Best practice approach for redo-surgeries after sleeve gastrectomy, an expert's modified Delphi consensus.

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Tytuł:: Best practice approach for redo-surgeries after sleeve gastrectomy, an expert's modified Delphi consensus.
Autorzy:: Kermansaravi M; Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Minimally Invasive Surgery Research Center, School of Medicine, Rasool‑E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. .
Parmar C; Whittington Hospital, London, UK.
Chiappetta S; Bariatric and Metabolic Surgery Unit, Ospedale Evangelico Betania, Naples, Italy.
Shikora S; Department of Surgery Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Aminian A; Department of General Surgery, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA.
Abbas SI; Iranian Hospital, Dubai, UAE.
Angrisani L; Department of Public Health, Federico II University of Naples, Naples, Italy.
Bashir A; Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Amman, Jordan.
Behrens E; New Life Center, Guatemala, Guatemala.
Bhandari M; Mohak Bariatrics and Robotics Center, Indore, India.
Clapp B; Department of Surgery, Texas Tech HSC Paul Foster School of Medicine, El Paso, TX, USA.
Cohen R; Center for Obesity and Diabetes, Oswaldo Cruz German Hospital, São Paulo, Brazil.
Dargent J; Polyclinique Lyon Nord, Rillieux-La-Pape, France.
Dilemans B; Department of General Surgery, AZ Sint Jan Brugge-Oostende, Brugge, Belgium.
De Luca M; Department of General Surgery, Rovigo Hospital, Rovigo, Italy.
Haddad A; Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Amman, Jordan.
Gawdat K; Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Elfawal MH; Makassed General Hospital, Beirut, Lebanon.
Himpens J; Bariatric Surgery Unit, Delta Chirec Hospital, Brussels, Belgium.
Huang CK; Body Science and Metabolic Disorders International Medical Center, China Medical University Hospital, Taichung City, Taiwan.
Husain F; University of Arizona College of Medicine, Phoenix, 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.
Kow L; Flinders Medical Centre, Adelaide, Australia.
Kroh M; Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.
Lakdawala M; Sir H N Reliance Foundation Hospital, Mumbai, India.
Corvala JAL; Hospital Ángeles Tijuana Mexico, Tijuana, Mexico.
Miller K; Diakonissen Wehrle Private Hospital, Salzburg, Austria.
Musella M; Advanced Biomedical Sciences Department, 'Federico II' University, Naples, Italy.
Nimeri A; Atrium Health, Charlotte, NC, USA.
Noel P; Clinique Bouchard, Elsan, 13006, Marseille, France.
Palermo M; Department of Surgery, Centro CIEN-Diagnomed, University of Buenos Aires, Buenos Aires, Argentina.
Poggi L; Department of Surgery Clinica Anglo Americana, Universidad Nacional Mayor de San Marcos, Lima, Peru.
Poghosyan T; Department of Digestive, Oeso-Gastrique and Bariatric Surgery, Hôpital Bichât, AP-HP, Université de Paris Cité, Paris, France.
Prager G; Medical University of Vienna, Vienna, Austria.
Prasad A; Apollo Hospital, New Delhi, India.
Alqahtani A; New You Medical Center, Obesity Chair, King Saud University, Riyadh, Saudi Arabia.
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.
Shabbir A; National University of Singapore, Singapore, Singapore.
Torres A; Department of Surgery, Hospital Clínico San Carlos, Complutense University of Madrid, Calle del Prof Martín Lagos, S/N, 28040, Madrid, Spain.
Villalonga 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.
Mahawar K; South Tyneside and Sunderland Foundation NHS Trust, Sunderland, UK.
Zundel N; Department of Surgery, State University of New York, Buffalo, NY, USA. .
Źródło:: Surgical endoscopy [Surg Endosc] 2023 Mar; Vol. 37 (3), pp. 1617-1628. Date of Electronic Publication: 2023 Jan 24.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: 1992- : New York : Springer
Original Publication: [Berlin] : Springer International, c1987-
MeSH Terms:: Gastric Bypass*/methods
Gastroesophageal Reflux*/etiology
Gastroesophageal Reflux*/surgery
Obesity, Morbid*/surgery
Humans ; Delphi Technique ; Reoperation/methods ; Gastrectomy/methods ; Weight Loss ; Retrospective Studies ; Treatment Outcome
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Contributed Indexing:: Keywords: Bariatric surgery; Consensus; Conversion; GERD; Revision; Sleeve gastrectomy
Entry Date(s):: Date Created: 20230124 Date Completed: 20230320 Latest Revision: 20230331
Update Code:: 20240105
DOI:: 10.1007/s00464-023-09879-x
PMID:: 36693918
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Background: Sleeve gastrectomy (SG) is the most common metabolic and bariatric surgical (MBS) procedure worldwide. Despite the desired effect of SG on weight loss and remission of obesity-associated medical problems, there are some concerns regarding the need to do revisional/conversional surgeries after SG. This study aims to make an algorithmic clinical approach based on an expert-modified Delphi consensus regarding redo-surgeries after SG, to give bariatric and metabolic surgeons a guideline that might help for the best clinical decision.
Methods: Forty-six recognized bariatric and metabolic surgeons from 25 different countries participated in this Delphi consensus study in two rounds to develop a consensus on redo-surgeries after SG. An agreement/disagreement ≥ 70.0% on statements was considered to indicate a consensus.
Results: Consensus was reached for 62 of 72 statements and experts did not achieve consensus on 10 statements after two rounds of online voting. Most of the experts believed that multi-disciplinary team evaluation should be done in all redo-procedures after SG and there should be at least 12 months of medical and supportive management before performing redo-surgeries after SG for insufficient weight loss, weight regain, and gastroesophageal reflux disease (GERD). Also, experts agreed that in case of symptomatic GERD in the presence of adequate weight loss, medical treatment for at least 1 to 2 years is an acceptable option and agreed that Roux-en Y gastric bypass is an appropriate option in this situation. There was disagreement consensus on efficacy of omentopexy in rotation and efficacy of fundoplication in the presence of a dilated fundus and GERD.
Conclusion: Redo-surgeries after SG is still an important issue among bariatric and metabolic surgeons. The proper time and procedure selection for redo-surgery need careful considerations. Although multi-disciplinary team evaluation plays a key role to evaluate best options in these situations, an algorithmic clinical approach based on the expert's consensus as a guideline can help for the best clinical decision-making.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

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