Current recommendations for procedure selection in class I and II obesity developed by an expert modified Delphi consensus.

Autor: Kermansaravi M; Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat-e Fatemeh Hospital, Iran University of Medical Sciences, Tehran, Iran. mkermansaravi@yahoo.com., Chiappetta S; Department of General and Laparoscopic Surgery, Obesity and Metabolic Surgery Unit, Ospedale Evangelico Betania, Naples, Italy. drschiappetta@gmail.com., Parmar C; Whittington Hospital, London, UK., Shikora SA; Department of Surgery, Center for Metabolic and Bariatric Surgery, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA., Prager G; Medical University of Vienna, Vienna, Austria., LaMasters T; Unitypoint Clinic Weight Loss Specialists, West Des Moines, IA, USA.; Department of Surgery, University of Iowa, Iowa City, IA, USA., Ponce J; Bariatric Surgery Program, CHI Memorial Hospital, Chattanooga, TN, USA., Kow L; Adelaide Bariatric Centre, Flinders University of South Australia, Adelaide, Australia., Nimeri A; Department of Surgery, Center for Metabolic and Bariatric Surgery, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA., Kothari SN; Prisma Health, Department of Surgery, University of South Carolina School of Medicine, Greenville, SC, USA., Aarts E; WeightWorks Clinics and Allurion Clinics, Amersfoort, The Netherlands., Abbas SI; Iranian Hospital, Alwasl Road, Dubai, UAE., Aly A; Austin and Repatriation Medical Centre, University of Melbourne, Heidelberg, VIC, Australia., Aminian A; Department of General Surgery, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA., Bashir A; Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Amman, Jordan., Behrens E; New Life Center, Guatemala, Guatemala., Billy H; Ventura Advanced Surgical Associates, Ventura, CA, USA., Carbajo MA; Centre of Excellence for the Study and Treatment of Obesity and Diabetes, Valladolid, Spain., Clapp B; Department of Surgery, Texas Tech HSC Paul Foster School of Medicine, El Paso, TX, USA., Chevallier JM; Université Paris 5, Paris, France., Cohen RV; Center for the Treatment of Obesity and Diabetes, Hospital Alemão Oswaldo Cruz, Sao Paolo, Brazil., Dargent J; Polyclinique Lyon Nord, Rillieux-la-Pape, France., Dillemans B; Department of General Surgery, AZ Sint Jan Brugge-Oostende, Bruges, Belgium., Faria SL; Gastrocirurgia de Brasilia, University of Brasilia, Brasilia, Brazil., Neto MG; Endovitta Institute, São Paulo, Brazil., Garneau PY; Division of Bariatric Surgery, CIUSSS-NIM, Montreal, Canada.; Department of Surgery, Université de Montréal, Montréal, Canada., Gawdat K; Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt., Haddad A; Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Amman, Jordan., ElFawal MH; Makassed General Hospital, Beirut, Lebanon., Higa K; Fresno Heart and Surgical Hospital, UCSF Fresno, Fresno, CA, USA., Himpens J; Bariatric Surgery Unit, Delta Chirec Hospital, Brussels, Belgium., Husain F; University of Arizona College of Medicine, Phoenix, USA., Hutter MM; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Kasama K; Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan., Kassir R; Department of Digestive Surgery, CHU Félix Guyon, Saint Denis, La Réunion, France., Khan A; Walsall Healthcare NHS Trust, Walsall, UK., Khoursheed M; Taiba Hospital, Kuwait City, Kuwait., Kroh M; Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA., Kurian MS; Department of Surgery, New York University Grossman School of Medicine, New York, NY, USA., Lee WJ; Medical Weight Loss Center, China Medical University Shinchu Hospital, Zhubei City, Taiwan., Loi K; Director of St George Surgery, Sydney, Australia., Mahawar K; South Tyneside and Sunderland Foundation NHS Trust, Sunderland, UK., McBride CL; University of Nebraska Medical Center, Omaha, USA., Almomani H; NMC Royal Hospital, Abu Dhabi, UAE., Melissas J; Bariatric Unit, Heraklion University Hospital, University of Crete, Crete, Greece., Miller K; Diakonissen Wehrle Private Hospital, Salzburg, Austria., Misra M; Cedars Sinai Medical Center, Los Angeles, USA., Musella M; Advanced Biomedical Sciences Department, Federico II' University, Naples, Italy., Northup CJ; BMI Surgery, New Lenox, IL, USA., O'Kane M; Department of Nutrition and Dietetics, Leeds Teaching Hospitals, NHS Trust, Leeds, UK., Papasavas PK; Division of Metabolic and Bariatric Surgery, Hartford Hospital, Hartford, CT, USA., Palermo M; Department of Surgery, Centro CIEN-Diagnomed, University of Buenos Aires, Buenos Aires, Argentina., Peterson RM; Department of General and Minimally Invasive Surgery, UT Health San Antonio, San Antonio, TX, USA., Peterli R; Department of Visceral Surgery, Clarunis, University Digestive Health Care Center, St. Clara Hospital and University Hospital Basel, Basel, Switzerland., Poggi L; Department of Surgery Clinica Anglo Americana, Universidad Nacional Mayor de San Marcos, Lima, Peru., Pratt JSA; Department of Surgery, Stanford School of Medicine, VA Palo Alto Health Care System, 3801 Miranda Avenue, GS 112, Palo Alto, CA, 94304, USA., Alqahtani A; New You Medical Center, King Saud University, Obesity Chair, Riyadh, Saudi Arabia., Ramos AC; Medical Director of Gastro-Obeso-Center, Institute for Metabolic Optimization, Sao Paulo, Brazil., Rheinwalt K; Department of Bariatric, Metabolic, and Plastic Surgery, St. Franziskus Hospital, Cologne, Germany., Ribeiro R; Centro Multidisciplinar Do Tratamento da Obesidade, Hospital Lusíadas Amadora e Lisbon, Amadora, Portugal., Rogers AM; Department of Surgery - Division of Minimally Invasive and Bariatric Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA., Safadi B; Aman Hospital, Doha, Qatar., Salminen P; Division of Digestive Surgery and Urology, Department of Digestive Surgery, Turku University Hospital, Turku, Finland., Santoro S; Hospital Israelita Albert Einstein, Av. Albert Einstein, 627, São Paulo, 05652-900, Brazil., Sann N; Advanced Surgical Partners of Virginia, Richmond, VA, USA., Scott JD; Division of Bariatric and Minimal Access Surgery, Department of Surgery, University of South Carolina School of Medicine, Greenville, SC, USA., Shabbir A; National University of Singapore, Singapore, Singapore., Sogg S; Massachusetts General Hospital Weight Center, Boston, MA, USA., Stenberg E; Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden., Suter M; Department of Surgery, Riviera-Chablais Hospital, Rennaz, Switzerland., Torres A; Department of Surgery, Hospital Clínico San Carlos, Complutense University of Madrid, Calle del Prof Martín Lagos, S/N, 28040, Madrid, Spain., Ugale S; Kirloskar and Virinchi Hospitals, Hyderabad, Telangana, India., Vilallonga R; Endocrine, Bariatric, and Metabolic Surgery Department, Universitary Hospital Vall Hebron, Barcelona, Spain., 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., Zundel N; Department of Surgery, University of Buffalo, Buffalo, NY, USA., Angrisani L; Department of Public Health, Federico II University of Naples, Naples, Italy., De Luca M; Department of General Surgery Rovigo Hospital, Rovigo, Italy.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Feb 11; Vol. 14 (1), pp. 3445. Date of Electronic Publication: 2024 Feb 11.
DOI: 10.1038/s41598-024-54141-6
Abstrakt: Metabolic and bariatric surgery (MBS) is widely considered the most effective option for treating obesity, a chronic, relapsing, and progressive disease. Recently, the American Society of Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) issued new guidelines on the indications for MBS, which have superseded the previous 1991 National Institutes of Health guidelines. The aim of this study is to establish the first set of consensus guidelines for selecting procedures in Class I and II obesity, using an Expert Modified Delphi Method. In this study, 78 experienced bariatric surgeons from 32 countries participated in a two-round Modified Delphi consensus voting process. The threshold for consensus was set at an agreement or disagreement of ≥ 70.0% among the experts. The experts reached a consensus on 54 statements. The committee of experts reached a consensus that MBS is a cost-effective treatment option for Class II obesity and for patients with Class I obesity who have not achieved significant weight loss through non-surgical methods. MBS was also considered suitable for patients with Type 2 diabetes mellitus (T2DM) and a body mass index (BMI) of 30 kg/m 2 or higher. The committee identified intra-gastric balloon (IGB) as a treatment option for patients with class I obesity and endoscopic sleeve gastroplasty (ESG) as an option for patients with class I and II obesity, as well as for patients with T2DM and a BMI of ≥ 30 kg/m 2 . Sleeve gastrectomy (1) and Roux-en-Y gastric bypass (RYGB) were also recognized as viable treatment options for these patient groups. The committee also agreed that one anastomosis gastric bypass (OAGB) is a suitable option for patients with Class II obesity and T2DM, regardless of the presence or severity of obesity-related medical problems. The recommendations for selecting procedures in Class I and II obesity, developed through an Expert Modified Delphi Consensus, suggest that the use of standard primary bariatric endoscopic (IGB, ESG) and surgical procedures (SG, RYGB, OAGB) are acceptable in these patient groups, as consensus was reached regarding these procedures. However, randomized controlled trials are still needed in Class I and II Obesity to identify the best treatment approach for these patients in the future.
(© 2024. The Author(s).)
Databáze: MEDLINE
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