications

(6 citation statements)

References 71 publications

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“…The most used procedures in bariatric surgery are sleeve gastrectomy, gastric bypass and intragastric balloon, which are indicated especially in class II and III obese after accurate clinical assessment, including psychological aspects. Arterial hypertension, T2DM and dyslipidemia generally improve significantly or can even resolve after bariatric surgery ( 94 ). All the baseline anthropometric parameters, such as body weight, BMI, WC, and abdominal excessive adipose tissue measurements significantly improved 3 months after surgery.…”

Section: Bariatric Surgerymentioning

confidence: 99%

Adipocentric origin of the common cardiometabolic complications of obesity in the young up to the very old: pathophysiology and new therapeutic opportunities

Sarzani,

Landolfo,

Di Pentima

et al. 2024

Front. Med.

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Obesity is a multifactorial chronic disease characterized by an excess of adipose tissue, affecting people of all ages. In the last 40 years, the incidence of overweight and obesity almost tripled worldwide. The accumulation of “visceral” adipose tissue increases with aging, leading to several cardio-metabolic consequences: from increased blood pressure to overt arterial hypertension, from insulin-resistance to overt type 2 diabetes mellitus (T2DM), dyslipidemia, chronic kidney disease (CKD), and obstructive sleep apnea. The increasing use of innovative drugs, namely glucagon-like peptide-1 receptor agonists (GLP1-RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2-i), is changing the management of obesity and its related cardiovascular complications significantly. These drugs, first considered only for T2DM treatment, are now used in overweight patients with visceral adiposity or obese patients, as obesity is no longer just a risk factor but a critical condition at the basis of common metabolic, cardiovascular, and renal diseases. An adipocentric vision and approach should become the cornerstone of visceral overweight and obesity integrated management and treatment, reducing and avoiding the onset of obesity-related multiple risk factors and their clinical complications. According to recent progress in basic and clinical research on adiposity, this narrative review aims to contribute to a novel clinical approach focusing on pathophysiological and therapeutic insights.

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Section: Bariatric Surgerymentioning

confidence: 99%

Adipocentric origin of the common cardiometabolic complications of obesity in the young up to the very old: pathophysiology and new therapeutic opportunities

Sarzani,

Landolfo,

Di Pentima

et al. 2024

Front. Med.

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“…Insufficient weight loss and unresponsive gastro-oesophageal reflux disease after SG may necessitate SG conversion to RYGB. In one SRMA of 21 studies (n=740 patients), revision to RYGB led to total weight loss of 19.9% (95% CI 14% to 25%)24; and in another analysis, revision with one-anastomosis sleeve procedure was the most effective although no direct comparisons with RYGB were available 25…”

Section: The Multidisciplinary Team Of Gastroenterologists Dietitians...mentioning

confidence: 99%

Ten reasons gastroenterologists and hepatologists should be treating obesity

Camilleri

El-Omar

2023

Gut

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Section: Introductionmentioning

confidence: 99%

“…The effectiveness of RBS in terms of weight loss has been demonstrated for both SG 9 and AGB 10 although the effect size appears to be lower than that of primary BS. 9 , 10 Some studies tend to show a positive effect of RBS on the treatment of T2DM, regardless of the surgical sequence. 9 , 11 , 12 However, this body of evidence mainly relies on studies compiling heterogeneous data or with a small sample size and would need to be strengthened.…”

Section: Introductionmentioning

confidence: 99%

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Cost-Effectiveness of Sleeve Gastrectomy and Gastric Bypass as Revisional Surgery on Antidiabetic Reimbursement: A Nationwide Cohort Study

Thereaux,

Bennani,

Khemis

et al. 2024

Annals of Surgery Open

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Objective: This study compared the effectiveness of 4 main revisional bariatric surgery (RBS) sequences after sleeve gastrectomy (SG) and adjustable gastric banding (AGB), on the reimbursement of antidiabetic treatments in France. Background: Few large-scale prospective cohort studies have assessed the changes in antidiabetic treatments after RBS. Method: This nationwide observational population-based cohort study analyzed data from the French National Health Insurance Database. All patients who underwent primary SG and AGB in France between January 2012 and December 2014 were included and followed up until December 31, 2020. The changes in categories and costs of reimbursed antidiabetic treatments across different RBS sequences were assessed (presented as follows: bariatric surgery (BS)-RBS). Results: Among the 107,088 patients who underwent BS, 6396 underwent RBS, 2400 SG-GBP (SG converted to gastric bypass [GBP] during follow-up), 2277 AGB-SG, 1173 AGB-GBP, and 546 SG-SG. Pre-RBS insulin was used in 10 (2.9%), 4 (0.9%), 8 (2.4%), and 10 (2.6%) patients, respectively. Two years after RBS, the treatment discontinuation or decrease (the change of treatment to a lighter one category rates [eg, insulin to bi/tritherapy]) was 47%, 47%, 49%, and 34%, respectively. Four years after RBS, the median annual cost per patient compared with baseline was lower (P < 0.01) for all sequences, except SG-SG (P = 0.24). The most notable effect concerned AGB-GBP (median of more than 220 euros to 0). Conclusions: This study demonstrated the positive impact of RBS over a 4-year follow-up period on antidiabetic treatments reimbursement, through the reduction or discontinuation of treatments and a significant decrease in costs per patient.

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Weight loss specific to indication, remission of diabetes, and short-term complications after sleeve gastrectomy conversion to Roux-en-Y gastric bypass: a systematic review and meta-analysis

Cited by 16 publications

References 71 publications

Adipocentric origin of the common cardiometabolic complications of obesity in the young up to the very old: pathophysiology and new therapeutic opportunities

Adipocentric origin of the common cardiometabolic complications of obesity in the young up to the very old: pathophysiology and new therapeutic opportunities

Ten reasons gastroenterologists and hepatologists should be treating obesity

Cost-Effectiveness of Sleeve Gastrectomy and Gastric Bypass as Revisional Surgery on Antidiabetic Reimbursement: A Nationwide Cohort Study

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