Top 25 Article Requests on ScienceDirect (Jan-Dec 2009)

1. THE BEST OF SOARDHarvey Sugerman, MD, FACS, FASMBSEditor-in-ChiefSurgery for Obesity and Related Diseases

2. Top 25 Article Requests on ScienceDirect (Jan-Dec 2009) Review Articles: 5/25: 20% Original FLA: 20/25: 80% Vol. 5: 56% Vol. 4: 32% Vol. 3: 12%

3. Top 25 Article Requests on SD, cont.

4. Top 25 Article Requests on SD, cont.

5. IMPACT FACTOR 3.85#9 Among ALL Surgical Journals

6. Top 20 Articles by Citations Comprising the 2009 Impact Factor of 3.862

7. EDITOR-IN-CHIEF’SBEST OF SOARD CHOICESVolume 1, 2005 • Eid et al. Effective treatment of polycystic ovarian syndrome with Roux-en-Y gastric bypass. pp. 77-80 • 24 women, 57% EWL 1 y, all resumed normal menses at ~ 3 mos, 12/23 complete, 6 moderate resolution hirsutism at ~ 8 mos, 5 conceptions • Brechner et al. A graded, evidence-based summary of evidence for bariatric surgery. pp. 430-41

9. BEST OF SOARD Vol 2, 2006 • Alagna et al. Biliopancreatic diversion: long-term effects on gonadal function in severely obese men. pp. 82-6 • 20 men (21-63 y), LH, FSH and total testosterone significantly increased from subnormal pre-op to normal; estradiol decreased from elevated basal levels to normal • Gustafson et al. History of sexual abuse among bariatric surgery candidates. pp. 369-74 • 16% (17% female, 11.5% male); ↑ binge eating, substance abuse and hx of psych rx

10. BEST OF SOARD: Vol 2, 2006(con’t) • Sampalis et al. Impact of bariatric surgery on cardiovascular and musculoskeletal morbidity. pp. 587-91 • 62% EWL, significant ↓ diagnosis and rx of above • Leichman et al. Improvements in systemic metabolism, anthropometrics and left ventricular geometry 3 months after bariatric surgery. pp. 592-9 • MRI showed significant ↓ in LV mass, visceral adipose tissue, CRP and ↑ insulin sensitivity

11. BEST OF SOARD: Vol 2, 2006(Con’t) • Parikh et al. LAGB for patients with BMI ≤ 35. pp. 518-22 • 93 pts Australia, BMI 32.7 to 27.6 at 3 y with 89% f-u, improved co-morbidities, no mortality • Salinas et al. Self-expandable metal stents to treat gastric leaks. pp. 146-8 • 17 pts (14 males) G-J leak after RYGB, 16 successful, oral feeding 2-3 days p stent, 5 OR to drain abscess

12. BEST OF SOARD: Vol 2, 2006(Con’t) • Jamal et al. Insurance-mandated preoperative dietary counseling does not improve outcome and increases dropout rates in patients considering gastric bypass for morbid obesity. pp.122-7 • 50% dropout, no difference in success of surgery • Gibbons et al. Previous weight loss experiences of bariatric surgery candidates: how much have patients dieted prior to surgery? pp. 259-64 • 4.7 ± 2.9 prior successful (≥ 10 lbs) + numerous unsuccessful diet attempts; wt ↑ from 89.4 ± 27.4 kg at time of first diet to 144.5 ± 30.8 kg

14. BEST OF SOARD:Vol 3, 2007 • Busetto et al. Comparative long term mortality after laparoscopic adjustable gastric binding versus nonsurgical controls. pp. 496-502 • 5y 60% < mortality than cohort • Sowemimo et al. Natural history of morbid obesity without surgical intervention. pp. 73-7 • Mortality in 743 after bariatric surgery (165 LTFU) = 2.8% vs. 14.3% no surgery. After adjusting for variables: 82% decreased mortality

15. BEST OF SOARD: Vol 3, 2007(Con’t) • Belle et al. Safety and efficacy of bariatric surgery: Longitudinal Assessment of bariatric surgery pp. 116-26 • 1st paper re. prospective, NIH, multicenter protocol • DeMaria et al. Obesity surgery mortality risk score: proposal for a clinically useful score to predict mortality risk in patients undergoing bariatric surgery. pp. 134-40 • BMI, Male, Htn, PE risk, age: 1 point each • Class A = 0-1, B = 2-3, C = 4-5 points • Mortality: Class A = .31%, B = 1.9%, C = 7.6%

16. BEST OF SOARD: Vol 3, 2007(Con’t) • Kuruba et al. Bariatric surgery improves urinary incontinence in morbidly obese individuals. pp. 586-91 • 65/201 (65%) surgery candidates (1 male) incontinent • 38 pts RYGB: 50% severe, 48% moderate, 2% mild • 50% complete resolution, 37% mild-moderate, 13% severe at ≥ 6 mos postop • Severity score 5.4±2.3 to 2.3±2.8 (p < .001)

17. BEST OF SOARD:Vol 3, 2007(Con’t) • Korner et al. Exaggerated glucagon-like peptide-1 and blunted glucose-dependent insulinotropic peptide (IP) secretion are associated with RYGB but not AGB. pp. 597- • BG at 60 min < after RYGB than LAGB (70 vs. 83mg/dL) • GLP-1 level 3X after RYGB than LAGB (96 vs. 28pmol/L) • IP level lower after RYGB than LAGB (20 vs. 31pmol/L) • Hagedorn et al. Does gastric bypass alter alcohol metabolism? pp. 543-8 • 5 oz red wine, q 5 min breath analysis • Peak EtOH: 0.08% RYGB vs. 0.05% controls • 0 level: 108 min RYGB vs. 72 min controls • No difference postingestion symptom profile

18. BEST OF SOARD: Vol 3 (Con’t) • Johnson et al. Surgical revision of loop (“mini”) gastric bypass procedure: multicenter review of complications and conversions to Roux-en-Y gastric bypass. 2007;3:37-41. • 5 med centers, 32 pts: bile reflux 20; GJ leak 3, marginal ulcer 5; malnutrition 8; weight gain 2 • 21 converted to RYGB; 2 with Braun entero-enterostomy • Miller KA, Pump A. Use of bioabsorbable reinforcement material in gastric bypass: a prospective randomized clinical trial. 2007;3:417-22 • < bleeding (fewer clips, higher Hgb), < OR time

19. BEST OF SOARD: Vol 3, 2007(Con’t) • McCloskey et al. Bariatric surgery improves cardiac function in morbidly obese patients with severe cardiomyopathy. pp. 503-7 • 14 pts (10 men); EF 23±2 to 32±4% at 6 mos • Preop: 2 Class IV; 6 Class III; 6 Class II • Postop: 0 Class IV; 2 Class III; 12 Class II • Dallal et al. Medicare and Medicaid status predicts prolonged length of stay (PLOS) after bariatric surgery. pp. 592-6. • PLOS (≥ 7d) = 3.7% • Medicare pts 6X and Medicaid 3.2X PLOS

21. BEST OF SOARD Vol 4 • Christou et al. Bariatric surgery reduces cancer risk in morbidly obese patients. 2008;4:691-7 • < physician/hospital visits vs. controls: 2.0 vs. 8.5% • < physician/hospital visits for breast cancer • Keto JL, Kemmeter P. Effect of Center of Excellence requirement by Centers for Medicare and Medicaid Services on practice trends. 2008;4:437-40 • % CMS/Medicaid ↑ from 15/10% 2004/2005 to 31% 2006 • Older (56 vs. 44), > comorbidities (5.1 vs. 3.5), more meds (10.3 vs. 5.6), more prior ops (2.1 vs. 1.3), longer OR times (148 vs. 121 min) than private 3rd party insured

22. BEST OF SOARD: Vol 4 (Con’t) • Song et al. Association between support group attendance and weight loss after Roux-en-Y gastric bypass 2008;4:100-3 • Significantly > %EWL at 9 (53 vs. 45) and 12 mos (56 vs. 47) in those attending support group • Arceo-Olaiz et al. Maximal weight loss after banded and unbanded laparoscopic Roux-en-Y gastric bypass: a randomized controlled trial. 2008;4:507-11 • No difference at 12 or 24 mos; 1 band removed

23. BEST OF SOARD: Vol. 4, 2008(Con’t) • Carbonell et al. Does diabetes affect weight loss after gastric bypass? pp. 441-4 • Of 655, DM pts had < %EWL: 67.6 no DM vs. 63.5 diet only vs. 60.5 for oral vs. 53.3 on insulin • Salem et al. Cost-effectiveness of laparoscopic gastric bypass, adjustable gastric banding, and nonoperative weight loss interventions. pp.26-32 • Both men & women, RYGB & LAGB were cost-effective at <$25,000 for QALY regardless of BMI, adverse outcomes, weight loss or costs. LAGB > RYGB

24. BEST OF SOARD: Vol 4,2008 (Con’t) • 2 baseline LABS studies: • Relationship of body mass index with demographic and clinical characteristics in the Longitudinal Assessment of Bariatric Surgery. pp.474-80. • Physical activity levels of patients undergoing bariatric surgery in the Longitudinal Assessment of Bariatric Surgery. pp. 721-8.

26. BEST OF SOARD: Vol 5 • ASMBS GUIDELINES AND POSITION STATEMENTS: • Emerging endosurgical interventions for the treatment of obesity • Detection and prevention of gastrointestinal leak after gastric bypass including the role of imaging and surgical exploration

27. BEST OF SOARD: Vol 5, 2009(Con’t) • Dolce et al. Does liver appearance predict histo-pathological findings: prospective analysis of routine liver biopsies during bariatric surgery. pp. 323-8 • NASH in 23% • 48% with normal liver appearance score had NASH • Martinez et al. Diagnosis and treatment of megaesophagus after LAGB for morbid obesity. pp.156-9 • 5/257; mean time at 32 (24-36) mos; preop manometry nl in 4; band deflation ineffective; all required band removal

28. BEST OF SOARD: Vol 5, 2009(Con’t) • Mumme et al. Effect of LRYGB on hgbA1c levels in diabetic patients: a matched cohort analysis. pp. 4-10 • Matched cohorts: HgbA1c at 3 y: 6.1 vs. 7.8 • RYGB decreased insulin/oral agents 84% to 22% at 1 y • Alexander et al. Improvement and stabilization of chronic kidney disease after gastric bypass. pp.237- • 45 pts with established renal disease before RYGB: 1 GN completely resolved, 4 pts d/c dialysis – but 2 had to resume, 6 pts had progressive improved function, all ↓ proteinuria

29. BEST OF SOARD: Vol 5, 2009(Con’t) • Ghandi et al. Elective laparoscopy for herald symptoms of mesenteric/internal hernia after L-RYGB. pp. 144-9 • 27/702 (3.8%) acute SBO; 15 (55%) internal hernia (IH) • Nearly ALL had prior sx of intermittent SBO • Elective laparoscopy in 9 with intermittent sx; all IH • Bond et al. Prevalence and degree of sexual dysfunction in a sample of women seeking bariatric surgery. pp. 698-704 • 60% female sexual dysfunction

30. BEST OF SOARD: Vol 5, 2009(Con’t) • Miller et al. Physical function improvements after L-RYGB. pp. 530-7 • ↓ disability, ↑ mobility within 3 wks, ↑ max muscle torque/kg within 6 mos after surgery • Farbris de Souza et al. Six-minute walk test: functional capacity of severely obese before and after bariatric surgery. pp. 540-3 • 382±49 m before vs. 468±40 m 7-12 mos after surgery

31. BEST OF SOARD: Vol 5, 2009(Con’t) • Topart et al. One-year weight loss after primary or revisional RYGB for failed LAGB. pp. 459-62. Revisional RYGB: • Longer OR times: 128±26 vs. 89±15 min • ↑ morbidity • Equivalent 1 y %EWL: 66±28 vs. 70±19

32. “Look, Fred, you’re a lousy surgical risk. I know the operation might save your life, but I can’t do it. It could wreck my statistics.”

33. BEST OF SOARD: Vol 6, 2010 • Smith et al. The relationship between surgeon volume and adverse outcomes after RYGB in the LABS study. pp. 118-25 • > surgeon volume < event rates; continuous variable • each 10 case/y ↑ vol, event rate ↓ 10% • DiGiorgi et al. Reemergence of diabetes after gastric bypass in patients with mid- to long-term follow-up. pp. 249-53 • 10/42 (24%) with improved or remitted DM at ≥ 3 y f/u recurred or worsened • had > wt regain, > wt loss failure

34. BEST OF SOARD: Vol 6, 2010(Con’t) • Bessler et al. AGB as a revisional procedure after failed RYGB – intermediate results. pp. 31-5 • 22 pts, % EWL from 13.5 to 59.4 at 12 mos (13/20), 53.1 at 24 mos (10/15), 59.3 at 48 mos (7/9) • Shah et al. Diabetes remission and reduced cardio-vascular risk after RYGB in Asian Indians BMI<35 pp. 332-8 • 15 pts (8 men), BMI 28.9±4, 80% on insulin • BMI ↓ 20%, all off DM meds d/c’d within 1 mo in 80% • At 3 mos, all euglycemic and off meds • FBS 233±87 to 89±12; HgbA1c 10.1±2.0% to 6.1±0.6% • ↓ ↓ cardiovascular risk factors for MI, stroke

35. BEST OF SOARD: Vol 6, 2010(Con’t) • Martin et al. Socioeconomic disparities in eligibility and access to bariatric surgery: a national population-based analysis. 8-15 • NHANES data: 22+ million eligible for bariatric surgery • Eligible lower family incomes and educational levels, < access to healthcare, 1/3 uninsured or underinsured • 75% bariatric surgery in Caucasians, 80% > income, 82% private insurance

36. BEST OF SOARD: Vol 6, 2010(Con’t • Josbeno et al. Physical activity and physical function changes in obese individuals following RYGB. pp. 361-6 • 20 pts, at 3 mos: X daily steps 4621±3701 to 7370±4240, 6 min walk test: 393±62 to 446±41 • Significant ↑ SF-36 physical function subscale • Fernandez-Esparrach et al. Peroral endoscopic anastomotic reduction for the treatment of intractable dumping syndrome following RYGB. pp. 36-40 • 6 pts, successful narrowing stoma, relief of dumping symptoms for median f/u 636 days

37. OTHER MAJOR ARTICLES • Christou et al: ↓Quebec mortality. Ann Surg • Sjostrom et al: ↓ SOS mortality at 10 y. NEJM • Adams et al: ↓ Utah mortality. NEJM • Peters et al: ↓ Australian LAGB mortality

38. OTHER MAJOR ARTICLES • O’Brien et al: Randomized LAGB BMI 30-35. Ann Intern Med 2006;144:625-33 • Perioperative safety in the longitudinal assessment of bariatric surgery. NEJM 2009;361:445-54 • Smith et al: ↓ maternal transmission obesity. J Clin Endocr Metab 2009;94:4275-83 • Keating et al: Cost efficacy, randomized LAGB for diabetes. Diabetes Care 2009;32:580-4 • O’Brien et al: LAGB in severely obese adolescents: a randomized trial. JAMA 2010;303:519-26.