Best practice approach for redo-surgeries after sleeve gastrectomy, an expert's modified Delphi consensus.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kermansaravi Mohammad, Parmar Chetan, Chiappetta Sonja, Shikora Scott, Aminian Ali, Abbas Syed Imran, Angrisani Luigi, Bashir Ahmad, Behrens Estuardo, Bhandari Mohit, Clapp Benjamin, Cohen Ricardo, Dargent Jerome, Dilemans Bruno, De Luca Maurizio, Haddad Ashraf, Gawdat Khaled, Elfawal Mohamed Hayssam, Himpens Jaques, Huang Chih-Kun, Husain Farah, Kasama Kazunori, Kassir Radwan, Khan Amir, Kow Lilian, Kroh Matthew, Lakdawala Muffazal, Corvala Juan Antonio Lopez, Miller Karl, Musella Mario, Nimeri Abdelrahman, Noel Patrick, Palermo Mariano, Poggi Luis, Poghosyan Tigran, Prager Gerhard, Prasad Arun, Alqahtani Aayad, Rheinwalt Karl, Ribeiro Rui, Shabbir Asim, Torres Antonio, Villalonga Ramon, Wang Cunchuan, Mahawar Kamal, Zundel Natan
Аннотация
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.