Gastro-Obeso-Center Institute of Metabolic Optimization, São Paulo, Brazil.
Hopital Européen Georges Pompidou, Paris, France.
Obes Surg. 2020 May;30(5):1625-1634. doi: 10.1007/s11695-020-04519-y.
One-anastomosis gastric bypass (OAGB-MGB) is currently the third performed primary bariatric surgical procedure worldwide. However, the procedure is hampered by numerous controversies and there is considerable variability in surgical technique, patient selection, and pre- and postoperative care among the surgeons performing this procedure. This paper reports the results of a modified Delphi consensus study organized by the International Federation for Surgery of Obesity and Metabolic Disorders (IFSO).
Fifty-two internationally recognized bariatric experts from 28 countries convened for voting on 90 consensus statements over two rounds to identify those on which consensus could be reached. Inter-voter agreement of ≥ 70% was considered consensus, with voting participation ≥ 80% considered a robust vote.
At least 70% consensus was achieved for 65 of the 90 questions (72.2% of the items), 61 during the first round of voting and an additional four in the second round. Where consensus was reached on a binary agree/disagree or yes/no item, there was agreement with the statement presented in 53 of 56 instances (94.6%). Where consensus was reached on a statement where options favorable versus unfavorable to OAGB-MGB were provided, including statements in which OAGB-MGB was compared to another procedure, the response option favorable to OAGB-MGB was selected in 13 of 23 instances (56.5%).
Although there is general agreement that the OAGB-MGB is an effective and usually safe option for the management of patients with obesity or severe obesity, numerous areas of non-consensus remain in its use. Further empirical data are needed.
单吻合口胃旁路术（OAGB-MGB）目前是全球开展的第三大原发性减重手术。然而，该手术存在诸多争议，不同术者在手术技术、患者选择以及围手术期处理方面存在较大差异。本文报告了国际肥胖与代谢外科学会（IFSO）组织的改良 Delphi 共识研究结果。
来自 28 个国家的 52 名国际知名减重专家参加了两轮投票，对 90 项共识声明进行了投票，以确定能够达成共识的声明。投票者之间的意见一致性≥70%被认为是共识，投票参与率≥80%被认为是可靠的投票。
在 90 个问题中，至少有 65 个（占项目的 72.2%）问题达到了 70%的共识，其中 61 个问题在第一轮投票中达成，另外 4 个问题在第二轮投票中达成。在对赞成/反对或是/否的二元问题达成共识的情况下，有 53 个问题（94.6%）与提出的声明一致。在对赞成 OAGB-MGB 的有利与不利声明达成共识的情况下，包括将 OAGB-MGB 与另一种手术进行比较的声明，有 13 个问题（56.5%）选择了赞成 OAGB-MGB 的回答选项。
尽管普遍认为 OAGB-MGB 是治疗肥胖或重度肥胖患者的有效且通常安全的选择，但在其使用方面仍存在许多存在分歧的领域。需要进一步的实证数据。
