De Luca Maurizio, Zese Monica, Bandini Giulia, Zappa Marco Antonio, Bardi Ugo, Carbonelli Maria Grazia, Carrano Francesco Maria, Casella Giovanni, Chianelli Marco, Chiappetta Sonja, Iossa Angelo, Martinino Alessandro, Micanti Fausta, Navarra Giuseppe, Piatto Giacomo, Raffaelli Marco, Romano Eugenia, Rugolotto Simone, Serra Roberto, Soricelli Emanuele, Vitiello Antonio, Schiavo Luigi, Zani Iris Caterina Maria, Ragghianti Benedetta, Lorenzoni Valentina, Medea Gerardo, Antognozzi Valentina, Bellini Rosario, Berardi Giovanna, Campanile Fabio Cesare, Facchiano Enrico, Foletto Mirto, Gentileschi Paolo, Olmi Stefano, Petrelli Massimiliano, Pilone Vincenzo, Sarro Giuliano, Ballardini Donatella, Bettini Dario, Costanzi Andrea, Frattini Francesco, Lezoche Giovanni, Neri Barbara, Porri Debora, Rizzi Andrea, Rossini Roberto, Sessa Luca, D'Alessio Rossella, Di Mauro Gianluca, Tolone Salvatore, Bernante Paolo, Docimo Ludovico, Foschi Diego, Angrisani Luigi, Basso Nicola, Busetto Luca, Di Lorenzo Nicola, Disoteo Olga, Forestieri Pietro, Musella Mario, Paolini Barbara, Silecchia Gianfranco, Monami Matteo
Rovigo Hospital, ULSS5 Polesana, Viale Tre Martini, Rovigo, Italy.
Azienda Ospedaliero Universitaria Careggi and University of Florence, Florence, Italy.
Updates Surg. 2024 Oct 17. doi: 10.1007/s13304-024-01996-z.
Obesity is a chronic disease associated with increased morbidity and mortality and reduced quality of life. Pharmacotherapy can be associated with life style changes in increasing and maintaining weight loss and ameliorating obesity-related complications and comorbidities. In patients affected by obesity and uncontrolled obesity-associated complications or high degrees of BMI (> 40 Kg/m), metabolic bariatric surgery can be a valid therapeutic option. Many different types of surgical procedures have been developed in last decades, mainly performed via laparoscopic approaches. However, clinical indications for metabolic and bariatric surgery (MBS) and the choice of the most appropriate type of procedure have not been clarified so far.The Italian Society of Bariatric and Metabolic Surgery for Obesity (Società Italiana di Chirurgia dell'Obesità e delle Malattie Metaboliche-SICOB) decided to design and develop the updated version of the Italian guidelines aimed at assisting healthcare professionals in the choice of the surgical option for the treatment of obesity and related conditions. Between June and October 2022, a panel of 24 experts and an evidence review team (ERT, 10 members), participated in the definition of clinical questions, outcomes, and recommendations and collected and analyzed all the available evidence on the basis of pre-specified search strategies. GRADE methodology and PICO (Patient, Intervention, Comparison, Outcome) conceptual framework have been adopted for the development of the present guidelines. Aim of the present guideline is to verify indications to surgery with respect to the presence of comorbid conditions, evaluate the different types of surgical approaches and endoscopic bariatric procedure and revise indication to revision surgery and postoperative procedures.
肥胖是一种与发病率和死亡率增加以及生活质量下降相关的慢性疾病。药物治疗可与生活方式改变相结合，以增加并维持体重减轻，改善肥胖相关并发症和合并症。对于肥胖且肥胖相关并发症未得到控制或BMI较高（>40 Kg/m）的患者，代谢性减重手术可能是一种有效的治疗选择。在过去几十年中已开发出许多不同类型的外科手术，主要通过腹腔镜手术进行。然而，代谢和减重手术（MBS）的临床适应症以及最合适手术类型的选择至今尚未明确。意大利肥胖症和代谢性疾病减重与代谢外科学会（Società Italiana di Chirurgia dell'Obesità e delle Malattie Metaboliche - SICOB）决定设计并制定意大利指南的更新版本，旨在协助医疗保健专业人员选择治疗肥胖及相关病症的手术方案。在2022年6月至10月期间，一个由24名专家组成的小组和一个证据审查团队（ERT，10名成员）参与了临床问题、结果和建议的定义，并根据预先指定的搜索策略收集和分析了所有可用证据。本指南的制定采用了GRADE方法和PICO（患者、干预措施、对照、结果）概念框架。本指南的目的是根据合并症的存在情况核实手术适应症，评估不同类型的手术方法和内镜减重手术，并修订翻修手术和术后程序的适应症。
