Obesity is considered a risk factor for different types of cancer, including colorectal cancer (CRC). Bariatric surgery has been associated with improvements in obesity-related co-morbidities and reductions in overall cancer risk. However, given the contradictory outcomes of several cohort studies, the impact of bariatric surgery on CRC risk appears controversial. Furthermore, measurement of CRC biomarkers following Roux-en-Y gastric bypass (RYGB) has revealed hyperproliferation and increased pro-inflammatory gene expression in the rectal mucosa. The proposed mechanisms leading to increased CRC risk are alterations of the gut microbiota and exposure of the colorectum to high concentrations of bile acids, both of which are caused by RYGB-induced anatomical rearrangements. Studies in animals and humans have highlighted the similarities between RYGB-induced microbial profiles and the gut microbiota documented in CRC. Microbial alterations common to post-RYGB cases and CRC include the enrichment of pro-inflammatory microbes and reduction in butyrate-producing bacteria. Lower concentrations of butyrate following RYGB may also contribute to an increased risk of CRC, given the anti-inflammatory and anticarcinogenic properties of this molecule. Laparoscopic sleeve gastrectomy appears to have a more moderate impact than RYGB; however, relatively few animal and human studies have investigated its effects on CRC risk. Moreover, evidence regarding the impact of anastomosis gastric bypass on one is even more limited. Therefore, further studies are required to establish whether the potential increase in CRC risk is restricted to RYGB or may also be associated with other bariatric procedures.

Background/Objectives: In metabolic bariatric surgery, structured follow-up protocols may play an essential role in achieving optimal patient outcomes. This study aims to report postoperative biochemical outcomes in a cohort of post-bariatric patients who underwent a structured follow-up protocol. Methods: This retrospective study included patients who underwent metabolic bariatric surgery and completed a one-year follow-up at Cannizaro Hospital from October 2022 to May 2024. Anthropometric, clinical, and laboratory data were collected for each patient at five different timepoints: baseline, 1, 3, 6, and 12 months post-surgery. All data were organized into a database and analyzed through descriptive statistics. Results: The study cohort (n = 80) showed a follow-up adherence equal to 97.5%. The mean value of BMI decreased from 42 to 27 one year after surgery. Lipid profiles improved, with significant reduction in total cholesterol and triglycerides and increase in HDL levels; LDL levels decreased initially but at one year returned to baseline. Thyroid hormones TSH and fT3 decreased significantly, while fT4 remained stable. A reduction in hepatic inflammation was observed, as evidenced by the decrease in GGT and transaminase levels. Pancreatic enzymes showed an initial increase but stabilized at the subsequent timepoints. Glycemic control improved, with statistically significant reductions in insulin, HbA1c, and glucose levels, and complete remission of type 2 diabetes mellitus in affected patients. Conclusions: This study shows significant weight loss and improved health outcomes in post-bariatric patients who underwent a structured follow-up protocol, suggesting the potential benefits of metabolic bariatric surgery.

In our surgical center, we have observed a high occurrence of hiccups and rhinorrhea following bariatric surgery. This retrospective study aimed to assess the frequency of post-prandial hiccups and rhinorrhea following bariatric surgery and explore potential behavioral and clinical associations. The study was performed at Cannizzaro Hospital (Catania, Italy), an institution accredited by SICOB (Italian Society for Bariatric and Metabolic Surgery) as a national referral center. The cohort included bariatric patients who completed a preoperative psychological evaluation and adhered to a one-year post-surgical follow-up between October 2022 and November 2023. Data on eating behaviors, mental status and dietary habits were collected for each patient before surgery, while clinical records, including the recurrence of hiccups and rhinorrhea, were acquired at the following time points: baseline and 1, 3, 6 and 12 months post-surgery. Post-prandial hiccups and/or rhinorrhea were reported by 49.5% of patients at 1 month and persisted in 46.8% after 12 months. No significant associations were found between the symptoms and weight loss, BES score, or psychological traits, except for slight associations with smoking and carbonated beverage intake. In our cohort, the etiology of hiccups and rhinorrhea appears unrelated to behavioral or psychological factors and may instead reflect vagal hyper-responsiveness after gastric fundus resection.

Nutritional deficiencies and metabolic alterations are common complications following bariatric surgery, requiring often lifelong monitoring and supplementation. The aim of this retrospective study is to investigate whether a structured follow-up can mitigate micronutrient deficiencies and metabolic changes. This study was conducted at Cannizaro Hospital (Catania, Italy), a national referral center accredited by SICOB (Italian Society for Bariatric and Metabolic Surgery). The cohort included patients who underwent bariatric surgery who completed one year follow-up between October 2022 and May 2024. Medical records such as anthropometric, clinical and laboratory data were collected for each patient at five different timepoints: baseline, 1-, 3-, 6- and 12-months post-surgery. Serum levels of iron, hemoglobin, vitamin D, folate, vitamin B12 and uric acid were analyzed to assess nutritional and metabolic status over time. One-year follow-up adherence of the patient cohort was equal to 97.5%. A significant increase in serum iron, vitamin D and folate levels was observed one year after surgery. Hemoglobin and vitamin B12 levels remained stable over time. Uric acid showed a significant rise at 1 month after surgery, followed by a progressive reduction by 12 months. This study highlights the importance of a structured follow-up program after bariatric surgery, contributing to the prevention of common postoperative complications.