Duodenal Switch vs. Single-Anastomosis Duodenal Switch (SADI-S) for the Treatment of Grade IV Obesity: 5-Year Outcomes of a Multicenter Prospective Cohort Comparative Study
Purpose The aims were to compare the 5-year outcomes of duodenal switch (DS) and single-anastomosis duodenal switch (SADI-S) in terms of weight loss; remission of comorbidities; nutritional status short- and long-term complications; postoperative mortality; and need for revisional surgery. Materials...
Gespeichert in:
| Veröffentlicht in: | Obesity surgery 2022-12, Vol.32 (12), p.3839-3846 |
|---|---|
| Hauptverfasser: | , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 3846 |
|---|---|
| container_issue | 12 |
| container_start_page | 3839 |
| container_title | Obesity surgery |
| container_volume | 32 |
| creator | Gebellí, Jordi Pujol Lazzara, Claudio de Gordejuela, Amador García Ruiz Nora, Mario Pereira, Ana Marta Sánchez-Pernaute, Andrés Osorio, Javier Sobrino, Lucia García, Antonio J. Torres |
| description | Purpose
The aims were to compare the 5-year outcomes of duodenal switch (DS) and single-anastomosis duodenal switch (SADI-S) in terms of weight loss; remission of comorbidities; nutritional status short- and long-term complications; postoperative mortality; and need for revisional surgery.
Materials and Methods
Multicenter prospective observational study of all consecutive patients undergoing DS or SADI-S in three high-volume hospitals.
Results
A total of 87 patients were included in the study, 43 submitted to DS and 44 to SADI-S, with similar basal characteristics, nutritional parameters, and BMI (52.9 kg/m
2
DS vs. 52.5 kg/m
2
SADI-S). Operative time was 152 min (± 32.6) in DS vs. 116 min (± 21.9) in SADI-S (
p
= 0.043). Short-term complications were similar for DS and SADI-S, both overall (11.8% vs. 11.6%), and ranged as Clavien-Dindo > II (4.5% vs. 4.7%), with no mortality. At 5 years, DS and SADI-S results were as follows: BMI 30.6 vs. 33.3 kg/m
2
(
p
= 0.023); %EWL 80.5% vs. 68.6% (
p
= 0.006); and %TWL 42.1 vs. 36.0 (
p
= 0.006). Comorbidity remission rates for DS and SADI-S were as follows: for diabetes, 92.8% vs. 85.7% (n.s.); for hypertension, 95.2% vs. 85.1% (n.s.); for sleep apnea, 75% vs. 73.3% (n.s.); and for dyslipidemia, 76.4% vs. 73.3% (n.s.). DS showed lower levels of vitamin B
12
, iron, vitamin E, and zinc than SADI-S (
p
= |
| doi_str_mv | 10.1007/s11695-022-06317-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2728466697</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2728466697</sourcerecordid><originalsourceid>FETCH-LOGICAL-c352t-70fb2362dc271212e7f22f6a118a6073573e968147eba2af434300779fc80cda3</originalsourceid><addsrcrecordid>eNp90cFqGzEQBmBRWqib9gV6EvSSHpRIo7W025tx0tSQ4sKmhZ6ErJ2NN-yuXEmb4nfqQ1a2A4UcehoQ3z-g-Ql5L_iF4FxfRiFUNWccgHElhWb8BZkJzUvGCyhfkhmvFGdlBfI1eRPjA-cgFMCM_LmafIOj7Wn9u0tuSx_jBa278b5HthhtTH7wsYv0OTuvF1crVn-krQ80bZHeBbRpwDFR39KbYBukqx90vcHYpf0nOmc_0Qa6npLzA8YDsvTr1KfO5QwG-i34uEOXukekS7_1IeUx7Gywx6c6Tc3-LXnV2j7iu6d5Rr5_vr5bfmG365vVcnHLnJxDYpq3G5AKGgdagADULUCrrBClVVzLuZZYqVIUGjcWbFvIQuYj6qp1JXeNlWfk_LR3F_yvCWMyQxcd9r0d0U_RgIayUEpVOtMPz-iDn0I-1EHJo6uqrOCkXP5lDNiaXegGG_ZGcHMo0JwKNLlAcyzQ8BySp1DMeLzH8G_1f1J_Abognbc</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2737284699</pqid></control><display><type>article</type><title>Duodenal Switch vs. Single-Anastomosis Duodenal Switch (SADI-S) for the Treatment of Grade IV Obesity: 5-Year Outcomes of a Multicenter Prospective Cohort Comparative Study</title><source>SpringerLink Journals - AutoHoldings</source><creator>Gebellí, Jordi Pujol ; Lazzara, Claudio ; de Gordejuela, Amador García Ruiz ; Nora, Mario ; Pereira, Ana Marta ; Sánchez-Pernaute, Andrés ; Osorio, Javier ; Sobrino, Lucia ; García, Antonio J. Torres</creator><creatorcontrib>Gebellí, Jordi Pujol ; Lazzara, Claudio ; de Gordejuela, Amador García Ruiz ; Nora, Mario ; Pereira, Ana Marta ; Sánchez-Pernaute, Andrés ; Osorio, Javier ; Sobrino, Lucia ; García, Antonio J. Torres</creatorcontrib><description>Purpose
The aims were to compare the 5-year outcomes of duodenal switch (DS) and single-anastomosis duodenal switch (SADI-S) in terms of weight loss; remission of comorbidities; nutritional status short- and long-term complications; postoperative mortality; and need for revisional surgery.
Materials and Methods
Multicenter prospective observational study of all consecutive patients undergoing DS or SADI-S in three high-volume hospitals.
Results
A total of 87 patients were included in the study, 43 submitted to DS and 44 to SADI-S, with similar basal characteristics, nutritional parameters, and BMI (52.9 kg/m
2
DS vs. 52.5 kg/m
2
SADI-S). Operative time was 152 min (± 32.6) in DS vs. 116 min (± 21.9) in SADI-S (
p
= 0.043). Short-term complications were similar for DS and SADI-S, both overall (11.8% vs. 11.6%), and ranged as Clavien-Dindo > II (4.5% vs. 4.7%), with no mortality. At 5 years, DS and SADI-S results were as follows: BMI 30.6 vs. 33.3 kg/m
2
(
p
= 0.023); %EWL 80.5% vs. 68.6% (
p
= 0.006); and %TWL 42.1 vs. 36.0 (
p
= 0.006). Comorbidity remission rates for DS and SADI-S were as follows: for diabetes, 92.8% vs. 85.7% (n.s.); for hypertension, 95.2% vs. 85.1% (n.s.); for sleep apnea, 75% vs. 73.3% (n.s.); and for dyslipidemia, 76.4% vs. 73.3% (n.s.). DS showed lower levels of vitamin B
12
, iron, vitamin E, and zinc than SADI-S (
p
= < 0.005). In the long term, there were 4 surgical reinterventions (due to 1 internal hernia in the DS group and 1 internal hernia and 2 biliary refluxes in the SADI-S group) with no cases of persistent diarrhea or malnutrition.
Conclusion
Both DS and SADI-S allowed good weight control and resolution of comorbidities. DS achieved a greater weight loss compared to SADI-S, at the expense of longer operative time and lower vitamin and mineral levels.
Graphical abstract</description><identifier>ISSN: 0960-8923</identifier><identifier>EISSN: 1708-0428</identifier><identifier>DOI: 10.1007/s11695-022-06317-0</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Cohort analysis ; Comorbidity ; Diabetes ; Diarrhea ; Gastrointestinal surgery ; Hernias ; Hospitals ; Malnutrition ; Medicine ; Medicine & Public Health ; Metabolic disorders ; Mortality ; Nutritional status ; Obesity ; Observational studies ; Original Contributions ; Remission (Medicine) ; Sleep apnea ; Surgery ; Vitamin deficiency ; Weight control</subject><ispartof>Obesity surgery, 2022-12, Vol.32 (12), p.3839-3846</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c352t-70fb2362dc271212e7f22f6a118a6073573e968147eba2af434300779fc80cda3</citedby><cites>FETCH-LOGICAL-c352t-70fb2362dc271212e7f22f6a118a6073573e968147eba2af434300779fc80cda3</cites><orcidid>0000-0002-4684-4538</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11695-022-06317-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11695-022-06317-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids></links><search><creatorcontrib>Gebellí, Jordi Pujol</creatorcontrib><creatorcontrib>Lazzara, Claudio</creatorcontrib><creatorcontrib>de Gordejuela, Amador García Ruiz</creatorcontrib><creatorcontrib>Nora, Mario</creatorcontrib><creatorcontrib>Pereira, Ana Marta</creatorcontrib><creatorcontrib>Sánchez-Pernaute, Andrés</creatorcontrib><creatorcontrib>Osorio, Javier</creatorcontrib><creatorcontrib>Sobrino, Lucia</creatorcontrib><creatorcontrib>García, Antonio J. Torres</creatorcontrib><title>Duodenal Switch vs. Single-Anastomosis Duodenal Switch (SADI-S) for the Treatment of Grade IV Obesity: 5-Year Outcomes of a Multicenter Prospective Cohort Comparative Study</title><title>Obesity surgery</title><addtitle>OBES SURG</addtitle><description>Purpose
The aims were to compare the 5-year outcomes of duodenal switch (DS) and single-anastomosis duodenal switch (SADI-S) in terms of weight loss; remission of comorbidities; nutritional status short- and long-term complications; postoperative mortality; and need for revisional surgery.
Materials and Methods
Multicenter prospective observational study of all consecutive patients undergoing DS or SADI-S in three high-volume hospitals.
Results
A total of 87 patients were included in the study, 43 submitted to DS and 44 to SADI-S, with similar basal characteristics, nutritional parameters, and BMI (52.9 kg/m
2
DS vs. 52.5 kg/m
2
SADI-S). Operative time was 152 min (± 32.6) in DS vs. 116 min (± 21.9) in SADI-S (
p
= 0.043). Short-term complications were similar for DS and SADI-S, both overall (11.8% vs. 11.6%), and ranged as Clavien-Dindo > II (4.5% vs. 4.7%), with no mortality. At 5 years, DS and SADI-S results were as follows: BMI 30.6 vs. 33.3 kg/m
2
(
p
= 0.023); %EWL 80.5% vs. 68.6% (
p
= 0.006); and %TWL 42.1 vs. 36.0 (
p
= 0.006). Comorbidity remission rates for DS and SADI-S were as follows: for diabetes, 92.8% vs. 85.7% (n.s.); for hypertension, 95.2% vs. 85.1% (n.s.); for sleep apnea, 75% vs. 73.3% (n.s.); and for dyslipidemia, 76.4% vs. 73.3% (n.s.). DS showed lower levels of vitamin B
12
, iron, vitamin E, and zinc than SADI-S (
p
= < 0.005). In the long term, there were 4 surgical reinterventions (due to 1 internal hernia in the DS group and 1 internal hernia and 2 biliary refluxes in the SADI-S group) with no cases of persistent diarrhea or malnutrition.
Conclusion
Both DS and SADI-S allowed good weight control and resolution of comorbidities. DS achieved a greater weight loss compared to SADI-S, at the expense of longer operative time and lower vitamin and mineral levels.
Graphical abstract</description><subject>Cohort analysis</subject><subject>Comorbidity</subject><subject>Diabetes</subject><subject>Diarrhea</subject><subject>Gastrointestinal surgery</subject><subject>Hernias</subject><subject>Hospitals</subject><subject>Malnutrition</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolic disorders</subject><subject>Mortality</subject><subject>Nutritional status</subject><subject>Obesity</subject><subject>Observational studies</subject><subject>Original Contributions</subject><subject>Remission (Medicine)</subject><subject>Sleep apnea</subject><subject>Surgery</subject><subject>Vitamin deficiency</subject><subject>Weight control</subject><issn>0960-8923</issn><issn>1708-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp90cFqGzEQBmBRWqib9gV6EvSSHpRIo7W025tx0tSQ4sKmhZ6ErJ2NN-yuXEmb4nfqQ1a2A4UcehoQ3z-g-Ql5L_iF4FxfRiFUNWccgHElhWb8BZkJzUvGCyhfkhmvFGdlBfI1eRPjA-cgFMCM_LmafIOj7Wn9u0tuSx_jBa278b5HthhtTH7wsYv0OTuvF1crVn-krQ80bZHeBbRpwDFR39KbYBukqx90vcHYpf0nOmc_0Qa6npLzA8YDsvTr1KfO5QwG-i34uEOXukekS7_1IeUx7Gywx6c6Tc3-LXnV2j7iu6d5Rr5_vr5bfmG365vVcnHLnJxDYpq3G5AKGgdagADULUCrrBClVVzLuZZYqVIUGjcWbFvIQuYj6qp1JXeNlWfk_LR3F_yvCWMyQxcd9r0d0U_RgIayUEpVOtMPz-iDn0I-1EHJo6uqrOCkXP5lDNiaXegGG_ZGcHMo0JwKNLlAcyzQ8BySp1DMeLzH8G_1f1J_Abognbc</recordid><startdate>20221201</startdate><enddate>20221201</enddate><creator>Gebellí, Jordi Pujol</creator><creator>Lazzara, Claudio</creator><creator>de Gordejuela, Amador García Ruiz</creator><creator>Nora, Mario</creator><creator>Pereira, Ana Marta</creator><creator>Sánchez-Pernaute, Andrés</creator><creator>Osorio, Javier</creator><creator>Sobrino, Lucia</creator><creator>García, Antonio J. Torres</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4684-4538</orcidid></search><sort><creationdate>20221201</creationdate><title>Duodenal Switch vs. Single-Anastomosis Duodenal Switch (SADI-S) for the Treatment of Grade IV Obesity: 5-Year Outcomes of a Multicenter Prospective Cohort Comparative Study</title><author>Gebellí, Jordi Pujol ; Lazzara, Claudio ; de Gordejuela, Amador García Ruiz ; Nora, Mario ; Pereira, Ana Marta ; Sánchez-Pernaute, Andrés ; Osorio, Javier ; Sobrino, Lucia ; García, Antonio J. Torres</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c352t-70fb2362dc271212e7f22f6a118a6073573e968147eba2af434300779fc80cda3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Cohort analysis</topic><topic>Comorbidity</topic><topic>Diabetes</topic><topic>Diarrhea</topic><topic>Gastrointestinal surgery</topic><topic>Hernias</topic><topic>Hospitals</topic><topic>Malnutrition</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolic disorders</topic><topic>Mortality</topic><topic>Nutritional status</topic><topic>Obesity</topic><topic>Observational studies</topic><topic>Original Contributions</topic><topic>Remission (Medicine)</topic><topic>Sleep apnea</topic><topic>Surgery</topic><topic>Vitamin deficiency</topic><topic>Weight control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gebellí, Jordi Pujol</creatorcontrib><creatorcontrib>Lazzara, Claudio</creatorcontrib><creatorcontrib>de Gordejuela, Amador García Ruiz</creatorcontrib><creatorcontrib>Nora, Mario</creatorcontrib><creatorcontrib>Pereira, Ana Marta</creatorcontrib><creatorcontrib>Sánchez-Pernaute, Andrés</creatorcontrib><creatorcontrib>Osorio, Javier</creatorcontrib><creatorcontrib>Sobrino, Lucia</creatorcontrib><creatorcontrib>García, Antonio J. Torres</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Obesity surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gebellí, Jordi Pujol</au><au>Lazzara, Claudio</au><au>de Gordejuela, Amador García Ruiz</au><au>Nora, Mario</au><au>Pereira, Ana Marta</au><au>Sánchez-Pernaute, Andrés</au><au>Osorio, Javier</au><au>Sobrino, Lucia</au><au>García, Antonio J. Torres</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Duodenal Switch vs. Single-Anastomosis Duodenal Switch (SADI-S) for the Treatment of Grade IV Obesity: 5-Year Outcomes of a Multicenter Prospective Cohort Comparative Study</atitle><jtitle>Obesity surgery</jtitle><stitle>OBES SURG</stitle><date>2022-12-01</date><risdate>2022</risdate><volume>32</volume><issue>12</issue><spage>3839</spage><epage>3846</epage><pages>3839-3846</pages><issn>0960-8923</issn><eissn>1708-0428</eissn><abstract>Purpose
The aims were to compare the 5-year outcomes of duodenal switch (DS) and single-anastomosis duodenal switch (SADI-S) in terms of weight loss; remission of comorbidities; nutritional status short- and long-term complications; postoperative mortality; and need for revisional surgery.
Materials and Methods
Multicenter prospective observational study of all consecutive patients undergoing DS or SADI-S in three high-volume hospitals.
Results
A total of 87 patients were included in the study, 43 submitted to DS and 44 to SADI-S, with similar basal characteristics, nutritional parameters, and BMI (52.9 kg/m
2
DS vs. 52.5 kg/m
2
SADI-S). Operative time was 152 min (± 32.6) in DS vs. 116 min (± 21.9) in SADI-S (
p
= 0.043). Short-term complications were similar for DS and SADI-S, both overall (11.8% vs. 11.6%), and ranged as Clavien-Dindo > II (4.5% vs. 4.7%), with no mortality. At 5 years, DS and SADI-S results were as follows: BMI 30.6 vs. 33.3 kg/m
2
(
p
= 0.023); %EWL 80.5% vs. 68.6% (
p
= 0.006); and %TWL 42.1 vs. 36.0 (
p
= 0.006). Comorbidity remission rates for DS and SADI-S were as follows: for diabetes, 92.8% vs. 85.7% (n.s.); for hypertension, 95.2% vs. 85.1% (n.s.); for sleep apnea, 75% vs. 73.3% (n.s.); and for dyslipidemia, 76.4% vs. 73.3% (n.s.). DS showed lower levels of vitamin B
12
, iron, vitamin E, and zinc than SADI-S (
p
= < 0.005). In the long term, there were 4 surgical reinterventions (due to 1 internal hernia in the DS group and 1 internal hernia and 2 biliary refluxes in the SADI-S group) with no cases of persistent diarrhea or malnutrition.
Conclusion
Both DS and SADI-S allowed good weight control and resolution of comorbidities. DS achieved a greater weight loss compared to SADI-S, at the expense of longer operative time and lower vitamin and mineral levels.
Graphical abstract</abstract><cop>New York</cop><pub>Springer US</pub><doi>10.1007/s11695-022-06317-0</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-4684-4538</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0960-8923 |
| ispartof | Obesity surgery, 2022-12, Vol.32 (12), p.3839-3846 |
| issn | 0960-8923 1708-0428 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2728466697 |
| source | SpringerLink Journals - AutoHoldings |
| subjects | Cohort analysis Comorbidity Diabetes Diarrhea Gastrointestinal surgery Hernias Hospitals Malnutrition Medicine Medicine & Public Health Metabolic disorders Mortality Nutritional status Obesity Observational studies Original Contributions Remission (Medicine) Sleep apnea Surgery Vitamin deficiency Weight control |
| title | Duodenal Switch vs. Single-Anastomosis Duodenal Switch (SADI-S) for the Treatment of Grade IV Obesity: 5-Year Outcomes of a Multicenter Prospective Cohort Comparative Study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T05%3A20%3A07IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Duodenal%20Switch%20vs.%20Single-Anastomosis%20Duodenal%20Switch%20(SADI-S)%20for%20the%20Treatment%20of%20Grade%20IV%20Obesity:%205-Year%20Outcomes%20of%20a%20Multicenter%20Prospective%20Cohort%20Comparative%20Study&rft.jtitle=Obesity%20surgery&rft.au=Gebell%C3%AD,%20Jordi%20Pujol&rft.date=2022-12-01&rft.volume=32&rft.issue=12&rft.spage=3839&rft.epage=3846&rft.pages=3839-3846&rft.issn=0960-8923&rft.eissn=1708-0428&rft_id=info:doi/10.1007/s11695-022-06317-0&rft_dat=%3Cproquest_cross%3E2728466697%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2737284699&rft_id=info:pmid/&rfr_iscdi=true |