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Pouwels S, Omar I, Aggarwal S, Aminian A, Angrisani L, Balibrea JM, Bhandari M, Biter LU, Blackstone RP, Carbajo MA, Copaescu CA, Dargent J, Elfawal MH, Fobi MA, Greve JW, Hazebroek EJ, Herrera MF, Himpens JM, Hussain FA, Kassir R, Kerrigan D, Khaitan M, Kow L, Kristinsson J, Kurian M, Lutfi RE, Moore RL, Noel P, Ozmen MM, Ponce J, Prager G, Purkayastha S, Rafols JP, Ramos AC, Ribeiro RJS, Sakran N, Salminen P, Shabbir A, Shikora SA, Singhal R, Small PK, Taylor CJ, Torres AJ, Vaz C, Yashkov Y, Mahawar K. The First Modified Delphi Consensus Statement for Resuming Bariatric and Metabolic Surgery in the COVID-19 Times. Obes Surg 2020; 31:451-456. [PMID: 32740826 PMCID: PMC7395568 DOI: 10.1007/s11695-020-04883-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/20/2020] [Accepted: 07/28/2020] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to achieve consensus amongst a global panel of expert bariatric surgeons on various aspects of resuming Bariatric and Metabolic Surgery (BMS) during the Coronavirus Disease-2019 (COVID-19) pandemic. A modified Delphi consensus-building protocol was used to build consensus amongst 44 globally recognised bariatric surgeons. The experts were asked to either agree or disagree with 111 statements they collectively proposed over two separate rounds. An agreement amongst ≥ 70.0% of experts was construed as consensus as per the predetermined methodology. We present here 38 of our key recommendations. This first global consensus statement on the resumption of BMS can provide a framework for multidisciplinary BMS teams planning to resume local services as well as guide future research in this area.
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Affiliation(s)
- Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth Tweesteden Hospital, Tilburg, The Netherlands
| | - Islam Omar
- Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, SR4 7TP, UK
| | - Sandeep Aggarwal
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | | | - Luigi Angrisani
- Public Health Department - Federico II School of Medicine, University of Naples, Naples, Italy
| | | | - Mohit Bhandari
- Mohak Bariatric and Robotic Surgery Center Indore, Indore, India
| | - L Ulas Biter
- Franciscus Gasthuis Rotterdam, Rotterdam, The Netherlands
| | | | - Miguel A Carbajo
- Center of Excellence for the Study and Treatment of the Obesity and Diabetes, Valladolid, Spain
| | | | | | | | - Mathias A Fobi
- Mohak Bariatric and Robotic Surgery Center Indore, Indore, India
| | - Jan-Willem Greve
- Zuyerland Medical Center, University of Maastricht, Maastricht, The Netherlands
| | | | - Miguel F Herrera
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
| | | | | | - Radwan Kassir
- Department of Bariatric Surgery, CHU Félix Guyon, Saint Denis, La Réunion, France
| | | | | | - Lilian Kow
- Flinders University, Adelaide, South Australia, Australia
| | | | - Marina Kurian
- New York University School of Medicine, New York, NY, USA
| | | | | | - Patrick Noel
- Bouchard Private Hospital, Elsan, Marseille, France.,Mediclinic Parkview, Dubai, United Arab Emirates
| | | | | | | | | | | | | | | | | | - Paulina Salminen
- Turku University Hospital, Turku, Finland.,Satasairaala Central Hospital, Pori, Finland
| | - Asim Shabbir
- National University Hospital, Singapore, Singapore
| | - Scott A Shikora
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Rishi Singhal
- Birmingham Heartlands Hospital, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | - Peter K Small
- Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, SR4 7TP, UK.,Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
| | - Craig J Taylor
- Concord Repatriation General Hospital, Sydney, Australia
| | - Antonio J Torres
- Hospital Clinico San Carlos, Universidad Complutense Madrid, IdISSC, Madrid, Spain
| | | | | | - Kamal Mahawar
- Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, SR4 7TP, UK. .,Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK.
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Sanches E, Topal B, Proczko M, Stepaniak PS, Severin R, Phillips SA, Sabbahi A, Pujol Rafols J, Pouwels S. Endothelial function in obesity and effects of bariatric and metabolic surgery. Expert Rev Cardiovasc Ther 2020; 18:343-353. [DOI: 10.1080/14779072.2020.1767594] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Elijah Sanches
- Department of Surgery, Haaglanden Medical Center, The Hague, The Netherlands
| | - Besir Topal
- Department of Cardiothoracic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Monika Proczko
- Department of General, Endocrine and Transplant Surgery, University Medical Center, Gdansk University, Gdansk, Poland
| | - Pieter S. Stepaniak
- Department of Operating Rooms, Catharina Hospital, Eindhoven, The Netherlands
| | - Rich Severin
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
- Doctor of Physical Therapy Program, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Shane A. Phillips
- Department of Physical Therapy, Integrative Physiologic Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Ahmad Sabbahi
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
- Department of Physical Therapy, Integrative Physiologic Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
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Sanches E, Timmermans M, Topal B, Celik A, Sundbom M, Ribeiro R, Parmar C, Ugale S, Proczko M, Stepaniak PS, Pujol Rafols J, Mahawar K, Buise MP, Neimark A, Severin R, Pouwels S. Cardiac remodeling in obesity and after bariatric and metabolic surgery; is there a role for gastro-intestinal hormones? Expert Rev Cardiovasc Ther 2019; 17:771-790. [PMID: 31746657 DOI: 10.1080/14779072.2019.1690991] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: Obesity is associated with various diseases such as type 2 diabetes, hypertension, obstructive sleep apnea syndrome (OSAS), metabolic syndrome, and cardiovascular diseases. It affects several organ systems, including the pulmonary and cardiac systems. Furthermore, it induces pulmonary and cardiac changes that can result in right and/or left heart failure.Areas covered: In this review, authors provide an overview of obesity and cardiovascular remodeling, the individual actions of the gut hormones (like GLP-1 and PYY), the effects after bariatric/metabolic surgery and its influence on cardiac remodeling. In this review, we focussed and searched for literature in Pubmed and The Cochrane library (from the earliest date until April 2019), regarding cardiac function changes before and after bariatric surgery and literature regarding changes in gastrointestinal hormones.Expert opinion: Regarding the surgical treatment of obesity and metabolic diseases there is recognition of the importance of both weight loss (bariatric surgery) and improvement in metabolic milieu (metabolic surgery). A growing body of evidence further suggests that bariatric surgical procedures [like the Sleeve Gastrectomy (SG), Roux-en Y Gastric Bypass (RYGB), or One Anastomosis Gastric Bypass (OAGB)] have can improve outcomes of patients suffering from a number of cardiovascular diseases, including heart failure.
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Affiliation(s)
- Elijah Sanches
- Department of Surgery, Haaglanden Medical Center, The Hague, The Netherlands
| | - Marieke Timmermans
- Department of Surgery, Haaglanden Medical Center, The Hague, The Netherlands
| | - Besir Topal
- Department of Cardiothoracic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Alper Celik
- Department of Bariatric and Metabolic Surgery, Metabolic Surgery Clinic, Sisli, Turkey
| | - Magnus Sundbom
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Rui Ribeiro
- Centro Multidisciplinar da Doença Metabólica, Clínica de Santo António, Lisbon, Portugal
| | - Chetan Parmar
- Department of Surgery, Whittington Hospital, London, UK
| | - Surendra Ugale
- Bariatric & Metabolic Surgery Clinic, Kirloskar Hospital, Hyderabad, India
| | - Monika Proczko
- Department of General, Endocrine and Transplant Surgery, University Medical Center, Gdansk University, Gdansk, Poland
| | - Pieter S Stepaniak
- Department of Operating Rooms, Catharina Hospital, Eindhoven, The Netherlands
| | | | - Kamal Mahawar
- Bariatric Unit, Sunderland Royal Hospital, Sunderland, UK
| | - Marc P Buise
- Department of Anesthesiology, Intensive Care and Pain Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | - Aleksandr Neimark
- Department of Surgery, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Rich Severin
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA.,Doctor of Physical Therapy Program, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Sjaak Pouwels
- Department of Surgery, Haaglanden Medical Center, The Hague, The Netherlands
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Pujol Rafols J, Al Abbas AI, Devriendt S, Guerra A, Herrera MF, Himpens J, Pardina E, Peinado-Onsurbe J, Ramos A, Ribeiro RJDS, Safadi B, Sanchez-Aguilar H, de Vries C, Van Wagensveld B. Roux-en-Y gastric bypass, sleeve gastrectomy, or one anastomosis gastric bypass as rescue therapy after failed adjustable gastric banding: a multicenter comparative study. Surg Obes Relat Dis 2018; 14:1659-1666. [PMID: 30236443 DOI: 10.1016/j.soard.2018.08.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 07/30/2018] [Accepted: 08/02/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND To date, laparoscopic adjustable gastric banding remains the third most commonly performed surgical procedure for weight loss. Some patients fail to get acceptable outcomes and undergo revisional surgery at rates ranging from 7% to 60%. Roux-en-Y gastric bypass (RYGB), one anastomosis gastric bypass (OAGB), and sleeve gastrectomy (SG) are among the most common salvage options for failed laparoscopic adjustable gastric banding. OBJECTIVE To compare the outcomes of converting failed laparoscopic adjustable gastric banding to RYGB, OAGB, or SG. METHODS Data collected from 7 experienced bariatric centers around the world were retrospectively collected, reviewed, and analyzed. Final body mass index (BMI), change in BMI, percentage excess BMI loss, and major complications with particular attention to leaks, hemorrhage, and mortality were reported. RESULTS Of 1219 patients analyzed, 74% underwent RYGB, 16% underwent OAGB, and 10% underwent SG after banding failure. The mean age was 38 years (±10 yr), and 82% of patients were women. The mean follow-up was 33 months. The follow-up rate was 100%, 87%, and 52% at 1, 3, and 5 years, respectively. At the latest follow-up, percentage excess BMI loss >50% was achieved by 75% of RYGB, 85% of OAGB, and 67% of SG patients. Postoperative complications occurred in 13% of patients after RYGB, 5% after OAGB, and 15% after SG. CONCLUSION Our data show that it is possible to achieve or maintain significant weight loss with an acceptable complication rate with all 3 surgical options.
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Affiliation(s)
| | - Amr I Al Abbas
- American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
| | - Stefanie Devriendt
- AZ Sint Blasius, Dendermonde, Belgium and CHIREC Hospitals, Brussels, Belgium
| | | | - Miguel F Herrera
- Instituto Nacional de Nutrición. Centro Médico ABC, México City, México
| | - Jacques Himpens
- AZ Sint Blasius, Dendermonde, Belgium and CHIREC Hospitals, Brussels, Belgium
| | - Eva Pardina
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - Julia Peinado-Onsurbe
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - Almino Ramos
- GastroObeso-Center - Advanced Institute In Bariatric And Metabolic Surgery, Sao Paulo, Brazil
| | | | - Bassem Safadi
- American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
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