Rodríguez Nelson R, Cote Lilia, Fuentes Clotilde, Jaramillo Eduardo, Arana Sebastián, Castro Alejandra, Behrens Estuardo, Ramos Almino, Zerrweck Carlos
Hospital Puerta de Hierro Andares, 45116, Zapopan, Jalisco, Mexico.
Fundación Academia Aesculap México A.C./Asociación Mexicana de Cirugía General A.C, 03700, Mexico City, Mexico.
Obes Surg. 2023 Apr;33(4):1060-1072. doi: 10.1007/s11695-023-06468-8. Epub 2023 Feb 2.
Medical tourism is increasing every year, especially in fields such as bariatric surgery. Global concerns rely on the fact of its safety, mainly because of a lack of standardization, unknown number of cases, and the type of specialists performing such procedures. Mexico continues to be among the top countries receiving patients from abroad, but there is no national consensus, guidelines, or recommendations about the practice in such fields.
A group of 32 bariatric surgeons with an accumulated experience of 25,196 procedures in the medical tourism modality were gathered to perform a national consensus in bariatric surgery tourism. The Delphi methodology was used for this project, with a total of 52 items applied. A consensus was reached when the experts' position was ≥ 70% for each statement. The items included pre- and postoperative phases, patient selection, follow-up, and ethical and legal considerations.
Of the 52 statements, 40 (76.9%) reached a consensus of ≥ 70%; 36 in favor, 5 against, and 11 with indeterminate responses.
Although more than two-thirds of the statements related to high standard practice reached a consensus, weak points in the medical tourism modality were identified. This first consensus serves to establish the basis of safe practices, eventually reach national guidelines, and define the top standards of care when performing bariatric surgery tourism.
医疗旅游每年都在增加，尤其是在减重手术等领域。全球对其安全性表示担忧，主要原因是缺乏标准化、病例数量不明以及实施此类手术的专科医生类型。墨西哥仍然是接收国外患者最多的国家之一，但在这些领域的实践方面没有全国性的共识、指南或建议。
召集了一组32名减重外科医生，他们在医疗旅游模式下积累了25196例手术经验，以就减重手术旅游达成全国性共识。本项目采用德尔菲法，共应用了52项内容。当专家对每项陈述的支持率≥70%时，即达成共识。这些内容包括术前和术后阶段、患者选择、随访以及伦理和法律考量。
在52项陈述中，40项（76.9%）达成了≥70%的共识；36项赞成，5项反对，11项回答不确定。
尽管超过三分之二与高标准实践相关的陈述达成了共识，但也发现了医疗旅游模式中的薄弱环节。这第一个共识有助于奠定安全实践的基础，最终达成国家指南，并确定进行减重手术旅游时的最高护理标准。
