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ArticleObesity surgery2024

Metabolic and Bariatric Surgery in Patients with Obesity Class V (BMI > 60 kg/m

Guillermo Ponce de Leon-Ballesteros, Sjaak Pouwels, Gustavo Romero-Velez, Ali Aminian, Luigi Angrisani, Mohit Bhandari, Wendy Brown, Catalin Copaescu, Maurizio De Luca, Mathias Fobi and 30 more

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Article in Obesity surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

40 authors.

Guillermo Ponce de Leon-BallesterosDepartment of Surgery, Hospital Angeles Morelia, Morelia, Postal: 331, Int. B-502, Av. Montaña Monarca, Montaña Monarca, 58350, Morelia, Michoacan, Mexico. guilllermoplb@hotmail.com.ORCID 0000-0003-0735-148X
Sjaak PouwelsDepartment of General, Abdominal Surgery and Coloproctology, Helios St. Elisabeth Hospital, Oberhausen, NRW, Germany.
Gustavo Romero-VelezDepartment of Endocrine Surgery, Cleveland Clinic, Cleveland, OH, USA.
Ali AminianDepartment of General Surgery, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA.
Luigi AngrisaniDepartment of Public Health, Federico II" University of Naples, Naples, Italy.
Mohit BhandariMohak Bariatrics and Robotics Hospital, Indore, India.
Wendy BrownDepartment of Surgery, Monash University, Melbourne, Australia.
Catalin CopaescuDepartment of Surgery, Ponderas Academic Hospital, Bucharest, Romania.
Maurizio De LucaDepartment of Surgery, Rovigo Hospital, Rovigo, Italy.
Mathias FobiFobi Medical Consulting, Stone Mountain, USA.
Omar M GhanemDepartment of Surgery, Mayo Clinic, Rochester, MN, USA.
Till HasenbergHelios Obesity Center West, Helios University Hospital Wuppertal, Wuppertal, Germany.
Miguel F HerreraClinic for Nutrition and Obesity, The American British Cowdray Medical Center Observatorio, Mexico City, Mexico.
Johnn H Herrera-KokDepartment of General and Digestive Surgery, University Hospital of Leon, Leon, Spain.
Jacques HimpensBariatric Surgery Unit, Delta CHIREC Hospital, Brussels, Belgium.
Lilian KowFlinders Medical Centre, Adelaide, Australia.
Matthew KrohDepartment of General Surgery, Cleveland Clinic, Cleveland, OH, USA.
Marina KurianNYU Langone Health, New York, NY, USA.
Mario MusellaAdvanced Biomedical Sciences Department, "Federico II" University of Naples, Naples, Italy.
Mahendra NarwariaAsian Bariatrics Private Ltd, Ahmedabad, Gujarat, India.
Patrick NoelClinique Bouchard, ELSAN, Marseille, France.
Juan P PantojaDepartment of Surgery, Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE.
Jaime PonceCHI Memorial Hospital Chattanooga, Chattanooga, TN, USA.
Gerhard PragerDepartment of Surgery, Medical University of Vienna, Vienna, Austria.
Almino RamosGastro Obeso Center, Sao Paulo, Brazil.
Rui RibeiroDepartment of General Surgery, Hospital Lusiadas Amadora, Amadora, Portugal.
Elena Ruiz-UcarDepartment of Bariatric and Endocrine Surgery, Fuenlabrada University Hospital, Madrid, Spain.
Paulina SalminenDepartment of Surgery, University of Turku, Turku, Finland.
Scott ShikoraDepartment of Surgery, Division of Gastrointestinal and General Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Peter SmallDirectorate of General Surgery, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK.
Christine StierDepartment of Interdisciplinary Endoscopy and Visceral Surgery, University Hospital Mannheim, Mannheim, Germany.
Safwan TahaBariatric and Metabolic Surgery Center, Mediclinic Hospital Airport Road, Abu Dhabi, UAE.
Eren Halit TaskinDepartment of Surgery, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey.
Antonio TorresGeneral and Digestive Surgery Service, Department of Surgery, Hospital Clínico San Carlos, Complutense University Medical School, Universidad Complutense de Madrid (UCM); IdISSC, Madrid, Spain.
Carlos VazObesity and Metabolic Surgery Unit, Hospital CUF Tejo, Lisbon, Portugal.
Ramon VilallongaDepartment of Surgery, Enodcrine-Metabolic and Bariatric Surgery Unit, Vall Hebron Barcelona Hospital Campus, Universitat Autonoma de Barcelona, Barcelona, Spain.
Sergio VerboonenObesity Goodbye Center, Tijuana, Mexico.
Carlos ZerrweckThe American British Cowdray Medical Center Santa Fe, Mexico City, Mexico.
Natan ZundelDepartment of Surgery, University of Buffalo, Buffalo, NY, USA.
Chetan ParmarDepartment of Surgery, The Whittington Hospital NHS Trust, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMetabolic and bariatric surgery (MBS) is the preferred method to achieve significant weight loss in patients with Obesity Class V (BMI > 60 kg/m

methodsA total of 36 recognized opinion-makers and highly experienced metabolic and bariatric surgeons participated in the present Delphi consensus. 81 statements on preoperative management, selection of the procedure, perioperative management, weight loss parameters, follow-up, and metabolic outcomes were voted on in two rounds. A consensus was considered reached when an agreement of ≥ 70% of experts' votes was achieved.

resultsA total of 54 out of 81 statements reached consensus. Remarkably, more than 90% of the experts agreed that patients should be notified of the greater risk of complications, the possibility of modifications to the surgical procedure, and the early start of chemical thromboprophylaxis. Regarding the choice of the procedure, SADI-S, RYGB, and OAGB were the top 3 preferred operations. However, no consensus was reached on the limb length in these operations.

conclusionThis study represents the first attempt to reach consensus on the choice of procedures as well as perioperative management in patients with obesity class V. Although overall consensus was reached in different areas, more research is needed to better serve this high-risk population.

Indexed as

Bariatric SurgeryObesity, MorbidVenous ThromboembolismAnticoagulantsBody Mass IndexDelphi TechniqueHumansObesityWeight LossAnticoagulantsBariatric surgeryBMI > 60Metabolic surgerySevere obesity

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.