Skip to main content
Erschienen in:

22.07.2017 | Original Contributions

Perioperative Practices Concerning One Anastomosis (Mini) Gastric Bypass: A Survey of 210 Surgeons

verfasst von: Kamal K. Mahawar, Kuldeepak Singh Kular, Chetan Parmar, Michael Van den Bossche, Yitka Graham, William R. J. Carr, Brijesh Madhok, Conor Magee, Sanjay Purkayastha, Peter K. Small

Erschienen in: Obesity Surgery | Ausgabe 1/2018

Einloggen, um Zugang zu erhalten

Abstract

Background

There is currently little evidence available on the perioperative practices concerning one anastomosis/mini gastric bypass (OAGB/MGB) and no published consensus amongst experts. Even the published papers are not clear on these aspects. The purpose of this study was to understand various perioperative practices concerning OAGB/MGB.

Methods

Bariatric surgeons from around the world were invited to participate in a questionnaire-based survey. Only surgeons performing this procedure were included.

Results

Two hundred and ten surgeons from 39 countries with a cumulative experience of 68,442 procedures took the survey. Surgeons described a large number of absolute (n = 55) and relative contraindications (n = 59) to this procedure in their practice. Approximately 71.0% (n = 148/208), 70.0% (n = 147/208) and 65.0% (n = 137/209), respectively, routinely perform a preoperative endoscopy, screening for Helicobacter pylori and ultrasound scan of the abdomen. A minority (35.0%, n = 74/208) of the surgeons used a constant bilio-pancreatic limb (BPL) length for all the patients with remaining preferring to tailor the limb length to the patient and approximately half (49.0%, n = 101/206) routinely approximate diaphragmatic crura in patients with hiatus hernia. Some 48.5% (n = 101/208) and 40.0% (n = 53/205) surgeons, respectively, do not recommend routine iron and calcium supplementation.

Conclusion

This survey is the first attempt to understand a range of perioperative practices with OAGB/MGB. The findings will help in identifying areas for future research and allow consensus building amongst experts with preparation of guidelines for future practice.
Literatur
1.
Zurück zum Zitat Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg. 2005;15(9):1304–8.CrossRefPubMed Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg. 2005;15(9):1304–8.CrossRefPubMed
2.
Zurück zum Zitat Lee WJ, Ser KH, Lee YC, et al. Laparoscopic Roux-en-Y vs. mini-gastric bypass for the treatment of morbid obesity: a 10-year experience. Obes Surg. 2012;22(12):1827–34.CrossRefPubMed Lee WJ, Ser KH, Lee YC, et al. Laparoscopic Roux-en-Y vs. mini-gastric bypass for the treatment of morbid obesity: a 10-year experience. Obes Surg. 2012;22(12):1827–34.CrossRefPubMed
3.
Zurück zum Zitat Noun R, Skaff J, Riachi E, et al. One thousand consecutive mini-gastric bypass: short- and long-term outcome. Obes Surg. 2012;22(5):697–703.CrossRefPubMed Noun R, Skaff J, Riachi E, et al. One thousand consecutive mini-gastric bypass: short- and long-term outcome. Obes Surg. 2012;22(5):697–703.CrossRefPubMed
4.
Zurück zum Zitat Musella M, Susa A, Greco F, et al. The laparoscopic mini-gastric bypass: the Italian experience: outcomes from 974 consecutive cases in a multicenter review. Surg Endosc. 2014;28(1):156–63.CrossRefPubMed Musella M, Susa A, Greco F, et al. The laparoscopic mini-gastric bypass: the Italian experience: outcomes from 974 consecutive cases in a multicenter review. Surg Endosc. 2014;28(1):156–63.CrossRefPubMed
5.
Zurück zum Zitat Kular KS, Manchanda N, Rutledge R. A 6-year experience with 1,054 mini-gastric bypasses-first study from Indian subcontinent. Obes Surg. 2014;24(9):1430–5.CrossRefPubMed Kular KS, Manchanda N, Rutledge R. A 6-year experience with 1,054 mini-gastric bypasses-first study from Indian subcontinent. Obes Surg. 2014;24(9):1430–5.CrossRefPubMed
6.
Zurück zum Zitat Chevallier JM, Arman GA, Guenzi M, et al. One thousand single anastomosis (omega loop) gastric bypasses to treat morbid obesity in a 7-year period: outcomes show few complications and good efficacy. Obes Surg. 2015;25(6):951–8.CrossRefPubMed Chevallier JM, Arman GA, Guenzi M, et al. One thousand single anastomosis (omega loop) gastric bypasses to treat morbid obesity in a 7-year period: outcomes show few complications and good efficacy. Obes Surg. 2015;25(6):951–8.CrossRefPubMed
7.
Zurück zum Zitat Parmar CD, Mahawar KK, Boyle M, et al. Mini Gastric Bypass: first report of 125 consecutive cases from United Kingdom. Clin Obes. 2016;6(1):61–7.CrossRefPubMed Parmar CD, Mahawar KK, Boyle M, et al. Mini Gastric Bypass: first report of 125 consecutive cases from United Kingdom. Clin Obes. 2016;6(1):61–7.CrossRefPubMed
8.
Zurück zum Zitat Mahawar KK, Jennings N, Brown J, et al. “mini” gastric bypass: systematic review of a controversial procedure. Obes Surg. 2013;23(11):1890–8.CrossRefPubMed Mahawar KK, Jennings N, Brown J, et al. “mini” gastric bypass: systematic review of a controversial procedure. Obes Surg. 2013;23(11):1890–8.CrossRefPubMed
9.
Zurück zum Zitat Mahawar KK, Carr WR, Balupuri S, et al. Controversy surrounding ‘mini’ gastric bypass. Obes Surg. 2014;24(2):324–33.CrossRefPubMed Mahawar KK, Carr WR, Balupuri S, et al. Controversy surrounding ‘mini’ gastric bypass. Obes Surg. 2014;24(2):324–33.CrossRefPubMed
10.
Zurück zum Zitat Lee WJ, Wang W, Lee YC, et al. Laparoscopic mini-gastric bypass: experience with tailored bypass limb according to body weight. Obes Surg. 2008;18(3):294–9.CrossRefPubMed Lee WJ, Wang W, Lee YC, et al. Laparoscopic mini-gastric bypass: experience with tailored bypass limb according to body weight. Obes Surg. 2008;18(3):294–9.CrossRefPubMed
11.
Zurück zum Zitat Mahawar K. One anastomosis gastric bypass is a “gastric bypass”. Obes Surg. 2016;26(11):2786–7.CrossRefPubMed Mahawar K. One anastomosis gastric bypass is a “gastric bypass”. Obes Surg. 2016;26(11):2786–7.CrossRefPubMed
12.
Zurück zum Zitat Mahawar KK, Kumar P, Parmar C, et al. Small bowel limb lengths and Roux-en-Y gastric bypass: a systematic review. Obes Surg. 2016;26(3):660–71.CrossRefPubMed Mahawar KK, Kumar P, Parmar C, et al. Small bowel limb lengths and Roux-en-Y gastric bypass: a systematic review. Obes Surg. 2016;26(3):660–71.CrossRefPubMed
13.
Zurück zum Zitat Kular KS, Prasad A, Ramana B, et al. Petersen’s hernia after mini (one anastomosis) gastric bypass. J Visc Surg. 2016 Aug;153(4):321.CrossRefPubMed Kular KS, Prasad A, Ramana B, et al. Petersen’s hernia after mini (one anastomosis) gastric bypass. J Visc Surg. 2016 Aug;153(4):321.CrossRefPubMed
14.
Zurück zum Zitat Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity (Silver Spring). 2013;21(Suppl 1):S1–27.CrossRef Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity (Silver Spring). 2013;21(Suppl 1):S1–27.CrossRef
Metadaten
Titel
Perioperative Practices Concerning One Anastomosis (Mini) Gastric Bypass: A Survey of 210 Surgeons
verfasst von
Kamal K. Mahawar
Kuldeepak Singh Kular
Chetan Parmar
Michael Van den Bossche
Yitka Graham
William R. J. Carr
Brijesh Madhok
Conor Magee
Sanjay Purkayastha
Peter K. Small
Publikationsdatum
22.07.2017
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 1/2018
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-017-2831-2

Neu im Fachgebiet Chirurgie

Mit Lidocain kommt der Darm nicht schneller in Schwung

Verzögertes Wiederanspringen der Darmfunktion ist ein Hauptfaktor dafür, wenn Patientinnen und Patienten nach einer Kolonresektion länger als geplant im Krankenhaus bleiben müssen. Ob man diesem Problem mit Lidocain vorbeugen kann, war Thema einer Studie.

Kein Unterschied bei inadäquaten Schocks zwischen ICD-Typen

Inadäquate Schockabgaben sind ein unerwünschter Effekt der Therapie mit implantierbaren Kardioverter-Defibrillatoren. Subkutanen Geräten haftet dabei der Ruf an, dafür besonders anfällig zu sein. Die PRAETORIAN-Forschungsgruppe ist dem nachgegangen.

DCIS: Ist ein Verzicht auf eine Operation möglich?

Die COMET-Studie zeigt, dass aktives Monitoring bei Patientinnen mit duktalem Carcinoma in situ (DCIS) hinsichtlich der kumulativen Zwei-Jahres-Rate an ipsilateralen invasiven Karzinomen der leitliniengerechten Standardbehandlung nicht unterlegen ist. Dennoch wird von einem Verzicht auf eine Operation abgeraten, wie in einem begleitenden Editorial betont wird.

Soll man bei Cholezystektomie routinemäßig cholangiografieren?

Eine US-Studie scheint den Befürwortern einer routinemäßigen intraoperativen Cholangiografie im Rahmen einer Cholezystektomie Recht zu geben. Die Studienkommentatoren in JAMA Surgery sparen jedoch nicht mit Kritik.

Update Chirurgie

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