Mahawar Kamal K, Himpens Jacques, Shikora Scott A, Chevallier Jean-Marc, Lakdawala Mufazzal, De Luca Maurizio, Weiner Rudolf, Khammas Ali, Kular Kuldeepak Singh, Musella Mario, Prager Gerhard, Mirza Mohammad Khalid, Carbajo Miguel, Kow Lilian, Lee Wei-Jei, Small Peter K
Bariatric Unit, Department of General Surgery, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK.
St. Pierre University Hospital, Brussels, Belgium.
Obes Surg. 2018 Feb;28(2):303-312. doi: 10.1007/s11695-017-3070-2.
An increasing number of surgeons worldwide are now performing one anastomosis/mini gastric bypass (OAGB/MGB). Lack of a published consensus amongst experts may be hindering progress and affecting outcomes. This paper reports results from the first modified Delphi consensus building exercise on this procedure.
A committee of 16 recognised opinion-makers in bariatric surgery with special interest in OAGB/MGB was constituted. The committee invited 101 OAGB/MGB experts from 39 countries to vote on 55 statements in areas of controversy or variation associated with this procedure. An agreement amongst ≥ 70.0% of the experts was considered to indicate a consensus.
A consensus was achieved for 48 of the 55 proposed statements after two rounds of voting. There was no consensus for seven statements. Remarkably, 100.0% of the experts felt that OAGB/MGB was an "acceptable mainstream surgical option" and 96.0% felt that it could no longer be regarded as a new or experimental procedure. Approximately 96.0 and 91.0% of the experts felt that OAGB/MGB did not increase the risk of gastric and oesophageal cancers, respectively. Approximately 94.0% of the experts felt that the construction of the gastric pouch should start in the horizontal portion of the lesser curvature. There was a consensus of 82, 84, and 85% for routinely supplementing iron, vitamin B, and vitamin D, respectively.
OAGB/MGB experts achieved consensus on a number of aspects concerning this procedure but several areas of disagreements persist emphasising the need for more studies in the future.
全球越来越多的外科医生正在开展单吻合口/迷你胃旁路手术（OAGB/MGB）。专家之间缺乏已发表的共识可能会阻碍进展并影响手术效果。本文报告了关于该手术的首次改良德尔菲共识达成活动的结果。
成立了一个由16名公认的对减重手术有特别兴趣且专注于OAGB/MGB的意见领袖组成的委员会。该委员会邀请了来自39个国家的101名OAGB/MGB专家就与该手术相关的争议或差异领域的55项声明进行投票。≥70.0%的专家达成一致被视为达成共识。
经过两轮投票，55项提议声明中的48项达成了共识。有7项声明未达成共识。值得注意的是，100.0%的专家认为OAGB/MGB是一种“可接受的主流手术选择”，96.0%的专家认为它不能再被视为一种新的或实验性手术。分别约96.0%和91.0%的专家认为OAGB/MGB不会增加胃癌和食管癌的风险。约94.0%的专家认为胃囊的构建应从小弯侧的水平部分开始。对于常规补充铁、维生素B和维生素D，分别有82%、84%和85%的专家达成了共识。
OAGB/MGB专家在该手术的多个方面达成了共识，但仍存在一些分歧领域，这强调了未来需要更多研究。
