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

被引：29

作者：

Kermansaravi, Mohammad ^{[1
]}

Parmar, Chetan ^{[2
]}

Chiappetta, Sonja ^{[3
]}

Shikora, Scott ^{[4
]}

Aminian, Ali ^{[5
]}

Abbas, Syed Imran ^{[6
]}

Angrisani, Luigi ^{[7
]}

Bashir, Ahmad ^{[8
]}

Behrens, Estuardo ^{[9
]}

Bhandari, Mohit ^{[10
]}

Clapp, Benjamin ^{[11
]}

Cohen, Ricardo ^{[12
]}

Dargent, Jerome ^{[13
]}

Dilemans, Bruno ^{[14
]}

De Luca, Maurizio ^{[15
]}

Haddad, Ashraf ^{[8
]}

Gawdat, Khaled ^{[16
]}

Elfawal, Mohamed Hayssam ^{[17
]}

Himpens, Jaques ^{[18
]}

Huang, Chih-Kun ^{[19
]}

Husain, Farah ^{[20
]}

Kasama, Kazunori ^{[21
]}

Kassir, Radwan ^{[22
]}

Khan, Amir ^{[23
]}

Kow, Lilian ^{[24
]}

Kroh, Matthew ^{[25
]}

Lakdawala, Muffazal ^{[26
]}

Corvala, Juan Antonio Lopez ^{[27
]}

Miller, Karl ^{[28
]}

Musella, Mario ^{[29
]}

Nimeri, Abdelrahman ^{[30
]}

Noel, Patrick ^{[31
]}

Palermo, Mariano ^{[32
]}

Poggi, Luis ^{[33
]}

Poghosyan, Tigran ^{[34
]}

Prager, Gerhard ^{[35
]}

Prasad, Arun ^{[36
]}

Alqahtani, Aayad ^{[37
]}

Rheinwalt, Karl ^{[38
]}

Ribeiro, Rui ^{[39
]}

Shabbir, Asim ^{[40
]}

Torres, Antonio ^{[41
]}

Villalonga, Ramon ^{[42
]}

Wang, Cunchuan ^{[43
]}

Mahawar, Kamal ^{[44
]}

Zundel, Natan ^{[45
]}

机构：

[1] Iran Univ Med Sci, Rasool E Akram Hosp, Minimally Invas Surg Res Ctr, Sch Med,Div Minimally Invas & Bariatr Surg,Dept S, Tehran, Iran

[2] Whittington Hosp, London, England

[3] Osped Evangel Betania, Bariatr & Metab Surg Unit, Naples, Italy

[4] Harvard Med Sch, Brigham & Womens Hosp, Dept Surg, Boston, MA USA

[5] Cleveland Clin, Bariatr & Metab Inst, Dept Gen Surg, Cleveland, OH USA

[6] Iranian Hosp, Dubai, U Arab Emirates

[7] Federico II Univ Naples, Dept Publ Hlth, Naples, Italy

[8] Jordan Hosp, Gastrointestinal Bariatr & Metab Ctr GBMC, Minimally Invas & Bariatr Surg, Amman, Jordan

[9] New Life Ctr, Guatemala City, Guatemala

[10] Mohak Bariatr & Robot Ctr, Indore, India

[11] Texas Tech HSC Paul Foster Sch Med, Dept Surg, El Paso, TX USA

[12] Oswaldo Cruz German Hosp, Ctr Obes & Diabet, Sao Paulo, Brazil

[13] Polyclin Lyon Nord, Rillieux La Pape, France

[14] AZ Sint Jan Brugge Oostende, Dept Gen Surg, Brugge, Belgium

[15] Rovigo Hosp, Dept Gen Surg, Rovigo, Italy

[16] Ain Shams Univ, Fac Med, Bariatr Surg Unit, Cairo, Egypt

[17] Makassed Gen Hosp, Beirut, Lebanon

[18] Delta Chirec Hosp, Bariatr Surg Unit, Brussels, Belgium

[19] China Med Univ Hosp, Body Sci & Metab Disorders Int Med Ctr, Taichung, Taiwan

[20] Univ Arizona, Coll Med, Phoenix, AZ USA

[21] Yotsuya Med Cube, Weight Loss & Metab Surg Ctr, Tokyo, Japan

[22] CHU Felix Guyon, Dept Digest Surg, St Denis, La Reunion, France

[23] Walsall Healthcare NHS Trust, Walsall, England

[24] Flinders Med Ctr, Adelaide, SA, Australia

[25] Cleveland Clin, Digest Dis & Surg Inst, Cleveland, OH USA

[26] Sir H N Reliance Fdn Hosp, Mumbai, India

[27] Hosp Angeles Tijuana Mexico, Tijuana, Mexico

[28] Diakonissen Wehrle Private Hosp, Salzburg, Austria

[29] Univ Naples Federico II, Adv Biomed Sci Dept, Naples, Italy

[30] Atrium Hlth, Charlotte, NC USA

[31] Clin Bouchard, F-13006 Marseille, France

[32] Univ Buenos Aires, Ctr CIEN Diagnomed, Dept Surg, Buenos Aires, Argentina

[33] Univ Nacl Mayor San Marcos, Dept Surg Clin Anglo Amer, Lima, Peru

[34] Univ Paris Cite, Hop Bichat, AP HP, Dept Digest Oeso Gastr & Bariatr Surg, Paris, France

[35] Med Univ Vienna, Vienna, Austria

[36] Apollo Hosp, New Delhi, India

[37] King Saud Univ, Obes Chair, New You Med Ctr, Riyadh, Saudi Arabia

[38] St Franziskus Hosp, Dept Bariatr Metab & Plast Surg, Cologne, Germany

[39] Hosp Lusiadas Amadora & Lisbon, Ctr Multidisciplinar Tratamento Obesidade, Amadora, Portugal

[40] Natl Univ Singapore, Singapore, Singapore

[41] Univ Complutense Madrid, Hosp Clin San Carlos, Dept Surg, Calle Prof Martin Lagos S-N, Madrid 28040, Spain

[42] Universitary Hosp Vall Hebron, Endocrine Bariatr & Metab Surg Dept, Barcelona, Spain

[43] Jinan Univ, Dept Metab & Bariatr Surg, Affiliated Hosp 1, Guangzhou, Peoples R China

[44] South Tyneside & Sunderland Fdn NHS Trust, Sunderland, England

[45] SUNY Buffalo, Dept Surg, Buffalo, NY 14260 USA

来源：

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 2023年 / 37卷 / 03期

关键词：

Sleeve gastrectomy; Revision; Conversion; GERD; Consensus; Bariatric surgery; Y GASTRIC BYPASS; GASTROESOPHAGEAL-REFLUX DISEASE; BARIATRIC SURGERY; BARRETTS-ESOPHAGUS; LIGAMENTUM TERES; HIATAL-HERNIA; CARDIOPEXY; CONVERSION; STATEMENT; DIAGNOSIS;

D O I：

10.1007/s00464-023-09879-x

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

BackgroundSleeve 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.MethodsForty-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.ResultsConsensus 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.ConclusionRedo-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.

引用

页码：1617 / 1628

页数：12

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