Clinical Advances in Obesity and Bariatric Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Endocrinology & Metabolism".

Deadline for manuscript submissions: closed (30 March 2024) | Viewed by 5248

Special Issue Editors


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Guest Editor
Department of Surgery, University of Alberta Hospital, University of Alberta, 8440 112 Street NW, Edmonton, AB T6G 2B7, Canada
Interests: general surgery; metabolic syndrome; inflammatory bowel disease; gut microbiome; bariatric surgery

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Guest Editor
Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA
Interests: bariatric surgery; metabolic surgery; flexible endoscopic surgery; foregut surgery; obesity; microbiome; minimally invasive surgery; gastrointestinal surgery
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Special Issue Information

Dear Colleagues,

This Special Issue, entitled "Clinical Advances in Obesity and Bariatric Surgery", compiled by guest editors Dr. Dang and Dr. Mocanu, is dedicated to exploring and highlighting the forefront of innovation within the obesity and bariatric surgery sector. This Special Issue serves as a call for research papers aiming to characterize and evaluate ongoing advancements in obesity treatment with a focus on the persistent evolution of surgical methodologies and metabolic procedures in the field.

This Special Issue is specifically designed as a call for research papers which offer novel and critical insights into the advancements in obesity treatment, including the continuously evolving surgical and metabolic procedures, in addition to clinical outcomes. This Special Issue intends to feature a variety of research including case studies, data-driven comparative analyses, and in-depth reviews to foster a stimulating academic discourse surrounding bariatric surgery and metabolic disease.

The call for contributions to this Special Issue is now open. We warmly invite all researchers interested in this field to share their innovative work, thereby contributing to the evolving landscape of obesity and bariatric surgery. Your contributions will help shape the future of this field while informing best practices and inspiring further advancements in the fight against obesity.

Dr. Valentin Mocanu
Dr. Jerry Dang
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly 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 2600 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

  • obesity
  • bariatric surgery
  • metabolic surgery
  • anti-obesity medications
  • obesity treatment

Published Papers (4 papers)

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Research

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11 pages, 461 KiB  
Article
Bariatric Surgery Outcomes in Patients with Severe Obesity Compared to Patients with Non-Severe Obesity at A New Institution in The United Arab Emirates
by Jamie P. DeCicco, Juan S. Barajas-Gamboa, Jerry T. Dang, Gabriel Diaz Del Gobbo, Javed Raza, Carlos Abril, Alfredo D. Guerron, Juan Pablo Pantoja, Safa Botros Hegazin, Ricard Corcelles, John Rodriguez and Matthew Kroh
J. Clin. Med. 2024, 13(7), 1907; https://doi.org/10.3390/jcm13071907 - 26 Mar 2024
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Abstract
Background: Bariatric surgery is an effective treatment for weight loss, but a higher body mass index (BMI) may lead to higher postoperative complication rates. This study aims to compare perioperative and postoperative outcomes between UAE patients with severe obesity (SO) [BMI ≥ 50 [...] Read more.
Background: Bariatric surgery is an effective treatment for weight loss, but a higher body mass index (BMI) may lead to higher postoperative complication rates. This study aims to compare perioperative and postoperative outcomes between UAE patients with severe obesity (SO) [BMI ≥ 50 kg/m2] and non-severe obesity (NSO) [BMI < 50 kg/m2] undergoing primary bariatric surgery. Methods: From September 2015 to July 2019, 542 patients, 94 SO (56.5 ± 6.2 kg/m2) and 448 NSO (41.8 ± 4.1 kg/m2), were retrospectively reviewed. Results: Patients with SO were younger (33.8 ± 13.4 vs. 37.0 ± 11.5 years, p = 0.02) but otherwise had similar demographic characteristics. Their rates of Roux-en-Y gastric bypass (39.4% SO vs. 44.4% NSO, p = 0.37) and sleeve gastrectomy (60.6% vs. 55.6%, p = 0.37) were similar. There were no differences between perioperative complications (6.4% SO vs. 5.8% NSO, p = 0.83), major postoperative complications (5.3% vs. 3.5%, p = 0.42), readmissions (5.3% vs. 3.3%, p = 0.36), or reoperations (3.2% vs. 2.7%, p = 0.78). There were no mortalities. Their total body weight loss was comparable at 12 months (28.1 ± 10.2% vs. 29.0 ± 7.7%, p = 0.58). Conclusions: Although a higher BMI may pose operative challenges, UAE patients with SO do not have worsened outcomes in bariatric surgery, demonstrating similarly low morbidity to patients with NSO, and similar rates of improvement in their BMI. Full article
(This article belongs to the Special Issue Clinical Advances in Obesity and Bariatric Surgery)
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12 pages, 273 KiB  
Article
Dynamic Evaluation of Vitamin D Metabolism in Post-Bariatric Patients
by Alexandra Povaliaeva, Artem Zhukov, Alina Tomilova, Axenia Bondarenko, Maksim Ovcharov, Mariya Antsupova, Vitaliy Ioutsi, Ekaterina Shestakova, Marina Shestakova, Ekaterina Pigarova, Liudmila Rozhinskaya and Natalia Mokrysheva
J. Clin. Med. 2024, 13(1), 7; https://doi.org/10.3390/jcm13010007 - 19 Dec 2023
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Abstract
Background: findings from the previously conducted studies indicate altered regulatory mechanisms of calcium and vitamin D metabolism in obese patients and a role for bariatric surgery in regulating vitamin D metabolism; however, the available data is controversial and does not provide an adequate [...] Read more.
Background: findings from the previously conducted studies indicate altered regulatory mechanisms of calcium and vitamin D metabolism in obese patients and a role for bariatric surgery in regulating vitamin D metabolism; however, the available data is controversial and does not provide an adequate understanding of the subject. Methods: we evaluated serum parameters of vitamin D and mineral metabolism (vitamin D metabolites (25(OH)D3, 25(OH)D2, 1,25(OH)2D3, 3-epi-25(OH)D3, and 24,25(OH)2D3), vitamin D-binding protein (DBP), free 25(OH)D, fibroblast growth factor 23 (FGF-23), parathyroid hormone (PTH), total calcium, albumin, phosphorus, creatinine, magnesium) in 30 patients referred for bariatric surgery in comparison with 30 healthy volunteers of similar age, sex and baseline 25(OH)D3. Patients were also followed up with repeated laboratory assessments 3 months and 6 months after surgery. During the first 3 months, patients were prescribed high-dose cholecalciferol therapy (50,000 IU per week), with subsequent correction based on the results of the 3-month visit examination. Results: Preoperatively, patients with morbid obesity were characterized by a high prevalence of vitamin D deficiency (median 25(OH)D3 level 11.9 (6.8; 22.2) ng/mL), significantly lower levels of active vitamin D metabolite 1,25(OH)2D3 (20 (10; 37) vs. 39 (33; 50) pg/mL, p < 0.001), lower serum albumin-adjusted calcium levels (2.24 (2.20; 2.32) vs. 2.31 (2.25; 2.35) mmol/L, p = 0.009) and magnesium levels (0.79 (0.72; 0.82) vs. 0.82 (0.78; 0.85) mmol/L, p = 0.043) with simultaneous similar PTH levels (p = 0.912), and higher DBP levels (328 (288; 401) vs. 248 (217; 284) mg/L, p < 0.001). The 25(OH)D3 levels remained suboptimal (24.5 (14.7; 29.5) ng/mL at the 3-month visit and 17.9 (12.4; 21.0) ng/mL at the 6-month visit, p = 0.052) despite recommended high-dose cholecalciferol supplementation. Patients also demonstrated an increase in 1,25(OH)2D3 levels (38 (31; 52) pg/mL at the 3-month visit and 49 (29; 59) pg/mL at the 6-month visit, p < 0.001) without a change in PTH or calcium levels during the follow-up. Conclusion: our results of a comprehensive laboratory evaluation of vitamin D status and mineral metabolism in patients undergoing bariatric surgery highlight the importance of improving current clinical guidelines, as well as careful monitoring and education of patients. Full article
(This article belongs to the Special Issue Clinical Advances in Obesity and Bariatric Surgery)
8 pages, 685 KiB  
Article
Marginal Ulcer and Dumping Syndrome in Patients after Duodenal Switch: A Multi-Centered Study
by Marita Salame, Andre F. Teixeira, Romulo Lind, Gilberto Ungson, Muhammad Ghanem, Kamal Abi Mosleh, Muhammad A. Jawad, Barham K. Abu Dayyeh, Michael L. Kendrick and Omar M. Ghanem
J. Clin. Med. 2023, 12(17), 5600; https://doi.org/10.3390/jcm12175600 - 28 Aug 2023
Cited by 2 | Viewed by 1886
Abstract
Background: The current design of biliopancreatic diversion with duodenal switch (BPD/DS) and single anastomosis duodenal–ileal bypass with sleeve (SADI-S) emphasizes the importance of the pylorus’ preservation to reduce the incidence of marginal ulcer (MU) and dumping. However, no institutional studies have yet reported [...] Read more.
Background: The current design of biliopancreatic diversion with duodenal switch (BPD/DS) and single anastomosis duodenal–ileal bypass with sleeve (SADI-S) emphasizes the importance of the pylorus’ preservation to reduce the incidence of marginal ulcer (MU) and dumping. However, no institutional studies have yet reported data on their prevalence. We aimed to assess the incidence of MU and dumping after duodenal switch (DS) and identify the associative factors. Methods: A multi-center review of patients who underwent BPD/DS or SADI-S between 2008 and 2022. Baseline demographics, symptoms, and management of both complications were collected. Fisher’s exact test was used for categorical variables and the independent t-test for continuous variables. Results: A total of 919 patients were included (74.6% female; age 42.5 years; BMI 54.6 kg/m2) with mean follow-up of 31.5 months. Eight patients (0.9%) developed MU and seven (0.8%) had dumping. Patients who developed MU were more likely to be using non-steroidal anti-inflammatory drugs (NSAID) (p = 0.006) and have a longer operation time (p = 0.047). Primary versus revisional surgery, and BDP/DS versus SADI-S were not associated with MU or dumping. Conclusions: The incidences of MU and dumping after DS were low. NSAID use and a longer operation time were associated with an increased risk of MU, whereas dumping was attributed to poor dietary habits. Full article
(This article belongs to the Special Issue Clinical Advances in Obesity and Bariatric Surgery)
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22 pages, 939 KiB  
Review
Weight Regain after Metabolic Surgery: Beyond the Surgical Failure
by Juan Salazar, Pablo Duran, Bermary Garrido, Heliana Parra, Marlon Hernández, Clímaco Cano, Roberto Añez, Henry García-Pacheco, Gabriel Cubillos, Neidalis Vasquez, Maricarmen Chacin and Valmore Bermúdez
J. Clin. Med. 2024, 13(4), 1143; https://doi.org/10.3390/jcm13041143 - 18 Feb 2024
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Abstract
Patients undergoing metabolic surgery have factors ranging from anatomo-surgical, endocrine metabolic, eating patterns and physical activity, mental health and psychological factors. Some of the latter can explain the possible pathophysiological neuroendocrine, metabolic, and adaptive mechanisms that cause the high prevalence of weight regain [...] Read more.
Patients undergoing metabolic surgery have factors ranging from anatomo-surgical, endocrine metabolic, eating patterns and physical activity, mental health and psychological factors. Some of the latter can explain the possible pathophysiological neuroendocrine, metabolic, and adaptive mechanisms that cause the high prevalence of weight regain in postbariatric patients. Even metabolic surgery has proven to be effective in reducing excess weight in patients with obesity; some of them regain weight after this intervention. In this vein, several studies have been conducted to search factors and mechanisms involved in weight regain, to stablish strategies to manage this complication by combining metabolic surgery with either lifestyle changes, behavioral therapies, pharmacotherapy, endoscopic interventions, or finally, surgical revision. The aim of this revision is to describe certain aspects and mechanisms behind weight regain after metabolic surgery, along with preventive and therapeutic strategies for this complication. Full article
(This article belongs to the Special Issue Clinical Advances in Obesity and Bariatric Surgery)
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