A 26-Year Evidence Map of Metabolic and Bariatric Surgery in Türkiye: A Systematic Scoping Review with Publication-Family Reconciliation

Abstract Background and Objectives: The literature on metabolic and bariatric surgery in Türkiye expanded substantially between 2000 and 2026; however, temporal changes in surgical procedures, clinical outcomes, and patient-level overlap caused by repeated reporting of the same cohorts have not been evaluated together. This systematic scoping review and evidence map aimed to comprehensively characterize the Turkish literature on metabolic and bariatric surgery, examine temporal changes in surgical procedures and reported weight-loss, metabolic, and safety outcomes, and estimate a conservative lower bound for unique patients represented in the literature through publication-family reconciliation. Materials and Methods: Reports of metabolic and bariatric surgery originating from Türkiye and published between 1 January 2000 and 1 June 2026 were systematically searched and mapped. After bibliographic deduplication, eligible reports were reconciled at the publication-family level using center, author group, surgical period, procedure, and cohort characteristics. Source-patient observations, analyzed-patient observations, and reconciled unique-patient counts were maintained as separate denominator layers. Temporal changes in procedures were assessed by publication period and, in reports with adequate operation/recruitment dates, by a secondary surgery-cohort-period analysis. Randomized clinical trials (RCTs) underwent outcome-specific Cochrane RoB 2 assessment, and safety outcomes were classified according to data provenance. Results : The final bibliographic evidence base comprised 191 unique reports, of which 177 (92.7%) were clinically/procedurally eligible and 29 were RCTs. After publication-family reconciliation, the conservative lower bound of unique patients represented in the published evidence was ≥27,377. Among reports in which procedures could be reliably classified, sleeve gastrectomy (SG/LSG) was represented in 35.7% of reports published through 2015, increasing to 92.0% in 2016–2020 and remaining dominant at 88.5% in 2021–2026; laparoscopic adjustable gastric banding (LAGB) declined from 28.6% to 6.0% and then to 0%, respectively. A secondary temporal analysis of 53 reports with adequate operation/recruitment dates supported the same direction of change. Weight loss and metabolic improvement were commonly reported, whereas heterogeneity in complication denominators and data provenance precluded calculation of a reliable single national pooled safety rate. Conclusions : The Turkish metabolic and bariatric surgery literature evolved from an early heterogeneous procedural profile to a strongly SG/LSG-dominant evidence base, with more recent diversification through bypass and newer metabolic procedures. After publication-family reconciliation, the literature represented at least 27,377 conservatively identified unique patients. Although weight loss and metabolic improvement were commonly reported, publication-family overlap and heterogeneous outcome denominators limited the generation of reliable national pooled estimates.