{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T18:28:30Z","timestamp":1791570510495,"version":"4.3.4"},"reference-count":57,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Metabolic and bariatric surgery (MBS) is the most effective intervention for severe adolescent obesity, yet persistent disparities exist in surgical access. The COVID-19 pandemic disrupted elective surgery and may have altered access for historically underserved populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using MBSAQIP, we identified adolescents aged 19\u00a0years or younger who underwent MBS from 2015 to 2023, stratified into three phases: pre-COVID (2015\u20132019), acute COVID (2020\u20132021), and recovery (2022\u20132023). Race\/ethnicity was classified using Hispanic-priority methodology. Racial and ethnic composition, comorbidity burden, and 30-day outcomes were compared using Fisher\u2019s exact and Kruskal\u2013Wallis tests. Firth penalized logistic regression was used for sensitivity analysis of rare outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 5432 adolescents underwent MBS from 2015 to 2023. White representation declined from 49% pre-COVID to 32% during recovery (\u2212\u200917%; 95% CI\u2009\u2212\u200919%,\u2009\u2212\u200914.7%), while Hispanic representation increased from 25 to 36% (+\u200911%; 95% CI\u2009+\u20099.1%,\u2009+\u200913.2%) and Black representation from 17 to 21% (+\u20094%; 95% CI\u2009+\u20092.6%,\u2009+\u20096.2%); cohort composition differed significantly across phases (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Comorbidity burden was stable. Overall, 30-day complication rates were low (1.0%). Among Black patients, complication rates declined from 3.9% pre-COVID to 0.8% during recovery (\u2212\u20093.1%; 95% CI\u2009\u2212\u20095.7%,\u2009\u2212\u20092.1%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). In sensitivity analysis, Black patients had higher odds of complications compared with White patients (OR 3.21; 95% CI 1.55, 6.71;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). No individual complication type differed significantly after Benjamini\u2013Hochberg correction. Readmission and reoperation rates did not differ significantly across phases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The racial and ethnic composition of adolescents undergoing MBS shifted substantially across the COVID-19 pandemic, with increased representation of historically underserved racial and ethnic groups. Complication disparities observed among Black patients pre-COVID were not statistically significant in later phases, though sparse event counts limit interpretation. Prospective studies are needed to clarify the mechanisms driving pandemic-era changes in equity of access to adolescent MBS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-026-12955-7","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T19:27:51Z","timestamp":1781638071000},"page":"6249-6261","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of the COVID-19 pandemic on racial disparities in adolescent bariatric surgery: an MBSAQIP analysis"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1710-3035","authenticated-orcid":false,"given":"Nikita S.","family":"Thareja","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Garcia","family":"Cabrera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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