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Upcoming Italian clinical practice guidelines on endoscopic bariatric treatment of overweight and obesity: design and methodological aspects

Affiliations
  • 1Surgery Unit, Azienda ULSS5 Polesana, Ospedale di Rovigo, Rovigo, Italy.
  • 2Diabetology, Careggi University Hospital, Florence, Italy.
  • 3Surgery Unit, Azienda ULSS5 Polesana, Ospedale di Rovigo, Rovigo, Italy. monica.zese@aulss5.veneto.it.
  • 4Endoscopy Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy.
  • 5Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
  • 6U.O.Dietology and Nutrition San Camillo Forlanini Hospital, Rome, Italy.
  • 7Research Unit of Anesthesia and Intensive Care, Università Campus Bio Medico di Roma e Fondazione Policlinico, Rome, Italy.
  • 8, Distretto 41-UOMI, ASL NAPOLI2 Nord, Naples, Italy.
  • 9Unit of Endocrinology, Ospedale Regina Apostolorum Albano, Rome, Italy.
  • 10Clinical Nutrition Service, ASUGI, S.Giovanni Hospital, Gorizia, Italy.
  • 11Gastroenterology and Digestive Endoscopy Unit_AOU-Modena, Modena, Italy.
  • 12Unit of Endocrinology, Galliera Hospital, Genoa, Italy.
  • 13University of Naples Federico II, Naples, Italy.
  • 14Surgery of the Alimentary Tract, Sant’Orsola Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy.
  • 15Division of General, Oncologic, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, Naples, Italy.
  • 16AULSS 5 Polesana, Anesthesiology, Intensive Care and Pain Medicine, Rovigo, Italy.
  • 17University “Tor Vergata”, Rome, Italy.
  • 18Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.
  • 19Department of Obesity Surgery, Policlinico Umberto I, Rome, Italy.
  • 20Department of Gastroenterology and Endoscopy, IRCCS San Matteo Pavia, Pavia, Italy.
  • 21Department of Surgery, University “La Sapienza”, Rome, Italy.
  • 22Digestive Surgical Endoscopy Unit, University of Naples, Naples, Italy.
  • 23Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
  • 24Scuola Superiore Sant’Anna, Pisa, Italy.
  • 25UOC di Gastroenterologia ed Endoscopia Digestiva, Ospedali Riuniti di Livorno, Livorno, Italy.
  • 26Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
  • 27General Practitioner, Brescia, Italy.
  • 28Department of Human Pathology, University of Messina, Messina, Italy.
  • 29Clinica Chirurgica Generale e d’Urgenza, AOU Umberto I-Lancisi-Salesi, Ancona, Italy.
  • 30Dietology, UOSA Dietetical and Clinical Nutrition, Santa Maria alle Scotte Hospital, Siena, Italy.
  • 31UOC Chirurgia Generale e d’Urgenza, Arnas Garibaldi, Catania, Italy.
  • 32Casa di Cura Carmona, Messina, Italy.
  • 33Clinical Nutrition Unit, Molinette University Hospital of Turin, Turin, Italy.
  • 34Pediatric Unit, Rovigo Hospital, 45030, Rovigo, Italy.
  • 35Rovigo Hospital, Padua University, Rovigo, Italy.
  • 36Unit of Digestive and Nutritional Pathophysiology, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy.
  • 37Amici Obesi ONLUS Milano, 20128, Milan, Italy.
  • 38ASST Fatebenefratelli-Sacco, 20157, Milan, Italy.
  • 39Division of Internal Medicine, Careggi University Hospital, Florence, Italy.

Published on:

July 10, 2024

Abstract

Obesity/overweight and its complications are a growing problem in many countries. Italian Society of Bariatric and Metabolic Surgery for Obesity (Società Italiana di Chirurgia dell’Obesità e delle Malattie Metaboliche-SICOB) decided to develop the first Italian guidelines for the endoscopic bariatric treatment of obesity. The creation of SICOB Guidelines is based on an extended work made by a panel of 44 members and a coordinator. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) methodology has been used to decide the aims, reference population, and target health professionals. Clinical questions have been created using the PICO (patient, intervention, comparison, outcome) conceptual framework. We will perform systematic reviews, formal meta-analyses, and network meta-analyses for each PICO and critical outcomes aimed at assessing and rating the efficacy and safety of endoscopic bariatric procedures in comparison with either no interventions, lifestyle interventions, or approved anti-obesity treatments in trials with a follow-up of at least 52 weeks. For PICO on temporary endoscopic bariatric treatments, we will also consider RCT with a minimum duration of 6 months. The panel proposed 8 questions, organized into four domains: A. Indication for endoscopic bariatric surgery; B. Revisional surgery; C. Temporary gastric and duodenal-jejunal procedures; D. Endoscopic diagnosis/treatment of bariatric and metabolic surgery complications. These guidelines will apply to patients aged ≥ 14 years) with body mass index (BMI) ≥ 27 kg/m and requiring endoscopic bariatric surgery or endoscopic diagnostic and/or therapeutic procedures. The areas covered by the clinical questions included indications of endoscopic bariatric surgery, types of surgery, revisional surgery, and management of bariatric and metabolic surgery complications.

Keywords:

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