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Kermansaravi M, Shahmiri SS, Kow L, Gawdat K, Abbas SI, Aly A, Bashir A, Bhandari M, Haddad A, ElFawal MH, Inam A, Kasama K, Kim SH, Kular KS, Lakdawala M, Layani LA, Lee WJ, Pazouki A, Prasad A, Safadi B, Wang C, Yang W, Adib R, Jazi AHD, Shabbir A. Technical Variations and Considerations around OAGB in IFSO-APC and IFSO-MENAC Chapters, an Expert Survey. Obes Surg 2024:10.1007/s11695-024-07239-9. [PMID: 38662251 DOI: 10.1007/s11695-024-07239-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 03/06/2024] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE This study aimed to evaluate the technical variations of one-anastomosis gastric bypass (OAGB) among IFSO-APC and MENAC experts. BACKGROUND The multitude of technical variations and patient selection challenges among metabolic and bariatric surgeons worldwide necessitates a heightened awareness of these issues. Understanding different perspectives and viewpoints can empower surgeons performing OAGB to adapt their techniques, leading to improved outcomes and reduced complications. METHODS The scientific team of IFSO-APC, consisting of skilled bariatric and metabolic surgeons specializing in OAGB, conducted a confidential online survey. The survey aimed to assess technical variations and considerations related to OAGB within the IFSO-APC and IFSO-MENAC chapters. A total of 85 OAGB experts participated in the survey, providing their responses through a 35-question online format. The survey took place from January 1, 2024, to February 15, 2024. RESULTS Most experts do not perform OAGB for children and adolescents younger than 18 years. Most experts create the gastric pouch over a 36-40-F bougie and prefer to create a gastrojejunostomy, at the posterior wall of the gastric pouch. An anti-reflux suture during OAGB is performed in all patients by 51.8% of experts. Most experts set a common limb length of > 4 m in revisional and conversional OAGBs to prevent nutritional complications. CONCLUSION The ongoing debate among metabolic and bariatric surgeons regarding the technical variations and patient selection in OAGB remains a significant point of discussion. This survey demonstrated the variations in technical aspects and patient selection for OAGB among MBS surgeons in the IFSO-APC and IFSO-MENAC chapters. Standardizing the OAGB technique is crucial to ensure optimal safety and efficacy in this procedure.
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Affiliation(s)
- Mohammad Kermansaravi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat‑E Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Shahab Shahabi Shahmiri
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat‑E Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Lilian Kow
- Adelaide Bariatric Centre, Flinders University of South Australia, Adelaide, Australia
| | - Khaled Gawdat
- Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Ahmad Aly
- Austin and Repatriation Medical Centre, Heidelberg, Victoria, Australia
- University of Melbourne, Melbourne, Australia
| | - Ahmad Bashir
- Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC), Jordan Hospital, Amman, Jordan
| | | | - Ashraf Haddad
- Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC), Jordan Hospital, Amman, Jordan
| | | | - Atif Inam
- Metabolic, Thoracic & General Surgery Unit III, Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Kazunori Kasama
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Sang Hyun Kim
- Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | | | | | | | - Wei-Jei Lee
- Medical Weight Loss Center, China Medical University Hsinchu Hospital, Zhubei, Taiwan
| | - Abdolreza Pazouki
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat‑E Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | | | - Cunchuan Wang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Reza Adib
- The Wesley Hospital, Auchenflower, Queensland, Australia
| | - Amir Hossein Davarpanah Jazi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat‑E Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Asim Shabbir
- National University of Singapore, Singapore, Singapore
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Kermansaravi M, Chiappetta S, Parmar C, Shikora SA, Prager G, LaMasters T, Ponce J, Kow L, Nimeri A, Kothari SN, Aarts E, Abbas SI, Aly A, Aminian A, Bashir A, Behrens E, Billy H, Carbajo MA, Clapp B, Chevallier JM, Cohen RV, Dargent J, Dillemans B, Faria SL, Neto MG, Garneau PY, Gawdat K, Haddad A, ElFawal MH, Higa K, Himpens J, Husain F, Hutter MM, Kasama K, Kassir R, Khan A, Khoursheed M, Kroh M, Kurian MS, Lee WJ, Loi K, Mahawar K, McBride CL, Almomani H, Melissas J, Miller K, Misra M, Musella M, Northup CJ, O'Kane M, Papasavas PK, Palermo M, Peterson RM, Peterli R, Poggi L, Pratt JSA, Alqahtani A, Ramos AC, Rheinwalt K, Ribeiro R, Rogers AM, Safadi B, Salminen P, Santoro S, Sann N, Scott JD, Shabbir A, Sogg S, Stenberg E, Suter M, Torres A, Ugale S, Vilallonga R, Wang C, Weiner R, Zundel N, Angrisani L, De Luca M. Current recommendations for procedure selection in class I and II obesity developed by an expert modified Delphi consensus. Sci Rep 2024; 14:3445. [PMID: 38341469 PMCID: PMC10858961 DOI: 10.1038/s41598-024-54141-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/08/2024] [Indexed: 02/12/2024] Open
Abstract
Metabolic and bariatric surgery (MBS) is widely considered the most effective option for treating obesity, a chronic, relapsing, and progressive disease. Recently, the American Society of Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) issued new guidelines on the indications for MBS, which have superseded the previous 1991 National Institutes of Health guidelines. The aim of this study is to establish the first set of consensus guidelines for selecting procedures in Class I and II obesity, using an Expert Modified Delphi Method. In this study, 78 experienced bariatric surgeons from 32 countries participated in a two-round Modified Delphi consensus voting process. The threshold for consensus was set at an agreement or disagreement of ≥ 70.0% among the experts. The experts reached a consensus on 54 statements. The committee of experts reached a consensus that MBS is a cost-effective treatment option for Class II obesity and for patients with Class I obesity who have not achieved significant weight loss through non-surgical methods. MBS was also considered suitable for patients with Type 2 diabetes mellitus (T2DM) and a body mass index (BMI) of 30 kg/m2 or higher. The committee identified intra-gastric balloon (IGB) as a treatment option for patients with class I obesity and endoscopic sleeve gastroplasty (ESG) as an option for patients with class I and II obesity, as well as for patients with T2DM and a BMI of ≥ 30 kg/m2. Sleeve gastrectomy (1) and Roux-en-Y gastric bypass (RYGB) were also recognized as viable treatment options for these patient groups. The committee also agreed that one anastomosis gastric bypass (OAGB) is a suitable option for patients with Class II obesity and T2DM, regardless of the presence or severity of obesity-related medical problems. The recommendations for selecting procedures in Class I and II obesity, developed through an Expert Modified Delphi Consensus, suggest that the use of standard primary bariatric endoscopic (IGB, ESG) and surgical procedures (SG, RYGB, OAGB) are acceptable in these patient groups, as consensus was reached regarding these procedures. However, randomized controlled trials are still needed in Class I and II Obesity to identify the best treatment approach for these patients in the future.
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Affiliation(s)
- Mohammad Kermansaravi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat-e Fatemeh Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - Sonja Chiappetta
- Department of General and Laparoscopic Surgery, Obesity and Metabolic Surgery Unit, Ospedale Evangelico Betania, Naples, Italy.
| | | | - Scott A Shikora
- Department of Surgery, Center for Metabolic and Bariatric Surgery, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
| | | | - Teresa LaMasters
- Unitypoint Clinic Weight Loss Specialists, West Des Moines, IA, USA
- Department of Surgery, University of Iowa, Iowa City, IA, USA
| | - Jaime Ponce
- Bariatric Surgery Program, CHI Memorial Hospital, Chattanooga, TN, USA
| | - Lilian Kow
- Adelaide Bariatric Centre, Flinders University of South Australia, Adelaide, Australia
| | - Abdelrahman Nimeri
- Department of Surgery, Center for Metabolic and Bariatric Surgery, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
| | - Shanu N Kothari
- Prisma Health, Department of Surgery, University of South Carolina School of Medicine, Greenville, SC, USA
| | - Edo Aarts
- WeightWorks Clinics and Allurion Clinics, Amersfoort, The Netherlands
| | | | - Ahmad Aly
- Austin and Repatriation Medical Centre, University of Melbourne, Heidelberg, VIC, Australia
| | - Ali Aminian
- Department of General Surgery, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Ahmad Bashir
- Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Amman, Jordan
| | | | - Helmuth Billy
- Ventura Advanced Surgical Associates, Ventura, CA, USA
| | - Miguel A Carbajo
- Centre of Excellence for the Study and Treatment of Obesity and Diabetes, Valladolid, Spain
| | - Benjamin Clapp
- Department of Surgery, Texas Tech HSC Paul Foster School of Medicine, El Paso, TX, USA
| | | | - Ricardo V Cohen
- Center for the Treatment of Obesity and Diabetes, Hospital Alemão Oswaldo Cruz, Sao Paolo, Brazil
| | | | - Bruno Dillemans
- Department of General Surgery, AZ Sint Jan Brugge-Oostende, Bruges, Belgium
| | - Silvia L Faria
- Gastrocirurgia de Brasilia, University of Brasilia, Brasilia, Brazil
| | | | - Pierre Y Garneau
- Division of Bariatric Surgery, CIUSSS-NIM, Montreal, Canada
- Department of Surgery, Université de Montréal, Montréal, Canada
| | - Khaled Gawdat
- Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ashraf Haddad
- Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Amman, Jordan
| | | | - Kelvin Higa
- Fresno Heart and Surgical Hospital, UCSF Fresno, Fresno, CA, USA
| | - Jaques Himpens
- Bariatric Surgery Unit, Delta Chirec Hospital, Brussels, Belgium
| | - Farah Husain
- University of Arizona College of Medicine, Phoenix, USA
| | - Matthew M Hutter
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Kazunori Kasama
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Radwan Kassir
- Department of Digestive Surgery, CHU Félix Guyon, Saint Denis, La Réunion, France
| | - Amir Khan
- Walsall Healthcare NHS Trust, Walsall, UK
| | | | - Matthew Kroh
- Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Marina S Kurian
- Department of Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Wei-Jei Lee
- Medical Weight Loss Center, China Medical University Shinchu Hospital, Zhubei City, Taiwan
| | - Ken Loi
- Director of St George Surgery, Sydney, Australia
| | - Kamal Mahawar
- South Tyneside and Sunderland Foundation NHS Trust, Sunderland, UK
| | | | | | - John Melissas
- Bariatric Unit, Heraklion University Hospital, University of Crete, Crete, Greece
| | - Karl Miller
- Diakonissen Wehrle Private Hospital, Salzburg, Austria
| | | | - Mario Musella
- Advanced Biomedical Sciences Department, Federico II" University, Naples, Italy
| | | | - Mary O'Kane
- Department of Nutrition and Dietetics, Leeds Teaching Hospitals, NHS Trust, Leeds, UK
| | - Pavlos K Papasavas
- Division of Metabolic and Bariatric Surgery, Hartford Hospital, Hartford, CT, USA
| | - Mariano Palermo
- Department of Surgery, Centro CIEN-Diagnomed, University of Buenos Aires, Buenos Aires, Argentina
| | - Richard M Peterson
- Department of General and Minimally Invasive Surgery, UT Health San Antonio, San Antonio, TX, USA
| | - Ralph Peterli
- Department of Visceral Surgery, Clarunis, University Digestive Health Care Center, St. Clara Hospital and University Hospital Basel, Basel, Switzerland
| | - Luis Poggi
- Department of Surgery Clinica Anglo Americana, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Janey S A Pratt
- Department of Surgery, Stanford School of Medicine, VA Palo Alto Health Care System, 3801 Miranda Avenue, GS 112, Palo Alto, CA, 94304, USA
| | - Aayad Alqahtani
- New You Medical Center, King Saud University, Obesity Chair, Riyadh, Saudi Arabia
| | - Almino C Ramos
- Medical Director of Gastro-Obeso-Center, Institute for Metabolic Optimization, Sao Paulo, Brazil
| | - Karl Rheinwalt
- Department of Bariatric, Metabolic, and Plastic Surgery, St. Franziskus Hospital, Cologne, Germany
| | - Rui Ribeiro
- Centro Multidisciplinar Do Tratamento da Obesidade, Hospital Lusíadas Amadora e Lisbon, Amadora, Portugal
| | - Ann M Rogers
- Department of Surgery - Division of Minimally Invasive and Bariatric Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | | | - Paulina Salminen
- Division of Digestive Surgery and Urology, Department of Digestive Surgery, Turku University Hospital, Turku, Finland
| | - Sergio Santoro
- Hospital Israelita Albert Einstein, Av. Albert Einstein, 627, São Paulo, 05652-900, Brazil
| | - Nathaniel Sann
- Advanced Surgical Partners of Virginia, Richmond, VA, USA
| | - John D Scott
- Division of Bariatric and Minimal Access Surgery, Department of Surgery, University of South Carolina School of Medicine, Greenville, SC, USA
| | - Asim Shabbir
- National University of Singapore, Singapore, Singapore
| | - Stephanie Sogg
- Massachusetts General Hospital Weight Center, Boston, MA, USA
| | - Erik Stenberg
- Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Michel Suter
- Department of Surgery, Riviera-Chablais Hospital, Rennaz, Switzerland
| | - Antonio Torres
- Department of Surgery, Hospital Clínico San Carlos, Complutense University of Madrid, Calle del Prof Martín Lagos, S/N, 28040, Madrid, Spain
| | - Surendra Ugale
- Kirloskar and Virinchi Hospitals, Hyderabad, Telangana, India
| | - Ramon Vilallonga
- Endocrine, Bariatric, and Metabolic Surgery Department, Universitary Hospital Vall Hebron, Barcelona, Spain
| | - Cunchuan Wang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Rudolf Weiner
- Bariatric Surgery Unit, Sana Clinic Offenbach, Offenbach, Germany
| | - Natan Zundel
- Department of Surgery, University of Buffalo, Buffalo, NY, USA
| | - Luigi Angrisani
- Department of Public Health, Federico II University of Naples, Naples, Italy
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Kermansaravi M, Husain FA, Bashir A, Valizadeh R, Abbas SI, Abouzeid T, Amini M, Davarpanah Jazi AH, Elfawal MH, Gado W, Gee T, Habeeb TAAM, Al Hadhrami B, Inam A, Vaziri NM, Mokhber S, Al-Momani H, Omerov T, Pazouki A, Rezapanah A, Rezvani M, Sadat Mansouri M, Sewefy AM, Taskin HE, Yunus T, Kassir R, Nimeri A. International survey on complications of religious fasting after metabolic and bariatric surgery. Sci Rep 2023; 13:20189. [PMID: 37980363 PMCID: PMC10657384 DOI: 10.1038/s41598-023-47673-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 11/16/2023] [Indexed: 11/20/2023] Open
Abstract
Religious fasting in Ramadan the 9th month of the lunar year is one of five pillars in Islam and is practiced for a full month every year. There may be risks with fasting in patients with a history of metabolic/bariatric surgery (MBS). There is little published evidence on the possible complications during fasting and needs stronger recommendations and guidance to minimize them. An international survey was sent to surgeons to study the types of complications occurring during religious fasting in patients with history of MBS to evaluate the risk factors to manage and prepare more evidence-based recommendations. In total, 21 centers from 11 countries participated in this survey and reported a total of 132 patients with complications occurring during religious fasting after MBS. The mean age of patients with complications was 36.65 ± 3.48 years and mean BMI was 43.12 ± 6.86 kg/m2. Mean timing of complication occurring during fasting after MBS was 14.18 months. The most common complications were upper GI (gastrointestinal) symptoms including [gastroesophageal reflux disease (GERD), abdominal pain, and dyspepsia], marginal ulcers and dumping syndrome in 24% (32/132), 8.3% (11/132) and 23% (31/132) patients respectively. Surgical management was necessary in 4.5% of patients presenting with complications (6/132) patients due to perforated marginal or peptic ulcer in Single Anastomosis Duodenoileostomy with Sleeve gastrectomy (SADI-S), one anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG), obstruction at Jejunojenostomy after Roux-en-Y gastric bypass (RYGB) (1/6) and acute cholecystitis (1/6). Patients after MBS should be advised about the risks while fasting including abdominal pain, dehydration, and peptic ulcer disease exacerbation, and a thorough review of their medications is warranted to minimize complications.
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Affiliation(s)
- Mohammad Kermansaravi
- Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Minimally Invasive Surgery Research Center, Rasool-E Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Farah A Husain
- Department of Surgery, Banner University of Arizona-Phoenix, Phoenix, USA
| | - Ahmad Bashir
- Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Amman, Jordan
| | | | | | - Tarek Abouzeid
- Department of Surgery, Ain-Shams University, Cairo, Egypt
| | - Masoud Amini
- Laparoscopy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Waleed Gado
- Endocrine and Bariatric Surgery Unit, Mansoura University, Mansoura, Egypt
| | - Tikfu Gee
- Department of Medical Science, School of Healthcare and Medical Sciences, Sunway University Jalan University, Selangor Darul Ehsan, Bandar Sunway, Petaling Jaya, Malaysia
| | - Tamer A A M Habeeb
- Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | - Atif Inam
- In Charge Metabolic, Thoracic and General Surgery Unit III, Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Nader Moein Vaziri
- Laparoscopy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Somayyeh Mokhber
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Taryel Omerov
- First Surgical Disease Department, Azerbaijan Medical University, Baku, Azerbaijan
| | - Abdolreza Pazouki
- Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Minimally Invasive Surgery Research Center, Rasool-E Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Rezapanah
- Department of Surgery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoud Rezvani
- Inova Fair Oaks Hospital, COE Bariatric Center, 14904 Jefferson Davis Hwy, Suite 205, Woodbridge, VA, 22191, USA
| | | | - Alaa M Sewefy
- Department of Surgery, Minia University Hospital, Minia, Egypt
| | - Halit Eren Taskin
- Cerrahpasa Medical Faculty, Department of Surgery, Istanbul University Cerrahpasa, Istanbul, Turkey
| | | | - Radwan Kassir
- Department of Digestive Surgery, Centre Hospitalier Universitaire Félix Guyon, St Denis de La Réunion, France
| | - Abdelrahman Nimeri
- Department of Surgery, Center for Metabolic and Bariatric Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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Shahmiri SS, Parmar C, Yang W, Lainas P, Pouwels S, DavarpanahJazi AH, Chiappetta S, Seki Y, Omar I, Vilallonga R, Kassir R, Abbas SI, Bashir A, Singhal R, Kow L, Kermansaravi M. Bariatric and metabolic surgery in patients with low body mass index: an online survey of 543 bariatric and metabolic surgeons. BMC Surg 2023; 23:272. [PMID: 37689633 PMCID: PMC10492360 DOI: 10.1186/s12893-023-02175-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/29/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND Metabolic and bariatric surgery (MBS) in patients with low body mass index patients is a topic of debate. This study aimed to address all aspects of controversies in these patients by using a worldwide survey. METHODS An online 35-item questionnaire survey based on existing controversies surrounding MBS in class 1 obesity was created by 17 bariatric surgeons from 10 different countries. Responses were collected and analysed by authors. RESULTS A total of 543 bariatric surgeons from 65 countries participated in this survey. 52.29% of participants agreed with the statement that MBS should be offered to class-1 obese patients without any obesity related comorbidities. Most of the respondents (68.43%) believed that MBS surgery should not be offered to patients under the age of 18 with class I obesity. 81.01% of respondents agreed with the statement that surgical interventions should be considered after failure of non-surgical treatments. CONCLUSION This survey demonstrated worldwide variations in metabolic/bariatric surgery in patients with class 1 obesity. Precise analysis of these results is useful for identifying different aspects for future research and consensus building.
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Affiliation(s)
- Shahab Shahabi Shahmiri
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, School of Medicine, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
- Centre of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat_e Rasool Hospital, Tehran, Iran
- Iran National Centre of Excellence for Minimally Invasive Surgery Education, Iran University of Medical Sciences, Tehran, Iran
| | - Chetan Parmar
- Consultant Surgeon and Head of Department, Whittington Hospital, London, UK
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Panagiotis Lainas
- Department of Surgery, Metropolitan Hospital, HEAL Academy, Athens, Greece
- Department of Minimally Invasive Digestive Surgery, Antoine-Béclère Hospital, Paris-Saclay University, Clamart, France
| | - Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands
| | - Amir Hossein DavarpanahJazi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, School of Medicine, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
- Centre of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat_e Rasool Hospital, Tehran, Iran
- Iran National Centre of Excellence for Minimally Invasive Surgery Education, Iran University of Medical Sciences, Tehran, Iran
| | - Sonja Chiappetta
- Obesity and Metabolic Surgery Unit, Ospedale Evangelico Betania, Naples, Italy
| | - Yosuke Seki
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Islam Omar
- Wirral University Teaching Hospital, Birkenhead, UK
| | - Ramon Vilallonga
- Obesity and Metabolic Surgery Unit, Vall Hebron Campus Hospital, Barcelona, Spain
| | - Radwan Kassir
- Department of Digestive Surgery, CHU Félix Guyon, Saint Denis, La Réunion, France
| | - Syed Imran Abbas
- Director Obesity & Metabolic Surgery Clinic, Iranian Hospital Dubai, UAE. CEO & Founder of GLR International, Dubai, UAE
| | | | - Rishi Singhal
- Consultant Bariatric & Upper GI Surgeon, Birmingham Heartlands Hospital, University Hospital Birmingham, UK. Honorary Senior Lecturer, University of Birmingham, Medical Director, Healthier Weight, Birmingham, UK
| | - Lilian Kow
- Flinders University South Australia, Adelaide, Australia
| | - Mohammad Kermansaravi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, School of Medicine, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
- Centre of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat_e Rasool Hospital, Tehran, Iran.
- Iran National Centre of Excellence for Minimally Invasive Surgery Education, Iran University of Medical Sciences, Tehran, Iran.
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Kermansaravi M, Parmar C, Chiappetta S, Shahabi S, Abbass A, Abbas SI, Abouzeid M, Antozzi L, Asghar ST, Bashir A, Bhandari M, Billy H, Caina D, Campos FJ, Carbajo MA, Chevallier JM, Jazi AHD, de Gordejuela AGR, Haddad A, ElFawal MH, Himpens J, Inam A, Kassir R, Kasama K, Khan A, Kow L, Kular KS, Lakdawala M, Layani LA, Lee WJ, Luque-de-León E, Loi K, Mahawar K, Mahdy T, Musella M, Nimeri A, González JCO, Pazouki A, Poghosyan T, Prager G, Prasad A, Ramos AC, Rheinwalt K, Ribeiro R, Ruiz-Úcar E, Rutledge R, Shabbir A, Shikora S, Singhal R, Taha O, Talebpour M, Verboonen JS, Wang C, Weiner R, Yang W, Vilallonga R, De Luca M. Patient Selection in One Anastomosis/Mini Gastric Bypass-an Expert Modified Delphi Consensus. Obes Surg 2022; 32:2512-2524. [PMID: 35704259 DOI: 10.1007/s11695-022-06124-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 05/20/2022] [Accepted: 05/25/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE One anastomosis/mini gastric bypass (OAGB/MGB) is up to date the third most performed obesity and metabolic procedure worldwide, which recently has been endorsed by ASMBS. The main criticisms are the risk of bile reflux, esophageal cancer, and malnutrition. Although IFSO has recognized this procedure, guidance is needed regarding selection criteria. To give clinicians a daily support in performing the right patient selection in OAGB/MGB, the aim of this paper is to generate clinical guidelines based on an expert modified Delphi consensus. METHODS A committee of 57 recognized bariatric surgeons from 24 countries created 69 statements. Modified Delphi consensus voting was performed in two rounds. An agreement/disagreement among ≥ 70.0% of the experts was considered to indicate a consensus. RESULTS Consensus was achieved for 56 statements. Remarkably, ≥ 90.0% of the experts felt that OAGB/MGB is an acceptable and suitable option "in patients with Body mass index (BMI) > 70, BMI > 60, BMI > 50 kg/m2 as a one-stage procedure," "as the second stage of a two-stage bariatric surgery after Sleeve Gastrectomy for BMI > 50 kg/m2 (instead of BPD/DS)," and "in patients with weight regain after restrictive procedures. No consensus was reached on the statement that OAGB/MGB is a suitable option in case of resistant Helicobacter pylori. This is likely as there is a concern that this procedure is associated with reflux and its related long-term complications including risk of cancer in the esophagus or stomach. Also no consensus reached on OAGB/MGB as conversional surgery in patients with GERD after restrictive procedures. Consensus for disagreement was predominantly achieved "in case of intestinal metaplasia of the stomach" (74.55%), "in patients with severe Gastro Esophageal Reflux Disease (GERD)(C,D)" (75.44%), "in patients with Barrett's metaplasia" (89.29%), and "in documented insulinoma" (89.47%). CONCLUSION Patient selection in OAGB/MGB is still a point of discussion among experts. There was consensus that OAGB/MGB is a suitable option in elderly patients, patients with low BMI (30-35 kg/m2) with associated metabolic problems, and patients with BMIs more than 50 kg/m2 as one-stage procedure. OAGB/MGB can also be a safe procedure in vegetarian and vegan patients. Although OAGB/MGB can be a suitable procedure in patients with large hiatal hernia with concurrent hiatal hernia, it should not be offered to patients with grade C or D esophagitis or Barrett's metaplasia.
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Affiliation(s)
- Mohammad Kermansaravi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | | | - Sonja Chiappetta
- Obesity and Metabolic Surgery Unit, Ospedale Evangelico Betania, Naples, Italy
| | - Shahab Shahabi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Alaa Abbass
- Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, 11591, Egypt
| | | | - Mohamed Abouzeid
- Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, 11591, Egypt
| | | | | | - Ahmad Bashir
- Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Amman, Jordan
| | | | - Helmuth Billy
- Ventura Advanced Surgical Associates, Ventura, CA, USA
| | - Daniel Caina
- Dr. Federico Abete Hospital for Trauma and Emergency, Obesity and Metabolic Center, Malvinas, Argentina
| | | | - Miguel-A Carbajo
- Centre of Excellence for the Study and Treatment of Obesity and Diabetes, Valladolid, Spain
| | | | - Amir Hossein Davarpanah Jazi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | | | - Ashraf Haddad
- Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Amman, Jordan
| | | | - Jacques Himpens
- Bariatric Surgery Unit, Delta Chirec Hospital, Brussels, Belgium
| | - Aatif Inam
- Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Radwan Kassir
- Department of Digestive Surgery, CHU Félix Guyon, Saint Denis, La Réunion, France
| | - Kazunori Kasama
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Amir Khan
- Walsall Healthcare NHS Trust, Walsall, UK
| | - Lilian Kow
- Flinders Medical Centre, Adelaide, Australia
| | | | | | | | - Wei-Jei Lee
- Min-Sheng General Hospital, Taoyuan City, Taiwan
| | | | - Ken Loi
- St George Surgery, Sydney, Australia
| | - Kamal Mahawar
- South Tyneside and Sunderland Foundation NHS Trust, Sunderland, UK
| | - Tarek Mahdy
- Mansoura Faculty of Medicine, Sharjah University Hospital, Sharjah, UAE
| | - Mario Musella
- Advanced Biomedical Sciences Department, "Federico II" University, Naples, Italy
| | | | | | - Abdolreza Pazouki
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Tigran Poghosyan
- Hôpital Européen-Georges Pompidou, AP-HP, Université de Paris, Paris, France
| | | | | | | | - Karl Rheinwalt
- Department of Bariatric, Metabolic and Plastic Surgery, St. Franziskus Hospital, Cologne, Germany
| | - Rui Ribeiro
- Centro de Excelencia Para a Cirurgia MetabolicaGrupo Lusiadas, Lisbon, Portugal
| | - Elena Ruiz-Úcar
- Bariatric and Metabolic Surgery Department, University Hospital of Fuenlabrada, Madrid, Spain
| | - Robert Rutledge
- International Center for Laparoscopic Obesity Surgery, Punjab, India
| | - Asim Shabbir
- National University of Singapore, Singapore, Singapore
| | - Scott Shikora
- Department of Surgery Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Rishi Singhal
- University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | - Osama Taha
- Plastic and Obesity Surgery Department, Bariatric Unit, Assiut University Hospital, Assiut, Egypt
| | - Mohammad Talebpour
- Department of General Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Cunchuan Wang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Rudolf Weiner
- Bariatric Surgery Unit, Sana Clinic Offenbach, Offenbach, Germany
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Ramon Vilallonga
- Endocrine, Bariatric and Metabolic Surgery Department, Universitary Hospital Vall Hebron, Barcelona, Spain
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6
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Kermansaravi M, Shahmiri SS, Khalaj A, Jalali SM, Amini M, Alamdari NM, Mahmoudieh M, Jangjoo A, Abbas SI, Naeini SMM, Sayadishahraki M, Eghbali F, Mirhashemi SH, Mokhber S, Jazi AD, Pazouki A. The First Web-Based Iranian National Obesity and Metabolic Surgery Database (INOSD). Obes Surg 2022; 32:2083-2086. [PMID: 35303260 DOI: 10.1007/s11695-022-06014-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 03/10/2022] [Accepted: 03/15/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Mohammad Kermansaravi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-E Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. .,Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat_e Rasool Hospital, Tehran, Iran.
| | - Shahab Shahabi Shahmiri
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-E Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat_e Rasool Hospital, Tehran, Iran
| | - Alireza Khalaj
- Tehran Obesity Treatment Center, Department of Surgery, Shahed University, Tehran, Iran
| | - Seyed Mehdi Jalali
- Department of Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Amini
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasser Malekpour Alamdari
- Critical Care Quality Improvement Research Center at Shahid Modarres Hospital, Department of General Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Mahmoudieh
- Department of Surgery, Isfahan Minimally Invasive Surgery and Obesity Research Center, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Jangjoo
- Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | | | - Masoud Sayadishahraki
- Department of Surgery, Isfahan Minimally Invasive Surgery and Obesity Research Center, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Foolad Eghbali
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-E Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat_e Rasool Hospital, Tehran, Iran
| | - Seyed Hadi Mirhashemi
- Department of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somayyeh Mokhber
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Davarpanah Jazi
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of General Surgery, Shariati Hospital, Isfahan, Iran
| | - Abdolreza Pazouki
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-E Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat_e Rasool Hospital, Tehran, Iran
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7
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Kermansaravi M, Omar I, Mahawar K, Shahabi S, Bashir A, Haddad A, Abbass A, Abbas SI, Abbas M, Abouzeid T, Akin F, Aghajani E, Aminian A, AlAnsari M, Asghar ST, Balta AZ, Bukhari W, Elfawal MH, Gado W, Gawdat K, Gee T, Ghavami B, Goel R, AlHadad M, AlHadhrami B, AlHaifi M, AlHamdani A, Hassan I, Illan SJ, Inam A, Ismaeil A, Kayyal Y, Mohammad K, Khan AU, Khoursheed M, Khwaja H, Kular KS, Layani LA, Maazulhassan, Mahdy T, Maher M, Mansoor E, Mirza S, Niam MS, Omarov T, Pazouki A, Alqahtani AR, Qassem M, Rezvani M, Sabry K, Salim S, Shabbir A, Skalli M, Taha O, Talebpour M, Taskin HE, Taskin M, Yunus T, Jazi AHD, Kassir R, Nimeri A. Religious Fasting of Muslim Patients After Metabolic and Bariatric Surgery: a Modified Delphi Consensus. Obes Surg 2021; 31:5303-5311. [PMID: 34617207 DOI: 10.1007/s11695-021-05724-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/11/2021] [Revised: 09/10/2021] [Accepted: 09/22/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Fasting during Ramadan is one of the five pillars of the Muslim faith. Despite the positive effects of fasting on health, there are no guidelines or clear recommendations regarding fasting after metabolic/bariatric surgery (MBS). The current study reports the result of a modified Delphi consensus among expert metabolic/bariatric surgeons with experience in managing patients who fast after MBS. METHODS A committee of 61 well-known metabolic and bariatric surgeons from 24 countries was created to participate in the Delphi consensus. The committee voted on 45 statements regarding recommendations and controversies around fasting after MBS. An agreement/disagreement ≥ of 70.0% was regarded as consensus. RESULTS The experts reached a consensus on 40 out of 45 statements after two rounds of voting. One hundred percent of the experts believed that fasting needs special nutritional support in patients who underwent MBS. The decision regarding fasting must be coordinated among the surgeon, the nutritionist and the patient. At any time after MBS, 96.7% advised stopping fasting in the presence of persistent symptoms of intolerance. Seventy percent of the experts recommended delaying fasting after MBS for 6 to 12 months after combined and malabsorptive procedures according to the patient's situation and surgeon's experience, and 90.1% felt that proton pump inhibitors should be continued in patients who start fasting less than 6 months after MBS. There was consensus that fasting may help in weight loss, improvement/remission of non-alcoholic fatty liver disease, dyslipidemia, hypertension and type 2 diabetes mellitus among 88.5%, 90.2%, 88.5%, 85.2% and 85.2% of experts, respectively. CONCLUSION Experts voted and reached a consensus on 40 statements covering various aspects of fasting after MBS.
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Affiliation(s)
- Mohammad Kermansaravi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Islam Omar
- Wirral University Teaching Hospital, NHS Foundation Trust, Birkenhead, Wirral, UK
| | - Kamal Mahawar
- Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, SR4 7TP, UK
| | - Shahab Shahabi
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Bashir
- Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Queen Noor Street, Amman, 11152, Jordan
| | - Ashraf Haddad
- Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Queen Noor Street, Amman, 11152, Jordan
| | - Alaa Abbass
- Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, 11591, Egypt
| | | | - Mujjahid Abbas
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Tarek Abouzeid
- Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, 11591, Egypt
| | - Faki Akin
- Bariatric and Metabolic Surgery, Istanbul, Turkey
| | - Ebrahim Aghajani
- Department of Surgery, Aleris Hospital, Fredrik Stangs gate 11-13, 0264, Oslo, Norway
| | - Ali Aminian
- Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Mohanad AlAnsari
- Robotic Surgery Academy, International Modern Hospital, Baghdad, Iraq
| | | | - Ahmet Ziya Balta
- Faculty of Health Sciences, Istanbul Rumeli University, Istanbul, Turkey
| | | | | | - Waleed Gado
- Endocrine and Bariatric Surgery Unit, Mansoura University, Mansoura, Egypt
| | - Khaled Gawdat
- Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, 11591, Egypt
| | - Tikfu Gee
- Department of Medical Science, School of Healthcare and Medical Sciences, Sunway UniversityJalan UniversitySelangor Darul Ehsan, 47500, Bandar SunwayPetaling Jaya, Malaysia
| | | | | | | | | | | | | | | | - Selim Jalil Illan
- International Center of Excellence in Bariatric and Metabolic Surgery, Hospital BC, Tijuana, Mexico
| | - Atif Inam
- In Charge Metabolic, Thoracic and General Surgery Unit III, Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | | | | | | | | | | | | | - K S Kular
- Founding President MGB-OAGB Club, Kular Research Institute, Bija, India
| | | | - Maazulhassan
- Shalimar Medical and Dental College, Lahore, Pakistan
| | - Tarek Mahdy
- Sharjah University Hospital, Mansoura Faculty of Medicine, Sharjah, UAE
| | | | | | | | - Muhammad S Niam
- Faculty of Medicine, Brawijaya University, Dr Saiful Anwar General Hospital, Malang, Indonesia
| | - Taryel Omarov
- First Surgical Disease Department, Azerbaijan Medical University, Baku, Azerbaijan
| | - Abdolreza Pazouki
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Aayed R Alqahtani
- New You Medical Center, King Saud University, Obesity Chair, Riyadh, Saudi Arabia
| | - Mohamed Qassem
- Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, 11591, Egypt
| | - Masoud Rezvani
- Inova Fair Oaks Hospital, COE Bariatric Center, 14904 Jefferson Davis Hwy, Suite 205, Woodbridge, VA, 22191, USA
| | - Karim Sabry
- Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, 11591, Egypt
| | | | - Asim Shabbir
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Surgery, University Surgical Cluster, National University Health System, Singapore, Singapore
| | | | - Osama Taha
- Bariatric Unit, Plastic and Obesity Surgery Department, Assiut University Hospital, Assiut, Egypt
| | - Mohammad Talebpour
- Department of General Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Halit Eren Taskin
- Cerrahpasa Medical Faculty, Department of Surgery, Istanbul University Cerrahpasa, Istanbul, Turkey
| | - Mustafa Taskin
- Cerrahpasa Medical Faculty, Department of Surgery, Istanbul University Cerrahpasa, Istanbul, Turkey
| | | | | | - Radwan Kassir
- Department of Digestive Surgery, CHU Félix Guyon, Saint Denis, La Réunion, France
| | - Abdelrahman Nimeri
- Chief, Bariatric and Metabolic Surgery Carolinas Medical Center, Ballantyne and Gastonia Director, Atrium Health University of North Carolina-Charlotte Campus Director, Bariatric Fellowship Program Carolinas Medical Center-Mercy, Atrium Health Weight Management Charlotte, ConcordCharlotte, NC, USA.
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8
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Haghpanah V, Abbas SI, Mahmoodzadeh H, Shojaei A, Soleimani A, Larijani B, Tavangar SM. Paraplegia as initial presentation of follicular thyroid carcinoma. J Coll Physicians Surg Pak 2007; 16:233-4. [PMID: 16542610 DOI: 3.2006/jcpsp.233234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/17/2005] [Accepted: 02/20/2006] [Indexed: 11/24/2022]
Abstract
Follicular thyroid carcinoma with metastasis rarely presents with clinical picture of spinal cord compression. This report describes a 53 years old patient with follicular thyroid carcinoma who presented with paraplegia and urinary incontinence. Magnetic resonance imaging (MRI) of neck revealed a mass with destruction of C5 and extension to C6. Histopathology study demonstrated metastatic carcinoma of thyroid.
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Affiliation(s)
- Vahid Haghpanah
- Endocrinology and Metabolism Research Center (EMRC), Shariati Hospital, Tehran Medical University of Medical Sciences, Tehran, Iran
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