Iqbal Fahad M, Askari Alan, Lee Matthew J, Hollyman Marianne, Zakeri Roxanna, Pournaras Dimitri J, Al-Taan Omar, Munasinghe Aruna, Mohamed Aly
Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, United Kingdom.
Department of General Surgery, Luton & Dunstable Hospital, Luton, United Kingdom.
Int J Surg Protoc. 2025 Mar 20;29(2):63-67. doi: 10.1097/SP9.0000000000000037. eCollection 2025 Jun.
The advent of bariatric surgery as a widespread intervention is paralleled by comprehensive data capture in bariatric registries following elective surgery. However, significant challenges hinder tracking the incidence and nature of severe complications in the context of bariatric surgery. As the prevalence of bariatric procedures escalates, the establishment of a dedicated, prospective complication registry becomes imperative. Such an initiative would facilitate a nuanced understanding of bariatric surgical emergency (BSE) within the current healthcare milieu, enhance economic evaluations, elucidate long-term patient outcomes, and inform requisite adjustments in professional training. This study is designed to capture and assess the ramifications of emergency bariatric surgical practices within the United Kingdom.
We propose a prospective, multi-center, audit of emergency bariatric surgical activity in all UK hospitals. Eligible participants are those who undergo any intervention or procedure (surgical or endoscopic) to diagnose or treat BSE. Primary outcome measures will include hospital length of stay, rates of complications (Clavien-Dindo), and 30-D mortality. Secondary outcomes will assess the broader impacts and patterns of care, including variations in practice and resource utilization across the nation, rates of outpatient follow-up, and the frequency of subsequent procedures (surgical or endoscopic) post-BSE. Additionally, the study will investigate potential predictors for patients' choice between state-funded and self-pay bariatric surgery options, considering factors such as ethnicity and previous engagement with NHS-specialized weight loss pathways.
This study will be registered as clinical audit at each participating hospital. The protocol will be disseminated through the British Obesity and Metabolic Surgery Society network and using a targeted social media-based strategy in the UK.
随着减肥手术作为一种广泛应用的干预措施出现，选择性手术后减肥登记处也开始进行全面的数据收集。然而，在减肥手术背景下，追踪严重并发症的发生率和性质面临重大挑战。随着减肥手术的普及程度不断提高，建立一个专门的前瞻性并发症登记处变得势在必行。这样一项举措将有助于在当前医疗环境中对减肥手术急症（BSE）有更细致的了解，加强经济评估，阐明患者的长期预后，并为专业培训中的必要调整提供依据。本研究旨在收集并评估英国紧急减肥手术实践的影响。
我们提议对英国所有医院的紧急减肥手术活动进行一项前瞻性、多中心审计。符合条件的参与者是那些接受任何诊断或治疗BSE的干预措施或手术（外科或内镜）的人。主要结局指标将包括住院时间、并发症发生率（Clavien-Dindo分级）和30天死亡率。次要结局将评估更广泛的护理影响和模式，包括全国范围内实践和资源利用的差异、门诊随访率以及BSE后后续手术（外科或内镜）的频率。此外，该研究将调查患者在公费和自费减肥手术选项之间做出选择的潜在预测因素，考虑种族和以前参与国民保健服务（NHS）专门减肥途径等因素。
本研究将在每个参与医院注册为临床审计。该方案将通过英国肥胖与代谢外科学会网络以及在英国采用有针对性的社交媒体策略进行传播。
