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. 2021 Dec;35(12):7027-7033.
doi: 10.1007/s00464-020-08216-w. Epub 2021 Jan 12.

The first modified Delphi consensus statement on sleeve gastrectomy

Kamal K Mahawar  1   2 , Islam Omar  3 , Rishi Singhal  4 , Sandeep Aggarwal  5 , Mustafa Ismail Allouch  6 , Salman K Alsabah  7 , Luigi Angrisani  8 , Faruq Mohamed Badiuddin  9 , Jose María Balibrea  10 , Ahmad Bashir  11 , Estuardo Behrens  12 , Kiron Bhatia  13 , Laurent Biertho  14 , L Ulas Biter  15 , Jerome Dargent  16 , Maurizio De Luca  17 , Eric DeMaria  18 , Mohamed Hayssam Elfawal  19 , Martin Fried  20 , Khaled A Gawdat  21 , Yitka Graham  3   22 , Miguel F Herrera  23 , Jacques M Himpens  24 , Farah A Hussain  25 , Kazunori Kasama  26 , David Kerrigan  27 , Lilian Kow  28 , Jon Kristinsson  29 , Marina Kurian  30 , Ronald Liem  31 , Rami Edward Lutfi  32 , Vinod Menon  33 , Karl Miller  34 , Patrick Noel  35   36 , Oral Ospanov  37 , Mahir M Ozmen  38 , Ralph Peterli  39 , Jaime Ponce  40 , Gerhard Prager  41 , Arun Prasad  42 , P Praveen Raj  43 , Nelson R Rodriguez  44 , Raul Rosenthal  45 , Nasser Sakran  46 , Jorge Nunes Santos  47 , Asim Shabbir  48 , Scott A Shikora  49 , Peter K Small  3   22 , Craig J Taylor  50 , Cunchuan Wang  51 , Rudolf Alfred Weiner  52 , Mariusz Wylezol  53 , Wah Yang  51 , Ali Aminian  54
Affiliations

The first modified Delphi consensus statement on sleeve gastrectomy

Kamal K Mahawar et al. Surg Endosc. 2021 Dec.

Abstract

Introduction: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Bariatric surgery; Gastric sleeve; Obesity surgery; Sleeve gastrectomy.

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References

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