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Metabolic and bariatric surgery in patients with obesity class V (BMI > 60 kg/m2): a modified delphi study

Background: Metabolic and bariatric surgery (MBS) is the preferred method to achieve significant weight loss in patients with Obesity Class V (BMI > 60 kg/m2). However, there is no consensus regarding the best procedure(s) for this population. Additionally, these patients will likely have a highe...

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Main Authors: Ponce de Leon-Ballesteros, Guillermo (Author) , Pouwels, Sjaak (Author) , Romero-Velez, Gustavo (Author) , Aminian, Ali (Author) , Angrisani, Luigi (Author) , Bhandari, Mohit (Author) , Brown, Wendy (Author) , Copaescu, Catalin (Author) , De Luca, Maurizio (Author) , Fobi, Mathias (Author) , Ghanem, Omar M. (Author) , Hasenberg, Till (Author) , Herrera, Miguel F. (Author) , Herrera-Kok, Johnn H. (Author) , Himpens, Jacques (Author) , Kow, Lilian (Author) , Kroh, Matthew (Author) , Kurian, Marina (Author) , Musella, Mario (Author) , Narwaria, Mahendra (Author) , Noel, Patrick (Author) , Pantoja, Juan P. (Author) , Ponce, Jaime (Author) , Prager, Gerhard (Author) , Ramos, Almino (Author) , Ribeiro, Rui (Author) , Ruiz-Ucar, Elena (Author) , Salminen, Paulina (Author) , Shikora, Scott (Author) , Small, Peter (Author) , Stier, Christine (Author) , Taha, Safwan (Author) , Taskin, Eren Halit (Author) , Torres, Antonio (Author) , Vaz, Carlos (Author) , Vilallonga, Ramon (Author) , Verboonen, Sergio (Author) , Zerrweck, Carlos (Author) , Zundel, Natan (Author) , Parmar, Chetan (Author)
Format: Article (Journal)
Language:English
Published: 2024
In: Obesity surgery
Year: 2024, Volume: 34, Issue: 3, Pages: 790-813
ISSN:1708-0428
DOI:10.1007/s11695-023-06990-9
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1007/s11695-023-06990-9
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Author Notes:Guillermo Ponce de Leon-Ballesteros, Sjaak Pouwels, Gustavo Romero-Velez, Ali Aminian, Luigi Angrisani, Mohit Bhandari, Wendy Brown, Catalin Copaescu, Maurizio De Luca, Mathias Fobi, Omar M. Ghanem, Till Hasenberg, Miguel F. Herrera, Johnn H. Herrera-Kok, Jacques Himpens, Lilian Kow, Matthew Kroh, Marina Kurian, Mario Musella, Mahendra Narwaria, Patrick Noel, Juan P. Pantoja, Jaime Ponce, Gerhard Prager, Almino Ramos, Rui Ribeiro, Elena Ruiz-Ucar, Paulina Salminen, Scott Shikora, Peter Small, Christine Stier, Safwan Taha, Eren Halit Taskin, Antonio Torres, Carlos Vaz, Ramon Vilallonga, Sergio Verboonen, Carlos Zerrweck, Natan Zundel, Chetan Parmar
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Summary:Background: Metabolic and bariatric surgery (MBS) is the preferred method to achieve significant weight loss in patients with Obesity Class V (BMI > 60 kg/m2). However, there is no consensus regarding the best procedure(s) for this population. Additionally, these patients will likely have a higher risk of complications and mortality. The aim of this study was to achieve a consensus among a global panel of expert bariatric surgeons using a modified Delphi methodology. Methods: A total of 36 recognized opinion-makers and highly experienced metabolic and bariatric surgeons participated in the present Delphi consensus. 81 statements on preoperative management, selection of the procedure, perioperative management, weight loss parameters, follow-up, and metabolic outcomes were voted on in two rounds. A consensus was considered reached when an agreement of ≥ 70% of experts’ votes was achieved. Results: A total of 54 out of 81 statements reached consensus. Remarkably, more than 90% of the experts agreed that patients should be notified of the greater risk of complications, the possibility of modifications to the surgical procedure, and the early start of chemical thromboprophylaxis. Regarding the choice of the procedure, SADI-S, RYGB, and OAGB were the top 3 preferred operations. However, no consensus was reached on the limb length in these operations. Conclusion: This study represents the first attempt to reach consensus on the choice of procedures as well as perioperative management in patients with obesity class V. Although overall consensus was reached in different areas, more research is needed to better serve this high-risk population.
Item Description:Online veröffentlicht: 19. Januar 2024
Gesehen am 14.05.2024
Physical Description:Online Resource
ISSN:1708-0428
DOI:10.1007/s11695-023-06990-9

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