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Title: The first modified Delphi consensus statement on sleeve gastrectomy.
Austin Authors: Mahawar, Kamal K;Omar, Islam;Singhal, Rishi;Aggarwal, Sandeep;Allouch, Mustafa Ismail;Alsabah, Salman K;Angrisani, Luigi;Badiuddin, Faruq Mohamed;Balibrea, Jose María;Bashir, Ahmad;Behrens, Estuardo;Bhatia, Kiron ;Biertho, Laurent;Biter, L Ulas;Dargent, Jerome;De Luca, Maurizio;DeMaria, Eric;Elfawal, Mohamed Hayssam;Fried, Martin;Gawdat, Khaled A;Graham, Yitka;Herrera, Miguel F;Himpens, Jacques M;Hussain, Farah A;Kasama, Kazunori;Kerrigan, David;Kow, Lilian;Kristinsson, Jon;Kurian, Marina;Liem, Ronald;Lutfi, Rami Edward;Menon, Vinod;Miller, Karl;Noel, Patrick;Ospanov, Oral;Ozmen, Mahir M;Peterli, Ralph;Ponce, Jaime;Prager, Gerhard;Prasad, Arun;Raj, P Praveen;Rodriguez, Nelson R;Rosenthal, Raul;Sakran, Nasser;Santos, Jorge Nunes;Shabbir, Asim;Shikora, Scott A;Small, Peter K;Taylor, Craig J;Wang, Cunchuan;Weiner, Rudolf Alfred;Wylezol, Mariusz;Yang, Wah;Aminian, Ali
Affiliation: Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK
Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
Birmingham Heartlands Hospital, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
All India Institute of Medical Sciences (AIIMS), New Delhi, India
Nini Hospital, Tripoli, Lebanon
Kuwait University, Kuwait, Kuwait
University of Naples, Naples, Italy
Valiant Clinic, Dubayy, United Arab Emirates
Hospital Clínic de Barcelona, Barcelona, Spain
GBMC at Jordan Hospital, Amman, Jordan
New Life Center, Guatemala, Guatemala
Austin Health
Quebec Heart and Lung Institute-Laval University, Quebec, Canada
Franciscus Gasthuis Rotterdam, Rotterdam, Netherlands
Polyclinique Lyon Nord, Rillieux-la-Pape, France
Castelfranco Montebelluna Hospitals, Montebelluna, Italy
East Carolina University, Greenville, USA
Makassed General Hospital, Beirut, Lebanon
OB Klinika-Center for Treatment of Obesity and Metabolic Disorders, Prague, Czech Republic
Ain Shams School of Medicine, Cairo, Egypt
Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, Mexico
CHIREC Delta Hospital, Brussels, Belgium
Oregon Health & Science University, Portland, USA
Yotsuya Medical Cube, Tokyo, Japan
Phoenix Health, London, UK
Flinders University, Adelaide, South Australia, Australia
Oslo University Hospital, Oslo, Norway
New York University School of Medicine, New York, USA
Dutch Obesity Clinic (NOK), The Hague, Netherlands
University of Illinois, Chicago, USA
University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
Diakonissen & Wehrle Private Hospital, Salzburg, Austria
Bouchard Private Hospital, Elsan, Marseille, France Mediclinic Parkview, Dubayy, United Arab Emirates
KF "University Medical Center", Nur-Sultan, Kazakhstan
Istinye University, Istanbul, Turkey
University Hospital Basel, Basel, Switzerland
CHI Memorial Hospital, Chattanooga, TN, USA
Medical University of Vienna, Vienna, Austria
Apollo Hospitals, New Delhi, India
Gem Hospital, Chennai, India
Centro Médico Puerta de Hierro Andares, Zapopan, Mexico
Cleveland Clinic, Weston, FL, USA
Emek Medical Center, Afula, Israel
Jorge Manuel Nunes dos Santos, Lisbon, Portugal
National University Hospital, Singapore, Singapore
Brigham and Women's Hospital, Harvard Medical School, Boston, USA
Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
Concord Repatriation General Hospital, Sydney, Australia
The First Affiliated Hospital of Jinan University, Guangzhou, China
Department for Metabolic Surgery, Sana Klinikum Offenbach, Offenbach, Germany
Medical University of Warsaw, Warsaw, Poland
The First Affiliated Hospital of Jinan University, Guangzhou, China
Cleveland Clinic, Cleveland, USA
Issue Date: 12-Jan-2021
Date: 2021-01-12
Publication information: Surgical endoscopy 2021; 35(12): 7027-7033
Abstract: Sleeve gastrectomy (SG) is the commonest bariatric procedure worldwide. Yet there is significant variation in practice concerning its various aspects. This paper report results from the first modified Delphi consensus-building exercise on SG. We established a committee of 54 globally recognized opinion makers in this field. The committee agreed to vote on several statements concerning SG. An agreement or disagreement amongst ≥ 70.0% experts was construed as a consensus. The committee achieved a consensus of agreement (n = 71) or disagreement (n = 7) for 78 out of 97 proposed statements after two rounds of voting. The committee agreed with 96.3% consensus that the characterization of SG as a purely restrictive procedure was inaccurate and there was 88.7% consensus that SG was not a suitable standalone, primary, surgical weight loss option for patients with Barrett's esophagus (BE) without dysplasia. There was an overwhelming consensus of 92.5% that the sleeve should be fashioned over an orogastric tube of 36-40 Fr and a 90.7% consensus that surgeons should stay at least 1 cm away from the angle of His. Remarkably, the committee agreed with 81.1% consensus that SG patients should undergo a screening endoscopy every 5 years after surgery to screen for BE. A multinational team of experts achieved consensus on several aspects of SG. The findings of this exercise should help improve the outcomes of SG, the commonest bariatric procedure worldwide, and guide future research on this topic.
DOI: 10.1007/s00464-020-08216-w
ORCID: 0000-0003-2551-3462
Journal: Surgical Endoscopy
PubMed URL: 33433676
Type: Journal Article
Subjects: Bariatric surgery
Gastric sleeve
Obesity surgery
Sleeve gastrectomy
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