专家修改了Delphi共识,为I和II类肥胖症的程序选择制定了当前的建议
Mohammad Kermansaravi1, Sonja Chiappetta2, Chetan Parmar3
1Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat-e Fatemeh Hospital, Iran University of Medical Sciences, Tehran, Iran. mkermansaravi@yahoo.com.
Scientific reports
|February 10, 2024
概括
新的指导方针建议代谢和减肥手术 (MBS) 用于I类和II类肥胖症,特别是2型糖尿病. 胃气球和袖子胃切除术等手术被认为是体重管理的有效选择.
科学领域:
- 腹和代谢手术 腹和代谢手术
- 肥胖管理 肥胖管理
- 临床指南 临床指南
背景情况:
- 肥胖是一种复杂的慢性疾病,需要有效的治疗.
- 代谢和减肥手术 (MBS) 是对肥胖的最有效的干预措施.
- 来自ASMBS和IFSO的新指南更新了MBS的适应症,取代了旧的NIH建议.
研究的目的:
- 在I和II类肥胖症中为选择MBS程序制定共识指南.
- 用专家修改的Delphi方法来制定指南.
- 为减肥外科医生提供基于证据的建议.
主要方法:
- 使用了专家修改的Delphi方法.
- 来自32个国家的78名腹部外科医生参加了两轮协商一致的投票.
- 使用了≥70.0%同意或不同意的共识值.
主要成果:
- 在54个关于MBS指示的陈述上达成共识.
- 对于II类肥胖症和精选的I类肥胖症患者来说,MBS具有成本效益.
- 胃内气球 (IGB),内镜袖子胃整形术 (ESG),袖子胃切除术 (SG),Roux-en-Y胃绕道术 (RYGB) 和一个解肠胃绕道术 (OAGB) 是针对I类和II类肥胖症,特别是2型糖尿病 (T2DM) 的公认程序.
结论:
- 对于I和II类肥胖症,标准的原发性肥胖内镜和手术程序是可以接受的.
- MBS适用于T2DM和BMI≥30kg/m2的患者.
- 需要进一步的随机对照试验来确定I和II类肥胖症的最佳治疗方法.
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