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This letter, published in the journal Obesity Surgery, discusses the role of Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RAs) in managing weight gain or inadequate weight loss after bariatric surgery. The authors agree with a previous study that found GLP-1RAs to be an effective therapeutic option for patients experiencing weight regain after surgery. They also highlight the importance of ongoing treatment with GLP-1RAs to sustain weight loss benefits and mitigate cardiometabolic risks. The letter emphasizes the need for a comprehensive, long-term therapeutic strategy for managing obesity, particularly in the post-bariatric surgery patient population. [Extracted from the article]

This document is a response to concerns raised by Dr. Chen and colleagues regarding a meta-regression analysis on the impact of dexmedetomidine on postoperative nausea and vomiting (PONV). The original study found no statistical significance in PONV incidence between the dexmedetomidine group and the control group in the post-anesthesia care unit (PACU). However, the meta-analysis showed a significant reduction in PONV risk with dexmedetomidine use. The authors attribute this discrepancy to the limited sample size of their cohort study compared to the broader dataset used in the meta-analysis. They also highlight the importance of considering advancements in surgical techniques and perioperative care, as well as the role of multimodal antiemetic prophylaxis and opioid-sparing analgesia in affecting PONV incidence. The authors acknowledge the need for further research with larger sample sizes and standardized protocols to clarify the role of dexmedetomidine in PONV prevention. [Extracted from the article]

We conducted a systematic review and meta-analysis to assess the efficacy of intragastric BTA injection in patients with obesity and morbid obesity. Five RCTs were identified. Intragastric BTA injection was no superior to saline in absolute weight loss or BMI change, but significantly lengthened the gastric emptying time (MD, 15.57; 95% CI, 8.75 to 22.38). In meta-regression analysis, the absolute weight loss was lower in the patients with high baseline BMI. In subgroup analysis, the use of BTA in absolute weight loss was significantly lower among the patients with baseline BMI more than 40 kg/m2 (MD, − 5.31; 95% CI, − 6.17 to − 4.45). The benefit of intragastric BTA injection in reduction of absolute weight was observed in patients with baseline BMI more than 40 kg/m2. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic adjustable gastric banded plication (LAGBP) is a novel bariatric procedure which is restrictive and reversible. The aim of this study were to compare two LAGBP techniques and analyze its postoperative outcomes, in order to standardize the procedure. Methods: Eighty patients who underwent LAGBP were enrolled in this study. Forty patients who underwent LAGBP (group 1) from December 2011 to June 2012 were compared with 40 patients (group 2) who underwent a modified LAGBP technique, which included preserving the right gastroepiploic vessels and uniform plication volume between July 2012 and January 2013. Relevant patient's data were collected and analyzed. Results: Both groups were similar in age, gender, preoperative body mass index (BMI), and hospital stay. The median total operative time was shorter in group 2 (100.5 min; range 41-189) compared to group 1 (124 min; range 63-192), p = 0.048. There were two major complications involving gastric fold herniation (GFH) in group 1, while none was seen in group 2, p = 0.07. The minor complications encountered in both groups were similar, p = 0.37. At 6-month follow-up, there was no difference in mean frequency of band adjustments, weight, and BMI reduction in both groups. No mortality was seen in our series. Conclusions: A standardized LAGBP procedure which includes uniform plication volume and preservation of right gastroepiploic vessels could potentially avoid early GFH. However, larger comparative studies with longer follow-up would be needed to evaluate the late outcomes of this procedure and its efficacy in weight loss. [ABSTRACT FROM AUTHOR]

We conducted a systematic review and meta-analysis to assess the efficacy of intragastric BTA injection in patients with obesity and morbid obesity. Five RCTs were identified. Intragastric BTA injection was no superior to saline in absolute weight loss or BMI change, but significantly lengthened the gastric emptying time (MD, 15.57; 95% CI, 8.75 to 22.38). In meta-regression analysis, the absolute weight loss was lower in the patients with high baseline BMI. In subgroup analysis, the use of BTA in absolute weight loss was significantly lower among the patients with baseline BMI more than 40 kg/m 2 (MD, - 5.31; 95% CI, - 6.17 to - 4.45). The benefit of intragastric BTA injection in reduction of absolute weight was observed in patients with baseline BMI more than 40 kg/m 2 .