{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T03:08:28Z","timestamp":1788404908370,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,3,15]],"date-time":"2025-03-15T00:00:00Z","timestamp":1741996800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Incisional hernia repairs (IHRs) are not recommended in patients with severe obesity (BMI \u2265 35\u00a0kg\/m<jats:sup>2<\/jats:sup>). Weight loss is challenging, but new medications, such as glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101 agonists), have recently attracted increased attention for their potential weight loss advantages. The aim was to analyze the preliminary results about the safety and weight loss efficiency of the use of GLP\u20101 agonists in the context of prehabilitation prior to complex IHR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients planned for IHR with a BMI \u2265 35\u00a0kg\/m<jats:sup>2<\/jats:sup> and treated with preoperative GLP\u20101 agonists were included in the experimental group and compared with a comparable historical surgical cohort treated with a conventional tailored nutritional preoperative management. Weight loss in the experimental group and perioperative and postoperative outcomes were compared between the two groups. The success rate of GLP1 agonists was defined as a weight loss that enables the patient to fall within the recommended limits of a BMI \u2264 35\u00a0kg\/m<jats:sup>2<\/jats:sup> before an IHR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010two patients in the control group were compared to 24 with GLP\u20101 agonists. The distribution of GLP\u20101 agonists was as follows: semaglutide (<jats:italic>n<\/jats:italic>\u00a0=\u00a012; 50%), dulaglutide (<jats:italic>n<\/jats:italic>\u00a0=\u00a07; 29.2%), and liraglutide (<jats:italic>n<\/jats:italic>\u00a0=\u00a05; 20.8%). The mean initial BMI was 40.1\u00a0\u00b1\u00a03.6\u00a0kg\/m<jats:sup>2<\/jats:sup> kg\/m<jats:sup>2<\/jats:sup>. The average percentage of weight loss was 11.3\u00a0\u00b1\u00a07.4% with GLP\u20101 agonists (maximum weight loss was observed with semaglutide 2.4\u00a0mg\/wk). The success rate of GLP1 agonists (defined as BMI \u2264\u00a035\u00a0kg\/m<jats:sup>2<\/jats:sup> before IHR) was reached for 15\/24 patients (62.5%). Postoperative total complication rate was lower in the group with GLP\u20101 agonists (59.6% in the control group vs. 45.8% in GLP\u20101 and <jats:italic>p<\/jats:italic>\u00a0=\u00a00.2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrated the efficacy of GLP\u20101 agonists in the optimization of patients with obesity, allowing two thirds of the patients to benefit from IHR, with a tendency for lower morbidity.<\/jats:p><jats:p><jats:bold>Trial Registration:<\/jats:bold> CPP Mediterranee, n\u00b0 21.00430.000004.<\/jats:p><\/jats:sec>","DOI":"10.1002\/wjs.12547","type":"journal-article","created":{"date-parts":[[2025,3,15]],"date-time":"2025-03-15T08:31:17Z","timestamp":1742027477000},"page":"898-905","source":"Crossref","is-referenced-by-count":8,"title":["Patients With Severe Obesity Are Made Eligible for Complex Abdominal Wall Repair After Preoptimization With GLP\u20101 Agonists: Results of a Bicentric Pilot 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