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Colorectal cancer (CRC) is a major global health concern with high morbidity and mortality, particularly complicated by postoperative complications. This narrative review explores the interplay between cancer-related malnutrition (CRM) and oxidative stress (OS) as key modifiable risk factors influencing surgical outcomes in CRC patients. Drawing on the recent literature, the article analyzes the multifactorial pathophysiology of CRM, including systemic inflammation, micronutrient deficiency, and metabolic derangements, and its role in weakening antioxidant defenses. Concurrently, oxidative stress, marked by elevated reactive oxygen species and impaired redox homeostasis, is linked to impaired wound healing, infection susceptibility, and anastomotic complications. The review highlights that CRM and OS are interdependent, synergistically exacerbating postoperative morbidity. It also emphasizes the diagnostic and therapeutic implications of integrating nutritional screening tools with oxidative biomarkers to optimize perioperative care. Current evidence suggests that early immunonutrition- and redox-modulating strategies may improve surgical resilience, though standardization of biomarkers and intervention protocols remains a challenge. This article underscores the need for individualized, integrated approaches to perioperative management and proposes CRM–OS interaction as a potential predictive model for surgical risk in CRC. The findings advocate for future clinical trials targeting both nutrition and oxidative status to enhance recovery and long-term prognosis.

Background: Bariatric surgery is an effective treatment for obesity, leading to significant weight loss and improvements in metabolic health. However, massive weight loss often results in excess skin, which can negatively impact body image, psychological well-being, and quality of life. Abdominoplasty is commonly performed after bariatric surgery to address these concerns. Our study aimed to evaluate the effects of post-bariatric abdominoplasty on psychological well-being, body image, social relationships, and sexual functioning in formerly obese patients. Methods: A single-center, cross-sectional recall study was conducted on 35 patients, out of 135 invited, who underwent sleeve gastrectomy followed by abdominoplasty 12–24 months after the initial surgery. Participants completed validated questionnaires assessing psychological well-being, depression, anxiety, self-esteem, body perception, social relationships, and sexual functioning. Pairwise comparisons were performed to assess changes across the preoperative, post-bariatric, and post-abdominoplasty stages. Results: Psychological well-being significantly improved post-bariatric surgery, with further reductions in anxiety and depressive symptoms after abdominoplasty. However, body shape perception and self-esteem improved after bariatric surgery but did not show additional enhancement following abdominoplasty. Social support remained largely unchanged, except for modest improvements in attachment and reliable alliance. Sexual functioning improved significantly after bariatric surgery but showed no further significant gains after abdominoplasty. Conclusions: While abdominoplasty is associated with additional psychological benefits, particularly in reducing anxiety and depressive symptoms, it does not significantly enhance body perception, self-esteem, or sexual functioning beyond the effects of bariatric surgery. These findings highlight the importance of setting realistic patient expectations regarding the benefits of body contouring surgery in post-bariatric care.

Resveratrol, as a polyphenolic compound that can be isolated from plants, and also a component of red wine has broad beneficial pharmacological properties. The aim was to investigate the role of nitric oxide and potassium channels in resveratrol-induced relaxation of human gastric smooth muscle. Gastric tissues were obtained from patients who underwent sleeve gastrectomy for severe obesity ( n = 10 aged 21–48; BMI 48.21 ± 1.14). The mechanical activity from the muscle strips was detected under isometric conditions as the response to increasing concentrations of resveratrol before and after different pharmacological treatments. Resveratrol caused an observable, dose-dependent gastric muscle relaxation. The maximal response caused by the highest concentration of resveratrol was 83.49 ± 2.85% ( p < 0.0001) of the control. Preincubation with L-NNA, L-NAME, or ODQ did not prevent the resveratrol-induced relaxation. Apamin, glibenclamide, 4AP or tamoxifen, did not inhibit the relaxing effect of resveratrol, as well. In turn, blocking BK Ca by TEA, iberiotoxin, or charybdotoxin resulted in inhibition of resveratrol-induced relaxation (91.08 ± 2.07, p < 0.05; 95.60 ± 1.52, p < 0.01 and 89.58 ± 1.98, p < 0.05, respectively). This study provides the first observation that the relaxant effects of resveratrol in human gastric muscle strips occur directly through BK Ca channels and independently of nitric oxide signaling pathways. Furthermore, there is considerable potential for further extensive clinical studies with resveratrol as an effective new drug or health supplement to treat gastrointestinal dyspepsia and other gastric hypermotility disorders.

The prevalence of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) has considerably increased over the last years. NAFLD is currently the most common cause of chronic liver disease in the developing world. The diagnosis of NAFLD/NASH is often incidental, as the early-stage of disease is frequently free of symptoms. Most patients recognized with NAFLD have severe obesity and other obesity-related disease such as type 2 diabetes mellitus (T2DM), insulin-resistance, dyslipidemia and hypertension. The only proven method for NAFLD improvement and resolution is weight loss. Bariatric surgery leads to significant and long-term weight loss as well as improvement of coexisting diseases. There is a lot of evidence suggesting that metabolic/bariatric surgery is an effective method of NAFLD treatment that leads to reduction in steatosis, hepatic inflammation and fibrosis. However, there is still a need to perform long-term studies in order to determine the role of bariatric surgery as a treatment option for NAFLD and NASH. This review discusses current evidence about epidemiology, pathogenesis and treatment options for NAFLD including bariatric/metabolic surgery and its effect on improvement and resolution of NAFLD.

Revisional surgery is more technically challenging and associated with increased morbidity and mortality. Nevertheless, the frequency of revisional bariatric surgery (RBS) is increasing. Therefore, investigating this group of patients appears to be currently valid. The objective of this multicenter study was to collect, systematize and present the available data on RBS after surgical treatment of morbid obesity among Polish patients. This multicenter study included a retrospective analysis of a prospectively maintained database. Outcomes included an analysis of the indications for RBS, the type of surgery most frequently chosen as RBS and the course of the perioperative period of treatment among patients undergoing RBS. The group consisted of 799 patients (624 (78.1%) women, 175 (21.9%) men). The mean age was 38.96 ±9.72 years. Recurrence of obesity was the most common indication for RBS. The most frequently performed RBS procedures were one anastomosis gastric bypass (OAGB) - 294 (36.8%) patients, Roux-en-Y gastric bypass (RYGB) - 289 (36.17%) patients and sleeve gastrectomy (SG) - 172 (21.52%) patients. After primary surgery 63.58% of patients achieved sufficient weight loss, but after RBS only 38.87%. Complications were noted in 222 (27.78%) cases after RBS with GERD being the most common - 117 (14.64%) patients. RBS most often concerns patients after SG. The main indication for RBS is weight regain. OAGB and RYGB were the two most frequently chosen types of RBS. Secondary operations lead to further weight reduction. However, RBS are associated with a significant risk of complications.

Introduction With continuously growing number of redo bariatric surgeries (RBS), it is necessary to look for factors determining success of redo-surgeries. Patients and methods A retrospective cohort study analyzed consecutive patients who underwent RBS in 12 referral bariatric centers in Poland from 2010 to 2020. The study included 529 patients. The efficacy endpoints were percentage of excessive weight loss (%EWL) and remission of hypertension (HT) and/or type 2 diabetes (T2D). Results Group 1: weight regain Two hundred thirty-eight of 352 patients (67.6%) exceeded 50% EWL after RBS. The difference in body mass index (BMI) pre-RBS and lowest after primary procedure < 10.6 kg/m2 (OR 2.33, 95% CI: 1.43–3.80, p  = 0.001) was independent factor contributing to bariatric success after RBS, i.e., > 50% EWL. Group 2: insufficient weight loss One hundred thirty of 177 patients (73.4%) exceeded 50% EWL after RBS. The difference in BMI pre-RBS and lowest after primary procedure (OR 0.76, 95% CI: 0.64–0.89, p  = 0.001) was independent factors lowering odds for bariatric success. Group 3: insufficient control of obesity-related diseases Forty-three of 87 patients (49.4%) achieved remission of hypertension and/or type 2 diabetes. One Anastomosis Gastric Bypass (OAGB) as RBS was independent factor contributing to bariatric success (OR 7.23, 95% CI: 1.67–31.33, p  = 0.008), i.e., complete remission of HT and/or T2D. Conclusions RBS is an effective method of treatment for obesity-related morbidity. Greater weight regain before RBS was minimizing odds for bariatric success in patients operated due to weight regain or insufficient weight loss. OAGB was associated with greater chance of complete remission of hypertension and/or diabetes. Graphical abstract

Background/Objectives: Metabolic syndrome, defined by the coexistence of central obesity, dyslipidemia, hypertension, and insulin resistance, is a significant contributor to increased cardiovascular morbidity and mortality in the aging population. We aimed to determine whether age influences the efficacy of LSG in treating obesity-related comorbidities. Methods: A retrospective analysis of lipid profiles, glycemic and clinical parameters was conducted in a group of 786 patients in two age groups (under 50 years old and over 50 years old) who underwent laparoscopic sleeve gastrectomy with follow-ups 1, 3, 6, 12 and 24 months after surgery. Results: There was a significant improvement in lipid metabolism with no significant differences between the two age groups in these parameters throughout the observation period. Furthermore, there was significant weight loss (54.82 kg vs. 54.56 kg) and BMI reductions (47.71 kg/m2 vs. 47.01 kg/m2 to 29.03 kg/m2 vs. 30.73 kg/m2). Total cholesterol decreased from 198 mg/dL to 184.9 mg/dL (<50 years old) and from 206.4 mg/dL to 193 mg/dL (>50 years old). LDL dropped from 136.2 mg/dL to 116.7 mg/dL and from 141.0 mg/dL to 121.0 mg/dL. Mean HbA1c decreased to comparable levels (5.66% vs. 5.53%). Both groups showed similar rates of remission for type 2 diabetes and hypertension. Conclusions: Our findings suggest that LSG is an effective method for treating components of metabolic syndrome regardless of age, supporting its use as a therapeutic tool for older patients.

Background: Morbid obesity co-exists with non-alcoholic fatty liver disease in up to 90% of cases. Laparoscopic sleeve gastrectomy leads to a reduction in body mass and thus may improve the course of non-alcoholic fatty liver disease. The aim of this study was to evaluate the effect of laparoscopic sleeve gastrectomy on the resolution of non-alcoholic fatty liver disease. Methods: The study included 55 patients with non-alcoholic fatty liver disease who underwent laparoscopic sleeve gastrectomy at a tertiary institution. The analysis consisted of preoperative liver biopsy, abdominal ultrasound, weight loss parameters, Non-Alcoholic Fatty Liver Fibrosis Score and selected laboratory parameters. Results: Before the surgery, 6 patients were diagnosed with grade 1 liver steatosis, 33 patients with grade 2 and 16 patients with grade 3. One year after the surgery, only 21 patients had features of liver steatosis at ultrasound. All weight loss parameters showed statistically significant changes during the observation; the median percentage of total weight loss was 31.0% (IQR: 27.5; 34.5) with p = 0.0003, the median percentage of excess weight loss was 61.8% (IQR: 52.4; 72.3) with p = 0.0013 and the median percentage of excess body mass index loss was 71.0% (IQR: 61.3; 86.9) with p = 0.0036 12 months after laparoscopic sleeve gastrectomy. The median Non-Alcoholic Fatty Liver Fibrosis Score at baseline was 0.2 (IQR: −0.8; 1.0) and decreased to −1.6 (IQR: −2.4; −0.4) (p < 0.0001). Moderate negative correlations between Non-Alcoholic Fatty Liver Fibrosis Score and percentage of total weight loss (r = −0.434, p < 0.0001), percentage of excess weight loss (r = −0.456, p < 0.0001) and percentage of excess body mass index loss (r = −0.512, p < 0.0001) were found. Conclusions: The study supports the thesis that laparoscopic sleeve gastrectomy is an effective method for treatment of non-alcoholic fatty liver disease in patients with morbid obesity.

Background: Although laparoscopic sleeve gastrectomy (LSG) is considered a safe bariatric procedure in the treatment of obesity, it still involves a risk of developing postoperative complications. Knowledge of risk factors for possible complications would allow appropriate preoperative planning, optimization of postoperative care, as well as early diagnosis and treatment. The aim of this study was to evaluate risk factors for complications after laparoscopic sleeve gastrectomy. Methods: A retrospective study of 610 patients who underwent LSG at a tertiary institution were included in the study through retrospective analysis of the medical data. Complications were categorized as early (<30 days) and late (≥30 days) and evaluated according to the Clavien–Dindo Classification. Results: Early complications were observed in 35 patients (5.74%) and late complications occurred in 10 patients (1.64%). Independent risk factors of early complications after laparoscopic sleeve gastrectomy included hypercholesterolemia (OR 3.73; p-value = 0.023) and smoking (OR = 274.66, p-value < 0.001). Other factors that may influence the postoperative course are length of hospital stay and operation time. Smoking, peptic ulcer diseases and co-existence of hiatal hernia were found to be an independent predictors of late complications. Conclusions: Smoking is associated with the higher risk of both, early and late complications, while hypercholesterolemia with only <30 days complications after laparoscopic sleeve gastrectomy.

The increasing prevalence of bariatric surgery has resulted in a rise in the number of redo procedures as well. While redo bariatric surgery has demonstrated its effectiveness, there is still a subset of patients who may not derive any benefits from it. This poses a significant challenge for bariatric surgeons, especially when there is a lack of clear guidelines. The primary objective of this study is to evaluate the outcomes of patients who underwent Re-Redo bariatric surgery. We conducted a retrospective cohort study on a group of 799 patients who underwent redo bariatric surgery between 2010 and 2020. Among these patients, 20 individuals underwent a second elective redo bariatric surgery (Re-Redo) because of weight regain (15 patients) or insufficient weight loss, i.e. < 50% EWL (5 patients). Mean BMI before Re-Redo surgery was 38.8 ± 4.9 kg/m 2 . Mean age was 44.4 ± 11.5 years old. The mean %TWL before and after Re-Redo was 17.4 ± 12.4% and %EBMIL was 51.6 ± 35.9%. 13/20 patients (65%) achieved > 50% EWL. The mean final %TWL was 34.2 ± 11.1% and final %EBMIL was 72.1 ± 20.8%. The mean BMI after treatment was 31.9 ± 5.3 kg/m 2 . Complications occurred in 3 of 20 patients (15%), with no reported mortality or need for another surgical intervention. The mean follow-up after Re-Redo was 35.3 months. Although Re-Redo bariatric surgery is an effective treatment for obesity, it carries a significant risk of complications.