Skip to main content
Erschienen in: Obesity Surgery 6/2016

04.10.2015 | Original Contributions

Predictors of Excess Weight Loss in Obese Patients After Gastric Bypass: a 60-Month Follow-up

verfasst von: Anália S. Barhouch, Alexandre V. Padoin, Daniela S. Casagrande, Raquel Chatkin, Samanta P. Süssenbach, Milene A. Pufal, Carina Rossoni, Cláudio C. Mottin

Erschienen in: Obesity Surgery | Ausgabe 6/2016

Einloggen, um Zugang zu erhalten

Abstract

Background

The objective of this study was to analyze the factors associated with change in body mass index (BMI) and with percentage of excess weight loss (%EWL) in patients undergoing Roux-en-Y gastric bypass (RYGB). The following factors were analyzed: sex, age, surgical access (laparotomy vs. laparoscopy), preoperative BMI, waist circumference (WC), type 2 diabetes mellitus (T2DM), high blood pressure, and dyslipidemia.

Methods

Retrospective cohort study using a convenience sample of 2070 patients of both sexes, aged 18 to 65 years, undergoing RYGB between 2000 and 2013. The outcomes of interest were BMI and %EWL at 0, 6, 12, 18, 24, 30, 36, 42, 48, 54, and 60 months after RYGB.

Results

After 36, 48, and 60 months, approximately 50 % of patients had BMI >30 kg/m2. As for %EWL, 60-month results were poor for 17 % of patients (%EWL <50 %), good for 40 % of patients (%EWL 50–75 %), very good for 24 % of patients (%EWL from >75–90 %), and excellent for 19 % of patients (%EWL >90 %). The four most significant predictors of BMI change 60 months after RYGB (in descending order of magnitude) were preoperative BMI, preoperative WC, surgical access, and age; and of %EWL, surgical access, preoperative BMI, preoperative WC, and age.

Conclusions

After 60 months of follow-up, the most relevant predictors of weight loss after RYGB were lower preoperative BMI and WC, videolaparoscopy as surgical access, and younger age. Further studies must be carried out to elucidate the impact of these factors on RYGB outcomes.
Literatur
1.
Zurück zum Zitat Contreras JE, Santander C, Bravo J. Correlation between age and weight loss after bariatric surgery. Obes Surg. 2013;1–4. Contreras JE, Santander C, Bravo J. Correlation between age and weight loss after bariatric surgery. Obes Surg. 2013;1–4.
2.
Zurück zum Zitat Campos GM, Rabl C, Mulligan K, Posselt A, Rogers SJ, Westphalen AC, et al. Factors associated with weight loss after gastric bypass. Arch Surg. 2008;143(9):877–83. discussion 84.CrossRefPubMedPubMedCentral Campos GM, Rabl C, Mulligan K, Posselt A, Rogers SJ, Westphalen AC, et al. Factors associated with weight loss after gastric bypass. Arch Surg. 2008;143(9):877–83. discussion 84.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Hatoum IJ, Stein HK, Merrifield BF, Kaplan LM. Capacity for physical activity predicts weight loss after Roux‐en‐Y gastric bypass. Obesity. 2009;17(1):92–9.CrossRefPubMedPubMedCentral Hatoum IJ, Stein HK, Merrifield BF, Kaplan LM. Capacity for physical activity predicts weight loss after Roux‐en‐Y gastric bypass. Obesity. 2009;17(1):92–9.CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Junior WS, do Amaral JL, Nonino-Borges CB. Factors related to weight loss up to 4 years after bariatric surgery. Obes Surg. 2011;21(11):1724–30.CrossRefPubMed Junior WS, do Amaral JL, Nonino-Borges CB. Factors related to weight loss up to 4 years after bariatric surgery. Obes Surg. 2011;21(11):1724–30.CrossRefPubMed
5.
Zurück zum Zitat Coupaye M, Sabate JM, Castel B, Jouet P, Clerici C, Msika S, et al. Predictive factors of weight loss 1 year after laparoscopic gastric bypass in obese patients. Obes Surg. 2010;20(12):1671–7.CrossRefPubMed Coupaye M, Sabate JM, Castel B, Jouet P, Clerici C, Msika S, et al. Predictive factors of weight loss 1 year after laparoscopic gastric bypass in obese patients. Obes Surg. 2010;20(12):1671–7.CrossRefPubMed
6.
Zurück zum Zitat Scozzari G, Passera R, Benvenga R, Toppino M, Morino M. Age as a long-term prognostic factor in bariatric surgery. Ann Surg. 2012;256(5):724–8. discussion 8–9.CrossRefPubMed Scozzari G, Passera R, Benvenga R, Toppino M, Morino M. Age as a long-term prognostic factor in bariatric surgery. Ann Surg. 2012;256(5):724–8. discussion 8–9.CrossRefPubMed
7.
Zurück zum Zitat Langer FB, Prager G, Poglitsch M, Kefurt R, Shakeri-Leidenmuhler S, Ludvik B, et al. Weight loss and weight regain-5-year follow-up for circular- vs. linear-stapled gastrojejunostomy in laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2013;23(6):776–81.CrossRefPubMed Langer FB, Prager G, Poglitsch M, Kefurt R, Shakeri-Leidenmuhler S, Ludvik B, et al. Weight loss and weight regain-5-year follow-up for circular- vs. linear-stapled gastrojejunostomy in laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2013;23(6):776–81.CrossRefPubMed
8.
Zurück zum Zitat Ma Y, Pagoto SL, Olendzki BC, Hafner AR, Perugini RA, Mason R, et al. Predictors of weight status following laparoscopic gastric bypass. Obes Surg. 2006;16(9):1227–311.CrossRefPubMed Ma Y, Pagoto SL, Olendzki BC, Hafner AR, Perugini RA, Mason R, et al. Predictors of weight status following laparoscopic gastric bypass. Obes Surg. 2006;16(9):1227–311.CrossRefPubMed
9.
Zurück zum Zitat Melton GB, Steele KE, Schweitzer MA, Lidor AO, Magnuson TH. Suboptimal weight loss after gastric bypass surgery: correlation of demographics, comorbidities, and insurance status with outcomes. J Gastrointest Surg. 2008;12(2):250–5.CrossRefPubMed Melton GB, Steele KE, Schweitzer MA, Lidor AO, Magnuson TH. Suboptimal weight loss after gastric bypass surgery: correlation of demographics, comorbidities, and insurance status with outcomes. J Gastrointest Surg. 2008;12(2):250–5.CrossRefPubMed
10.
Zurück zum Zitat Carbonell AM, Wolfe LG, Meador JG, Sugerman HJ, Kellum JM, Maher JW. Does diabetes affect weight loss after gastric bypass? Surg Obes Relat Dis. 2008;4(3):441–4.CrossRefPubMed Carbonell AM, Wolfe LG, Meador JG, Sugerman HJ, Kellum JM, Maher JW. Does diabetes affect weight loss after gastric bypass? Surg Obes Relat Dis. 2008;4(3):441–4.CrossRefPubMed
11.
Zurück zum Zitat Jamal MK, DeMaria EJ, Johnson JM, Carmody BJ, Wolfe LG, Kellum JM, et al. Impact of major co-morbidities on mortality and complications after gastric bypass. Surg Obes Relat Dis. 2005;1(6):511–6.CrossRefPubMed Jamal MK, DeMaria EJ, Johnson JM, Carmody BJ, Wolfe LG, Kellum JM, et al. Impact of major co-morbidities on mortality and complications after gastric bypass. Surg Obes Relat Dis. 2005;1(6):511–6.CrossRefPubMed
12.
Zurück zum Zitat Still CD, Wood GC, Chu X, Manney C, Strodel W, Petrick A, et al. Clinical factors associated with weight loss outcomes after Roux-en-Y gastric bypass surgery. Obesity (Silver Spring). 2014;22(3):888–94.CrossRef Still CD, Wood GC, Chu X, Manney C, Strodel W, Petrick A, et al. Clinical factors associated with weight loss outcomes after Roux-en-Y gastric bypass surgery. Obesity (Silver Spring). 2014;22(3):888–94.CrossRef
13.
Zurück zum Zitat Lutfi R, Torquati A, Sekhar N, Richards W. Predictors of success after laparoscopic gastric bypass: a multivariate analysis of socioeconomic factors. Surg Endosc. 2006;20(6):864–7.CrossRefPubMed Lutfi R, Torquati A, Sekhar N, Richards W. Predictors of success after laparoscopic gastric bypass: a multivariate analysis of socioeconomic factors. Surg Endosc. 2006;20(6):864–7.CrossRefPubMed
14.
Zurück zum Zitat Livhits M, Mercado C, Yermilov I, Parikh JA, Dutson E, Mehran A, et al. Preoperative predictors of weight loss following bariatric surgery: systematic review. Obes Surg. 2012;22(1):70–89.CrossRefPubMed Livhits M, Mercado C, Yermilov I, Parikh JA, Dutson E, Mehran A, et al. Preoperative predictors of weight loss following bariatric surgery: systematic review. Obes Surg. 2012;22(1):70–89.CrossRefPubMed
15.
Zurück zum Zitat Barhouch AS, Zardo M, Padoin AV, Colossi FG, Casagrande DS, Chatkin R, et al. Excess weight loss variation in late postoperative period of gastric bypass. Obes Surg. 2010;20(11):1479–83.CrossRefPubMed Barhouch AS, Zardo M, Padoin AV, Colossi FG, Casagrande DS, Chatkin R, et al. Excess weight loss variation in late postoperative period of gastric bypass. Obes Surg. 2010;20(11):1479–83.CrossRefPubMed
16.
Zurück zum Zitat Dunkle-Blatter SE, St Jean MR, Whitehead C, Strodel III W, Bennotti PN, Still C, et al. Outcomes among elderly bariatric patients at a high-volume center. Surg Obes Relat Dis. 2007;3(2):163–9.CrossRefPubMed Dunkle-Blatter SE, St Jean MR, Whitehead C, Strodel III W, Bennotti PN, Still C, et al. Outcomes among elderly bariatric patients at a high-volume center. Surg Obes Relat Dis. 2007;3(2):163–9.CrossRefPubMed
17.
18.
Zurück zum Zitat St Peter SD, Craft RO, Tiede JL, Swain JM. Impact of advanced age on weight loss and health benefits after laparoscopic gastric bypass. Arch Surg. 2005;140(2):165.CrossRefPubMed St Peter SD, Craft RO, Tiede JL, Swain JM. Impact of advanced age on weight loss and health benefits after laparoscopic gastric bypass. Arch Surg. 2005;140(2):165.CrossRefPubMed
19.
Zurück zum Zitat Singhal R, Kitchen M, Bridgwater S, Super P. Age ≥ 50 does not influence outcome in laparoscopic gastric banding. Obes Surg. 2009;19(4):418–21.CrossRefPubMed Singhal R, Kitchen M, Bridgwater S, Super P. Age ≥ 50 does not influence outcome in laparoscopic gastric banding. Obes Surg. 2009;19(4):418–21.CrossRefPubMed
20.
Zurück zum Zitat Wool D, Bellatorre N, Wren S, Eisenberg D. Male patients above age 60 have as good outcomes as male patients 50–59 years old at 1-year follow-up after bariatric surgery. Obes Surg. 2009;19(1):18–21.CrossRefPubMed Wool D, Bellatorre N, Wren S, Eisenberg D. Male patients above age 60 have as good outcomes as male patients 50–59 years old at 1-year follow-up after bariatric surgery. Obes Surg. 2009;19(1):18–21.CrossRefPubMed
21.
Zurück zum Zitat Christou NV, Look D, MacLean LD. Weight gain after short-and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244(5):734–40.CrossRefPubMedPubMedCentral Christou NV, Look D, MacLean LD. Weight gain after short-and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244(5):734–40.CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Sjöström L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.CrossRefPubMed Sjöström L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.CrossRefPubMed
23.
Zurück zum Zitat Lopez PP, Patel NA, Koche LS. Outpatient complications encountered following Roux-en-Y gastric bypass. Med Clin North Am. 2007;91(3):471–83. xii.CrossRefPubMed Lopez PP, Patel NA, Koche LS. Outpatient complications encountered following Roux-en-Y gastric bypass. Med Clin North Am. 2007;91(3):471–83. xii.CrossRefPubMed
24.
Zurück zum Zitat Magro DO, Geloneze B, Delfini R, Pareja BC, Callejas F, Pareja JC. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18(6):648–51.CrossRefPubMed Magro DO, Geloneze B, Delfini R, Pareja BC, Callejas F, Pareja JC. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18(6):648–51.CrossRefPubMed
25.
Zurück zum Zitat Shah M, Simha V, Garg A. Long-term impact of bariatric surgery on body weight, comorbidities, and nutritional status. J Clin Endocrinol Metab. 2006;91(11):4223–31.CrossRefPubMed Shah M, Simha V, Garg A. Long-term impact of bariatric surgery on body weight, comorbidities, and nutritional status. J Clin Endocrinol Metab. 2006;91(11):4223–31.CrossRefPubMed
26.
Zurück zum Zitat Hulley SB, Cummings SR, Browner WS, Grady D, Hearst N, Newman TB. Designing clinical research. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2001. Hulley SB, Cummings SR, Browner WS, Grady D, Hearst N, Newman TB. Designing clinical research. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2001.
30.
31.
Zurück zum Zitat Bray GA, Bouchard C, Church TS, Cefalu WT, Greenway FL, Gupta AK, et al. Is it time to change the way we report and discuss weight loss? Obesity. 2009;17(4):619–21.CrossRefPubMed Bray GA, Bouchard C, Church TS, Cefalu WT, Greenway FL, Gupta AK, et al. Is it time to change the way we report and discuss weight loss? Obesity. 2009;17(4):619–21.CrossRefPubMed
32.
Zurück zum Zitat Biering K, Hjollund NH, Frydenberg M. Using multiple imputation to deal with missing data and attrition in longitudinal studies with repeated measures of patient-reported outcomes. Clin Epidemiol. 2015;7:91–106.CrossRefPubMedPubMedCentral Biering K, Hjollund NH, Frydenberg M. Using multiple imputation to deal with missing data and attrition in longitudinal studies with repeated measures of patient-reported outcomes. Clin Epidemiol. 2015;7:91–106.CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Salem L, Jensen CC, Flum DR. Are bariatric surgical outcomes worth their cost? A systematic review. J Am Coll Surg. 2005;200(2):270–8.CrossRefPubMed Salem L, Jensen CC, Flum DR. Are bariatric surgical outcomes worth their cost? A systematic review. J Am Coll Surg. 2005;200(2):270–8.CrossRefPubMed
34.
Zurück zum Zitat Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux en-Y-500 patients: technique and results, with 3–60 month follow-up. Obes Surg. 2000;10(3):233–9.CrossRefPubMed Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux en-Y-500 patients: technique and results, with 3–60 month follow-up. Obes Surg. 2000;10(3):233–9.CrossRefPubMed
35.
Zurück zum Zitat Stefanidis D, Kuwada TS, Gersin KS. The importance of the length of the limbs for gastric bypass patients—an evidence-based review. Obes Surg. 2011;21(1):119–24.CrossRefPubMed Stefanidis D, Kuwada TS, Gersin KS. The importance of the length of the limbs for gastric bypass patients—an evidence-based review. Obes Surg. 2011;21(1):119–24.CrossRefPubMed
36.
Zurück zum Zitat Dallal RM, Quebbemann BB, Hunt LH, Braitman LE. Analysis of weight loss after bariatric surgery using mixed-effects linear modeling. Obes Surg. 2009;19(6):732–7.CrossRefPubMed Dallal RM, Quebbemann BB, Hunt LH, Braitman LE. Analysis of weight loss after bariatric surgery using mixed-effects linear modeling. Obes Surg. 2009;19(6):732–7.CrossRefPubMed
37.
Zurück zum Zitat Mônaco DV, Marhi VAL, Aranha N, Brandalise NA. Impacto da cirurgia bariátrica “tipo capella modificado” sobre a perda ponderal em pacientes com obesidade mórbida. Rev Ciênc Méd. 2012;15(4):289–98. Mônaco DV, Marhi VAL, Aranha N, Brandalise NA. Impacto da cirurgia bariátrica “tipo capella modificado” sobre a perda ponderal em pacientes com obesidade mórbida. Rev Ciênc Méd. 2012;15(4):289–98.
38.
Zurück zum Zitat Dalcanale L, Oliveira CP, Faintuch J, Nogueira MA, Rondo P, Lima VM, et al. Long-term nutritional outcome after gastric bypass. Obes Surg. 2010;20(2):181–7.CrossRefPubMed Dalcanale L, Oliveira CP, Faintuch J, Nogueira MA, Rondo P, Lima VM, et al. Long-term nutritional outcome after gastric bypass. Obes Surg. 2010;20(2):181–7.CrossRefPubMed
39.
Zurück zum Zitat Puzziferri N, Nakonezny PA, Livingston EH, Carmody TJ, Provost DA, Rush AJ. Variations of weight loss following gastric bypass and gastric band. Ann Surg. 2008;248(2):233–42.CrossRefPubMed Puzziferri N, Nakonezny PA, Livingston EH, Carmody TJ, Provost DA, Rush AJ. Variations of weight loss following gastric bypass and gastric band. Ann Surg. 2008;248(2):233–42.CrossRefPubMed
40.
Zurück zum Zitat Bobbioni-Harsch E, Huber O, Morel P, Chassot G, Lehmann T, Volery M, et al. Factors influencing energy intake and body weight loss after gastric bypass. Eur J Clin Nutr. 2002;56(6):551–6.CrossRefPubMed Bobbioni-Harsch E, Huber O, Morel P, Chassot G, Lehmann T, Volery M, et al. Factors influencing energy intake and body weight loss after gastric bypass. Eur J Clin Nutr. 2002;56(6):551–6.CrossRefPubMed
41.
Zurück zum Zitat Alger-Mayer S, Rosati C, Polimeni J, Malone M. Preoperative binge eating status and gastric bypass surgery: a long-term outcome study. Obes Surg. 2009;19(2):139–45.CrossRefPubMed Alger-Mayer S, Rosati C, Polimeni J, Malone M. Preoperative binge eating status and gastric bypass surgery: a long-term outcome study. Obes Surg. 2009;19(2):139–45.CrossRefPubMed
42.
Zurück zum Zitat Alami RS, Morton JM, Schuster R, Lie J, Sanchez BR, Peters A, et al. Is there a benefit to preoperative weight loss in gastric bypass patients? A prospective randomized trial. Surg Obes Relat Dis. 2007;3(2):141–5.CrossRefPubMed Alami RS, Morton JM, Schuster R, Lie J, Sanchez BR, Peters A, et al. Is there a benefit to preoperative weight loss in gastric bypass patients? A prospective randomized trial. Surg Obes Relat Dis. 2007;3(2):141–5.CrossRefPubMed
43.
Zurück zum Zitat Gould JC, Garren MJ, Boll V, Starling JR. Laparoscopic gastric bypass: risks vs. benefits up to two years following surgery in super-super obese patients. Surgery. 2006;140(4):524–31.CrossRefPubMed Gould JC, Garren MJ, Boll V, Starling JR. Laparoscopic gastric bypass: risks vs. benefits up to two years following surgery in super-super obese patients. Surgery. 2006;140(4):524–31.CrossRefPubMed
44.
Zurück zum Zitat Sussenbach S, Padoin A, Silva E, Benzano D, Pufal M, Barhouch A, et al. Economic benefits of bariatric surgery. Obes Surg. 2012;22(2):266–70.CrossRefPubMed Sussenbach S, Padoin A, Silva E, Benzano D, Pufal M, Barhouch A, et al. Economic benefits of bariatric surgery. Obes Surg. 2012;22(2):266–70.CrossRefPubMed
45.
Zurück zum Zitat Flier J, Maratos-Flier E. Primer: energy homeostasis and body weight. Curr Biol. 2000;10(6):R215–7.CrossRefPubMed Flier J, Maratos-Flier E. Primer: energy homeostasis and body weight. Curr Biol. 2000;10(6):R215–7.CrossRefPubMed
47.
Zurück zum Zitat Turner R, Holman R, Cull C, Stratton I, Matthews D, Frighi V, et al. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352(9131):837–53.CrossRef Turner R, Holman R, Cull C, Stratton I, Matthews D, Frighi V, et al. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352(9131):837–53.CrossRef
Metadaten
Titel
Predictors of Excess Weight Loss in Obese Patients After Gastric Bypass: a 60-Month Follow-up
verfasst von
Anália S. Barhouch
Alexandre V. Padoin
Daniela S. Casagrande
Raquel Chatkin
Samanta P. Süssenbach
Milene A. Pufal
Carina Rossoni
Cláudio C. Mottin
Publikationsdatum
04.10.2015
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 6/2016
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-015-1911-4

Weitere Artikel der Ausgabe 6/2016

Obesity Surgery 6/2016 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.