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New Advances and Challenges in Metabolic and Bariatric Surgery
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New Advances and Challenges in Metabolic and Bariatric Surgery

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Clinical Medicine, Cell, and Organism Physiology".

Deadline for manuscript submissions: closed (25 March 2024) | Viewed by 5268

Special Issue Editors

Dr. Hugo Santos-Sousa

E-Mail Website
Guest Editor
1. Integrated Obesity Center (CRI-O) & Center of Excellence in Obesity (CED-O), São João University Hospital Center (CHUSJ), Porto, Portugal
2. Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
3. Obesity Clinic, Casa de Saúde da Boavista (CSB), Porto, Portugal
Interests: obesity; metabolic and bariatric surgery, metabolic syndrome, minimally invasive surgery; clinical and translational research
Special Issues, Collections and Topics in MDPI journals
Dr. Jorge Pedro Martins Nogueiro

E-Mail Website
Guest Editor
Department of General Surgery, São João University Hospital Center, Porto, Portugal
Interests: bariatric surgery; peritoneal carcinomatosis; gastric cancer; colorectal cancer; abdominal surgery
Special Issues, Collections and Topics in MDPI journals
Dr. André Costa-Pinho

E-Mail Website
Guest Editor
1. Integrated Obesity Center (CRI-O) & Center of Excellence in Obesity (CED-O), São João University Hospital Center (CHUSJ), Porto, Portugal
2. Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
Interests: obesity; metabolic and bariatric surgery, metabolic syndrome, minimally invasive surgery; clinical and translational research

Special Issue Information

Dear Colleagues,

It is with great pleasure and enthusiasm that I welcome you to this special edition of Journal of Personalized Medicine dedicated to the “New Advances and Challenges in Metabolic and Bariatric Surgery”. Obesity, an ever-growing global health concern, continues to demand innovative solutions, both surgical and pharmaceutical, to alleviate its profound impact on public health and individual well-being. This issue will provide a comprehensive overview of the latest developments in this field, with a particular focus on the expansion of indications for metabolic and bariatric surgery (MBS), novel single anastomosis bariatric procedures, transit bipartition surgeries grounded in incretin and anti-incretin theory, and emerging pharmaceutical interventions for obesity management.

Alarming Trends and Expanded Indications

The rising prevalence of obesity-related comorbidities such as type 2 diabetes, cardiovascular diseases, and non-alcoholic fatty liver disease has spurred a paradigm shift in the application of bariatric surgery. Recent research has demonstrated the benefits of MBS in patients with lower BMI thresholds, emphasizing the role of surgery as a preventive measure and not just a treatment for severe obesity.

Incretins, Anti-Incretins, Transit Bipartition and Single Anastomosis Procedures

In this special issue, we delve into the cutting-edge field of MBS, exploring the latest advancements in transit bipartition and single anastomosis procedures rooted in the incretin and anti-incretin theory. These innovative surgeries, such as Single Anastomosis Sleeve Ileal (SASI) Bypass, harness the power of gut hormones to regulate glucose metabolism, appetite, and energy expenditure.  An essential component of these new procedures is intestinal bipartition, where the intestine is partitioned into two segments, each with distinct functions. This innovative approach plays a pivotal role in modulating incretin and anti-incretin responses, contributing to improved metabolic outcomes. We will examine the scientific underpinnings of these procedures and their clinical outcomes, shedding light on their potential to redefine the landscape of MBS.

Pharmaceutical Breakthroughs

Beyond surgical interventions, the realm of pharmacotherapy for obesity management is undergoing a renaissance. This issue will provide insights into the latest generation of anti-obesity medications, including incretin mimetics, leptin analogs, and selective serotonin receptor agonists. These pharmacological agents hold promise in addressing obesity with greater precision, potentially reducing the need for surgery in certain cases, or as a neo-adjuvant treatment and a bridge for surgery.

In conclusion, the field of MBS stands at the forefront of medical innovation, offering new hope to individuals struggling with obesity and its associated metabolic disorders. As guest editor, I am excited to present to you a collection of articles that encapsulate the diverse facets of this evolving field, from expanded indications to the frontiers of surgical techniques and pharmaceutical interventions. With the ever-increasing challenges posed by the obesity epidemic, it is our hope that this special edition of Journal of Personalized Medicine will inspire further research, collaboration, and innovation in the pursuit of effective and holistic solutions for obesity and its metabolic consequences.

Sincerely,

Dr. Hugo Santos-Sousa
Dr. Jorge Pedro Martins Nogueiro
Dr. André Costa-Pinho
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 Personalized Medicine 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 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
  • metabolic and bariatric surgery
  • metabolic syndrome
  • clinical and translational research
  • novel surgical procedures
  • new drugs
  • indications for surgery
  • incretin and anti-incretin
  • transit bipartition
  • single anastomosis procedures

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Published Papers (3 papers)

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12 pages, 594 KiB  
Article
Neck Circumference Cut-Off Points for Identifying Adiposity: Association with Chronic Metabolic Diseases in Older People
by Dominique A. Díaz, Lydia Lera, Carlos Márquez, Andrea Valenzuela, Rodrigo Saguez, Gerardo Weisstaub and Cecilia Albala
J. Pers. Med. 2024, 14(7), 710; https://doi.org/10.3390/jpm14070710 - 1 Jul 2024
Viewed by 1242
Abstract
Background: The leading cause of death in older people is cardiovascular diseases. Several studies have found that neck circumference (NC) is a simple anthropometric marker associated with adiposity. The aim of this study is to estimate and validate NC cut-off points as adiposity [...] Read more.
Background: The leading cause of death in older people is cardiovascular diseases. Several studies have found that neck circumference (NC) is a simple anthropometric marker associated with adiposity. The aim of this study is to estimate and validate NC cut-off points as adiposity markers and analyze their association with cardiovascular and chronic metabolic diseases in older people. Methods: A cross-sectional study in 358 non-disabled, community-dwelling older people (71.7 ± 3.9 years) living in Santiago de Chile and participating in the HTSMayor study was conducted. Measurements of body composition and cardiovascular risks were evaluated. Receiver operating characteristic (ROC) curves and multiple logistic regression models were used to evaluate the association of NC with cardiovascular and chronic metabolic diseases. NC cut-off points were obtained to predict obesity, abdominal obesity, and adiposity. Results: The best performance values of neck circumference relative to obesity and adiposity were obtained with respect to abdominal obesity (40.6 cm in men and 34.2 cm in women). Higher NC values were associated with a higher area under the curve (AUC) for men and women (men: AUC = 0.84; women: AUC = 0.86). NC was significantly associated with a higher risk for diabetes mellitus (OR = 1.95), hypertension (OR = 2.42), acute myocardial infarction (OR = 4.36), and comorbidities (OR = 2.01), and a lower risk for sarcopenia (OR = 0.35). Conclusions: This study shows that NC is a useful tool for detecting abdominal obesity, obesity, and adiposity in older people and that a higher NC increases the risk of chronic diseases. Full article
(This article belongs to the Special Issue New Advances and Challenges in Metabolic and Bariatric Surgery)
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13 pages, 300 KiB  
Article
Assessing Nutritional Deficiencies in Bariatric Surgery Patients: A Comparative Study of Roux-en-Y Gastric Bypass versus Sleeve Gastrectomy
by José P. Vieira de Sousa, Hugo Santos-Sousa, Sofia Vieira, Rita Nunes, Jorge Nogueiro, André Pereira, Fernando Resende, André Costa-Pinho, John Preto, Bernardo Sousa-Pinto, Silvestre Carneiro and Eduardo Lima-da-Costa
J. Pers. Med. 2024, 14(6), 650; https://doi.org/10.3390/jpm14060650 - 18 Jun 2024
Cited by 1 | Viewed by 2134
Abstract
Obesity is a worldwide epidemic, and bariatric surgery is considered the primary treatment for long-term weight loss and managing obesity-related health issues. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the most performed procedures. Nutritional deficiencies are a significant concern following bariatric [...] Read more.
Obesity is a worldwide epidemic, and bariatric surgery is considered the primary treatment for long-term weight loss and managing obesity-related health issues. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the most performed procedures. Nutritional deficiencies are a significant concern following bariatric surgery and can have serious consequences. This study aims to compare the incidence of nutritional deficiencies in patients undergoing RYGB and SG. A retrospective analysis was conducted on the nutritional status of 505 consecutive patients who underwent either RYGB or SG between January and December 2019. Data were collected regarding vitamin B12, folic acid, vitamin D, calcium, PTH, magnesium, hemoglobin, iron, ferritin, and transferrin at preoperative, 6-month, and 12-month intervals post-surgery. The RYGB group showed significantly higher excess weight loss. Vitamin B12, hemoglobin, and ferritin levels were consistently higher in the SG group throughout the study. Vitamin D deficiency was prevalent, with no significant difference between the groups. Vitamin B12 deficiency was significantly more common in the RYGB group (6 months: 17.46% vs. 4.69%, p < 0.001; 12 months: 16.74% vs. 0.93%, p < 0.001). Despite differences in their mechanisms, bariatric surgeries were associated with nutritional deficiencies. It is crucial to efficiently assess, prevent, and manage these deficiencies tailored to each surgical procedure. Full article
(This article belongs to the Special Issue New Advances and Challenges in Metabolic and Bariatric Surgery)

Other

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12 pages, 665 KiB  
Systematic Review
Portomesenteric Venous Thrombosis after Bariatric Surgery: A Case Series and Systematic Review Comparing LSG and LRYGB
by Raquel Gomes, André Costa-Pinho, Francisca Ramalho-Vasconcelos, Bernardo Sousa-Pinto, Hugo Santos-Sousa, Fernando Resende, John Preto, Eduardo Lima-da-Costa and CRI-O Group
J. Pers. Med. 2024, 14(7), 722; https://doi.org/10.3390/jpm14070722 - 4 Jul 2024
Cited by 1 | Viewed by 1500
Abstract
(1) Background: Portomesenteric Venous Thrombosis (PMVT) is a rare but serious complication of Metabolic Bariatric Surgery (MBS). Although more frequently reported after laparoscopic sleeve gastrectomy (LSG), the risk factors for PMVT remain unclear. This study aims to compare the incidence and determinants of [...] Read more.
(1) Background: Portomesenteric Venous Thrombosis (PMVT) is a rare but serious complication of Metabolic Bariatric Surgery (MBS). Although more frequently reported after laparoscopic sleeve gastrectomy (LSG), the risk factors for PMVT remain unclear. This study aims to compare the incidence and determinants of PMVT between LSG and laparoscopic Roux-en-Y gastric bypass (LRYGB). (2) Methods: A retrospective analysis of 5235 MBSs conducted at our institution between 2015 and 2023 identified five cases of PMVT. Additionally, a systematic review in March 2023, covering PubMed, Web of Science and Scopus, was performed. Several data were analyzed regarding risk factors. (3) Results: In our case series, the incidence of PMVT was 0.1%. The five cases described involved four females with a BMI between 39.7 and 56.0 kg/m2. Their comorbidities were associated with metabolic syndrome, all women used oral contraceptive and two patients were diagnosed with thrombophilia or pulmonary embolism. Per protocol, thromboprophylaxis was administered to all patients. Diagnosis was made at a median of 16 days post-surgery, with abdominal pain being the main presenting symptom. Acute cases were managed with enoxaparin, unfractionated heparin and fibrinolysis. One patient required surgery. Ten studies were included in the systematic review and 205 patients with PMVT were identified: 193 (94.1%) post-LSG and 12 post-LRYGB. The most common comorbidities were dyslipidemia, hypertension, diabetes, sleep apnea and liver disorders; (4) Conclusions: PMVT is a potentially life-threatening complication after MBS, requiring preventive measures, timely diagnosis and several treatments. Our findings suggest a higher occurrence in women with an elevated BMI and post-LSG. Tailored thromboprophylaxis for MBS patients at risk of PMVT may be warranted. Full article
(This article belongs to the Special Issue New Advances and Challenges in Metabolic and Bariatric Surgery)
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