Perioperative GLP-1 Receptor Agonist Use and Surgical Outcomes in Nonbariatric Abdominal Panniculectomy: A 10-Year Retrospective Analysis.

Abstract

<h4>Background</h4>Glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) are increasingly used for treatment of patients with type 2 diabetes and obesity because of their metabolic benefits and potential wound-healing properties. However, their perioperative safety in acute surgical settings remains unclear. GLP-1 RAs may alter tissue quality and intensify GLP-1 RA-related side effects. This study was performed to examine postoperative complications and GLP-1 RA-associated adverse effects in nonbariatric patients undergoing panniculectomy.<h4>Methods</h4>The authors conducted a retrospective review of 373 patients who underwent panniculectomy from January of 2013 through January of 2023, including 81 GLP-1 RA users and 292 nonusers. Patients with previous bariatric surgery or concomitant hernia repair were excluded due to the added complexity of mesh placement and altered tissue planes, which could confound wound-healing outcomes. 1 All participants had at least 1 year of follow-up. Baseline demographics, nutritional markers, and GLP-1 RA therapy duration were recorded. Logistic regression was performed to adjust for confounders when comparing complications and adverse effects.<h4>Results</h4>GLP-1 RA users had higher rates of type 2 diabetes (55.6% versus 29.5% [ P = 0.01]), hypertension (69.1% versus 52.7% [ P = 0.04]), and chronic obstructive pulmonary disease (17.3% versus 6.5% [ P = 0.02]), along with elevated prealbumin levels (22.8 ± 6.6 versus 20.4 ± 7.7 mg/dL [ P = 0.030]). Analyses showed a greater incidence of delayed wound healing (18.5% versus 7.5% [ P = 0.0066]) but lower seroma rates (4.9% versus 14.0% [ P = 0.032]) in GLP-1 RA users. These differences persisted on multivariable regression. No significant differences were noted in infection, fat necrosis, hematoma, or GLP-1 RA-related gastrointestinal side effects.<h4>Conclusions</h4>GLP-1 RAs demonstrate promise in chronic wound care. Their use was correlated with increased incidence of delayed wound healing but fewer seromas in acute surgical settings. Overall, these findings support their perioperative safety, but vigilant monitoring for potential wound-healing delays is advised.