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Comment on: Bariatric surgery and secondary hyperparathyroidism: a meta-analysis

Published:October 12, 2022DOI:https://doi.org/10.1016/j.soard.2022.10.012
      I thank Cai et al. [

      Cai Z, Zhang Q, Jiang Y, Zhang J, Liu W. Bariatric surgery and secondary hyperparathyroidism: a meta-analysis. Surg Obes Relat Dis. Epub 2022 Sep 22.

      ] for their excellent meta-analysis addressing the important topic of secondary hyperparathyroidism and metabolic and bariatric surgery (MBS). This meta-analysis represents the first quantitative summary of the effect of MBS on secondary hyperparathyroidism (SHPT) risk and includes a large sample size of patients. This meta-analysis included a total of 5585 patients from 9 studies with a mean follow-up time of 3.5 years (range, .25–5). In addition to comparing the impact of MBS on SHPT, this meta-analysis compared the impact of follow-up time and surgical procedure on SHPT. For example, the first 2 years after MBS was not associated with an increased risk of SHPT (odds ratio [OR] = 1.34; 95% confidence interval [CI], .81–2.20; I2 = 95%) in either gastric bypass (GB) or SG procedures (for GB: OR = 1.42; 95% CI, .66–3.07; for SG: OR = .39; 95% CI, .09–1.62). However, at the 2-year follow-up mark and long-term follow-up intervals, a marked increase in SHPT was detected for GB (OR = 6.06; 95% CI, 3.39–10.85) (Figs. 3 and 4 in Cai et al. [

      Cai Z, Zhang Q, Jiang Y, Zhang J, Liu W. Bariatric surgery and secondary hyperparathyroidism: a meta-analysis. Surg Obes Relat Dis. Epub 2022 Sep 22.

      ]). Additionally, this meta-analysis showed that biliopancreatic diversion with duodenal switch had higher rates of SHPT than GB which had higher rates of SHPT than SG.
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      References

      1. Cai Z, Zhang Q, Jiang Y, Zhang J, Liu W. Bariatric surgery and secondary hyperparathyroidism: a meta-analysis. Surg Obes Relat Dis. Epub 2022 Sep 22.

        • Salman M.A.
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      Linked Article

      • Bariatric surgery and secondary hyperparathyroidism: a meta-analysis
        Surgery for Obesity and Related Diseases
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          Obesity increases the risk of obesity-related medical problems. Weight loss after metabolic and bariatric surgery (MBS) has been well studied. However, the effects of MBS on parathyroid function remain unclear.
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      • Comment on: Bariatric surgery and secondary hyperparathyroidism: a meta-analysis
        Surgery for Obesity and Related Diseases
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          I was recently asked by a younger bariatric surgeon why a general surgeon with no formal bariatric fellowship training was allowed to perform laparoscopic sleeve gastrostomies in her town. I explained that there are many bariatric surgeons in our great subspeciality who either were grandfathered into their career path before minimally invasive fellowships were in existence or perfected their bariatric skill sets by other means outside of a formal fellowship training paradigm. These options are perfectly acceptable within the confines and standards set forth in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program [1].
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