Bariatric Surgery for Patients with Overweight/Obesity. A Comprehensive Grading Methodology and Network Metanalysis of Randomized Controlled Trials on Weight Loss Outcomes and Adverse Events

被引：11

作者：

De Luca, Maurizio ^{[1
]}

Zese, Monica ^{[1
]}

Silverii, Giovanni Antonio ^{[2
,3
]}

Ragghianti, Benedetta ^{[2
,3
]}

Bandini, Giulia ^{[2
,3
]}

Forestieri, Pietro ^{[4
]}

Zappa, Marco Antonio ^{[5
]}

Navarra, Giuseppe ^{[6
]}

Foschi, Diego ^{[7
]}

Musella, Mario ^{[4
]}

Sarro, Giuliano ^{[8
]}

Pilone, Vincenzo ^{[9
]}

Facchiano, Enrico ^{[10
]}

Foletto, Mirto ^{[11
]}

Olmi, Stefano ^{[12
]}

Raffelli, Marco ^{[13
]}

Bellini, Rosario ^{[14
]}

Gentileschi, Paolo ^{[15
]}

Cerbone, Maria Rosaria ^{[16
]}

Grandone, Ilenia ^{[17
]}

Berardi, Giovanna ^{[4
]}

Di Lorenzo, Nicola ^{[18
]}

Lucchese, Marcello ^{[19
]}

Piazza, Luigi ^{[20
]}

Casella, Giovanni ^{[21
]}

Manno, Emilio ^{[22
]}

Zaccaroni, Alberto ^{[23
]}

Balani, Alessandro ^{[24
]}

Mannucci, Edoardo ^{[2
,3
]}

Monami, Matteo ^{[2
,3
]}

机构：

[1] Osped Rovigo, Azienda ULSS5 Polesana, Dipartimento Chirurg Gen & Metab, I-45010 Rovigo, Italy

[2] Azienda Osped Univ Careggi, I-50134 Florence, Italy

[3] Univ Firenze, I-50134 Florence, Italy

[4] Univ Napoli Federico II, Dipartimento Sci Biochim Avanzate, I-80138 Naples, Italy

[5] ASST Fatebenefratelli Sacco, I-20157 Milan, Italy

[6] Policlin Univ G Martino Messina, I-98124 Messina, Italy

[7] Osped San Giuseppe, I-20100 Milan, Italy

[8] UOC Chirurg Gen & Bariatr, Ist Clin Alta Specialita San Gaudenzio Novara, Grp Policlin Monza, I-28100 Novara, Italy

[9] Univ Salerno, AOU San Giovanni Dio & Ruggi Aragona Ospedale G Fu, Salerno, Italy

[10] Asl 3, I-51100 Pistoia, Pistoia, Italy

[11] Univ Padua Polyclin, I-35128 Padua, Italy

[12] Policlin San Marco, I-24046 Bergamo, Italy

[13] Univ Cattolica Sacro Cuore, Fdn Policlin Univ Agostino Gemelli IRCCS, I-00168 Rome, Italy

[14] Azienda Osped Univ Pisana, I-56126 Pisa, Italy

[15] Univ Roma Tor Vergata, Roma & Maria Cecilia Hosp, Osped San Carlo Nancy, Dipartimento Chirurg Bariatr & Metab, I-00165 Cotignola, Ravenna, Italy

[16] ASL NAPOLI2 nord, Dist 41 UOMI, I-80027 Naples, Italy

[17] Azienda Osped Santa Maria Terni, SC Diabetol Dietol & Nutr Clin, I-05100 Terni, Italy

[18] Univ Roma Tor Vergata, I-00133 Rome, Italy

[19] Osped Santa Maria Nuova Chirurg Gen, Bariatr Azienda Sanit Toscana Ctr, I-50122 Florence, Italy

[20] UOC Chirurg Gen & Urgenza, Arnas Garibaldi, I-95123 Catania, Italy

[21] Univ Roma La Sapienza, Dipartimento Chirurg, AOU Policlin Umberto 1, I-00161 Rome, Italy

[22] UO Chirurg Bariatr & Metab, AORN A Cardarelli Napoli, I-80131 Naples, Italy

[23] Osped GBMorgagni, Chirurg Endocrina & Metab, I-47121 Forli, Italy

[24] ASS2 Isontina, Dipartimento Chirurg Presidio Osped Gorizia Monfa, I-34170 Gorizia, Italy

来源：

OBESITY SURGERY | 2023年 / 33卷 / 12期

关键词：

Metabolic surgery for diabetes; Best choice in treatment of obesity; Network meta-analysis; Y GASTRIC BYPASS; LAPAROSCOPIC-SLEEVE-GASTRECTOMY; VERTICAL BANDED GASTROPLASTY; LIFE-STYLE INTERVENTION; QUALITY-OF-LIFE; NON-SUPEROBESE POPULATION; TYPE-2; DIABETES-MELLITUS; MORBIDLY OBESE-PATIENTS; CLINICAL-TRIAL; DOUBLE-BLIND;

D O I：

10.1007/s11695-023-06909-4

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

This study aims to compare different types of metabolic bariatric surgery (MBS) with lifestyle intervention/medical therapy (LSI/MT) for the treatment of overweight/obesity. The present and network meta-analysis (NMA) includes randomized trials. MBS was associated with a reduction of BMI, body weight, and percent weight loss, when compared to LSI/MT, and also with a significant reduction of HbA1c and a higher remission of diabetes. Meta-regression analyses revealed that BMI, a higher proportion of women, and a longer duration of trial were associated with greater effects of MBS. The NMA showed that all surgical procedures included (except greater curvature plication) were associated with a reduction of BMI. MBS is an effective option for the treatment of obesity. The choice of BMI thresholds for eligibility for surgery of patients with different complications should be performed making an evaluation of risks and benefits in each BMI category.

引用

页码：4147 / 4158

页数：12

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