Patient Selection in One Anastomosis/Mini Gastric Bypass-an Expert Modified Delphi Consensus.

Autor: Kermansaravi M; Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran., Parmar C; Whittington Hospital, London, UK., Chiappetta S; Obesity and Metabolic Surgery Unit, Ospedale Evangelico Betania, Naples, Italy., Shahabi S; Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran., Abbass A; Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, 11591, Egypt., Abbas SI; Iranian Hospital, Al Wasl Road, Dubai, UAE., Abouzeid M; Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, 11591, Egypt., Antozzi L; Centro de Cirugías Especiales, Bahía Blanca, Argentina., Asghar ST; Capital Hospital, CDA, Islamabad, Pakistan., Bashir A; Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Amman, Jordan., Bhandari M; Mohak Bariatrics and Robotics Center, Indore, India., Billy H; Ventura Advanced Surgical Associates, Ventura, CA, USA., Caina D; Dr. Federico Abete Hospital for Trauma and Emergency, Obesity and Metabolic Center, Malvinas, Argentina., Campos FJ; Obesity Clinic, Mexico City, Mexico., Carbajo MA; Centre of Excellence for the Study and Treatment of Obesity and Diabetes, Valladolid, Spain., Chevallier JM; Université Paris 5, Paris, France., Jazi AHD; Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran., de Gordejuela AGR; Vall d'Hebron University Hospital, Barcelona, Spain., Haddad A; Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Amman, Jordan., ElFawal MH; Makassed General Hospital, Beirut, Lebanon., Himpens J; Bariatric Surgery Unit, Delta Chirec Hospital, Brussels, Belgium., Inam A; Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan., Kassir R; Department of Digestive Surgery, CHU Félix Guyon, Saint Denis, La Réunion, France., Kasama K; Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan., Khan A; Walsall Healthcare NHS Trust, Walsall, UK., Kow L; Flinders Medical Centre, Adelaide, Australia., Kular KS; Kular Research Institute, Bija, India., Lakdawala M; Sir H N Reliance Foundation Hospital, Mumbai, India., Layani LA; Al Sharq Hospital, Fujairah, UAE., Lee WJ; Min-Sheng General Hospital, Taoyuan City, Taiwan., Luque-de-León E; The American British Cowdray Medical Center, Mexico City, Mexico., Loi K; St George Surgery, Sydney, Australia., Mahawar K; South Tyneside and Sunderland Foundation NHS Trust, Sunderland, UK., Mahdy T; Mansoura Faculty of Medicine, Sharjah University Hospital, Sharjah, UAE., Musella M; Advanced Biomedical Sciences Department, 'Federico II' University, Naples, Italy., Nimeri A; Atrium Health, Charlotte, NC, USA., González JCO; Obesity Surgeons Mexico, Reynosa, Tamaulipas, Mexico., Pazouki A; Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran., Poghosyan T; Hôpital Européen-Georges Pompidou, AP-HP, Université de Paris, Paris, France., Prager G; Medical University of Vienna, Vienna, Austria., Prasad A; Apollo Hospital, New Delhi, India., Ramos AC; Institute for Metabolic Optimization, Sao Paulo, Brazil., Rheinwalt K; Department of Bariatric, Metabolic and Plastic Surgery, St. Franziskus Hospital, Cologne, Germany., Ribeiro R; Centro de Excelencia Para a Cirurgia MetabolicaGrupo Lusiadas, Lisbon, Portugal., Ruiz-Úcar E; Bariatric and Metabolic Surgery Department, University Hospital of Fuenlabrada, Madrid, Spain., Rutledge R; International Center for Laparoscopic Obesity Surgery, Punjab, India., Shabbir A; National University of Singapore, Singapore, Singapore., Shikora S; Department of Surgery Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA., Singhal R; University Hospital Birmingham NHS Foundation Trust, Birmingham, UK., Taha O; Plastic and Obesity Surgery Department, Bariatric Unit, Assiut University Hospital, Assiut, Egypt., Talebpour M; Department of General Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran., Verboonen JS; Obesity Goodbye Center, Tijuana, Mexico., Wang C; Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China., Weiner R; Bariatric Surgery Unit, Sana Clinic Offenbach, Offenbach, Germany., Yang W; Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China., Vilallonga R; Endocrine, Bariatric and Metabolic Surgery Department, Universitary Hospital Vall Hebron, Barcelona, Spain., De Luca M; Department of General Surgery, Rovigo Hospital, Rovigo, Italy. nnwdel@tin.it.
Jazyk: angličtina
Zdroj: Obesity surgery [Obes Surg] 2022 Aug; Vol. 32 (8), pp. 2512-2524. Date of Electronic Publication: 2022 Jun 15.
DOI: 10.1007/s11695-022-06124-7
Abstrakt: Purpose: One anastomosis/mini gastric bypass (OAGB/MGB) is up to date the third most performed obesity and metabolic procedure worldwide, which recently has been endorsed by ASMBS. The main criticisms are the risk of bile reflux, esophageal cancer, and malnutrition. Although IFSO has recognized this procedure, guidance is needed regarding selection criteria. To give clinicians a daily support in performing the right patient selection in OAGB/MGB, the aim of this paper is to generate clinical guidelines based on an expert modified Delphi consensus.
Methods: A committee of 57 recognized bariatric surgeons from 24 countries created 69 statements. Modified Delphi consensus voting was performed in two rounds. An agreement/disagreement among ≥ 70.0% of the experts was considered to indicate a consensus.
Results: Consensus was achieved for 56 statements. Remarkably, ≥ 90.0% of the experts felt that OAGB/MGB is an acceptable and suitable option "in patients with Body mass index (BMI) > 70, BMI > 60, BMI > 50 kg/m 2 as a one-stage procedure," "as the second stage of a two-stage bariatric surgery after Sleeve Gastrectomy for BMI > 50 kg/m 2 (instead of BPD/DS)," and "in patients with weight regain after restrictive procedures. No consensus was reached on the statement that OAGB/MGB is a suitable option in case of resistant Helicobacter pylori. This is likely as there is a concern that this procedure is associated with reflux and its related long-term complications including risk of cancer in the esophagus or stomach. Also no consensus reached on OAGB/MGB as conversional surgery in patients with GERD after restrictive procedures. Consensus for disagreement was predominantly achieved "in case of intestinal metaplasia of the stomach" (74.55%), "in patients with severe Gastro Esophageal Reflux Disease (GERD)(C,D)" (75.44%), "in patients with Barrett's metaplasia" (89.29%), and "in documented insulinoma" (89.47%).
Conclusion: Patient selection in OAGB/MGB is still a point of discussion among experts. There was consensus that OAGB/MGB is a suitable option in elderly patients, patients with low BMI (30-35 kg/m 2 ) with associated metabolic problems, and patients with BMIs more than 50 kg/m 2 as one-stage procedure. OAGB/MGB can also be a safe procedure in vegetarian and vegan patients. Although OAGB/MGB can be a suitable procedure in patients with large hiatal hernia with concurrent hiatal hernia, it should not be offered to patients with grade C or D esophagitis or Barrett's metaplasia.
(© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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