Impact of glucagon-Like peptide-1 agonists in optimizing abdominal wall Reconstruction patients
- 01.12.2025
- Original Article
Erschienen in:
- Verfasst von
- Daniel Tran
- Daylon A. Farias
- Mathew Tanner
- Monica Marroquin
- Rachel S. Jefferies
- Gerald O. Ogola
- Santiago Quevedo
- William J. Hlavinka
- Steven G. Leeds
- Marc A. Ward
- Bola G. Aladegbami
- Erschienen in
- Hernia | Ausgabe 1/2025
Abstract
Purpose
Pre-optimization of obese patients prior to abdominal wall reconstruction (AWR) is essential in mitigating their increased preoperative risks. Traditionally diet, exercising, bariatric surgery are the tools typically prescribed for weight loss. The advent of glucagon-like peptide-1 agonists (GLP-1A) which stimulate insulin secretion and inhibit gastric emptying have improved the weight loss armamentarium. However, there is a limited amount of literature on GLP-1A effectiveness and postoperative outcomes in AWR patients. This study compares the efficacy of GLP-1A to Bariatric Surgery (BAS) in perioperative AWR patient.
Methods
A prospectively maintained database was retrospectively reviewed to identify all patients undergoing AWR at our institution between January 2021 and March 2024. We included patients who required GLP-1A or BAS for weight optimization prior to AWR. We excluded patients on GLP1-A or history BAS not performed for AWR preoptimization. Basic demographics such as age, sex, race, weight and BMI at initial clinic visit and at surgery were compared. Primary endpoints included time to surgery, time to bowel recovery and length of stay (LOS). Time to surgery was defined as the number of months between the initial clinic visit and AWR. Time to bowel recovery was defined as the number of days it took for the first postoperative bowel function. Secondary endpoints included standard 30-days postoperative variables. Nominal variables were analyzed using a Fisher exact test and continuous variables were analyzed with Student’s T test.
Results
35 patients were included in this study (GLP-1A: 17, BAS: 18). The GLP-1A cohort had a lesser BMI at the initial clinic visit (40.8 vs 43.4, p = 0.188). GLP-1A cohort made it to the operating room faster (9.1 months vs 13.5 months, p = 0.06) from the first clinic visit; and (7.9 months vs 9.7 months, p = 0.4) from initiation of weight loss intervention. Albeit losing less weight (14.9 kg vs 27.1 kg, p = 0.008) with a lesser reduction in the BMI (4.69 vs 9.23, p = 0.004). The GLP-1A cohort showed a non-significant elevated LOS (5.2 days vs 3.6 days, p = 0.25) and an increased ileus rate (17.6% vs 0%, p = 0.1). However, there were no differences noted in time to bowel recovery (2.9 days vs 3.1 days, p = 0.76).
Conclusion
GLP-1A is effective in optimizing patients needing weight loss before AWR. They shorten the timeline to AWR intervention and have comparable peri-operative outcomes to BAS patients.
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- Titel
- Impact of glucagon-Like peptide-1 agonists in optimizing abdominal wall Reconstruction patients
- Verfasst von
-
Daniel Tran
Daylon A. Farias
Mathew Tanner
Monica Marroquin
Rachel S. Jefferies
Gerald O. Ogola
Santiago Quevedo
William J. Hlavinka
Steven G. Leeds
Marc A. Ward
Bola G. Aladegbami
- Publikationsdatum
- 01.12.2025
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 1/2025
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-024-03214-6
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