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EAES rapid guideline: systematic review, network meta-analysis, CINeMA and GRADE assessment, and European consensus on bariatric surgery-extension 2022
FM. Carrano, A. Iossa, N. Di Lorenzo, G. Silecchia, KM. Kontouli, D. Mavridis, I. Alarçon, DM. Felsenreich, S. Sanchez-Cordero, A. Di Vincenzo, MC. Balagué-Ponz, RL. Batterham, N. Bouvy, C. Copaescu, D. Dicker, M. Fried, D. Godoroja, D. Goitein,...
Jazyk angličtina Země Německo
Typ dokumentu časopisecké články, směrnice pro lékařskou praxi, práce podpořená grantem
NLK
ProQuest Central
od 2000-01-01 do Před 1 rokem
Medline Complete (EBSCOhost)
od 1987-03-01 do Před 1 rokem
Nursing & Allied Health Database (ProQuest)
od 2000-01-01 do Před 1 rokem
Health & Medicine (ProQuest)
od 2000-01-01 do Před 1 rokem
- MeSH
- bariatrická chirurgie * metody MeSH
- dospělí MeSH
- film jako téma MeSH
- gastrektomie metody MeSH
- konsensus MeSH
- laparoskopie * metody MeSH
- lidé MeSH
- morbidní obezita * chirurgie MeSH
- síťová metaanalýza MeSH
- systém GRADE MeSH
- výsledek terapie MeSH
- žaludeční bypass * metody MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- směrnice pro lékařskou praxi MeSH
BACKGROUND: The European Association for Endoscopic Surgery Bariatric Guidelines Group identified a gap in bariatric surgery recommendations with a structured, contextualized consideration of multiple bariatric interventions. OBJECTIVE: To provide evidence-informed, transparent and trustworthy recommendations on the use of sleeve gastrectomy, Roux-en-Y gastric bypass, adjustable gastric banding, gastric plication, biliopancreatic diversion with duodenal switch, one anastomosis gastric bypass, and single anastomosis duodeno-ileal bypass with sleeve gastrectomy in patients with severe obesity and metabolic diseases. Only laparoscopic procedures in adults were considered. METHODS: A European interdisciplinary panel including general surgeons, obesity physicians, anesthetists, a psychologist and a patient representative informed outcome importance and minimal important differences. We conducted a systematic review and frequentist fixed and random-effects network meta-analysis of randomized-controlled trials (RCTs) using the graph theory approach for each outcome. We calculated the odds ratio or the (standardized) mean differences with 95% confidence intervals for binary and continuous outcomes, respectively. We assessed the certainty of evidence using the CINeMA and GRADE methodologies. We considered the risk/benefit outcomes within a GRADE evidence to decision framework to arrive at recommendations, which were validated through an anonymous Delphi process of the panel. RESULTS: We identified 43 records reporting on 24 RCTs. Most network information surrounded sleeve gastrectomy and Roux-en-Y gastric bypass. Under consideration of the certainty of the evidence and evidence to decision parameters, we suggest sleeve gastrectomy or laparoscopic Roux-en-Y gastric bypass over adjustable gastric banding, biliopancreatic diversion with duodenal switch and gastric plication for the management of severe obesity and associated metabolic diseases. One anastomosis gastric bypass and single anastomosis duodeno-ileal bypass with sleeve gastrectomy are suggested as alternatives, although evidence on benefits and harms, and specific selection criteria is limited compared to sleeve gastrectomy and Roux-en-Y gastric bypass. The guideline, with recommendations, evidence summaries and decision aids in user friendly formats can also be accessed in MAGICapp: https://app.magicapp.org/#/guideline/Lpv2kE CONCLUSIONS: This rapid guideline provides evidence-informed, pertinent recommendations on the use of bariatric and metabolic surgery for the management of severe obesity and metabolic diseases. The guideline replaces relevant recommendations published in the EAES Bariatric Guidelines 2020.
Biomedical Research Centre National Institute of Health Research London UK
Center for Treatment of Obesity and Metabolic Disorders OB Klinika Prague Czech Republic
Centre for Obesity Research University College London London UK
Department of Anesthesiology Ponderas Academic Hospital Regina Maria Bucharest Romania
Department of General Surgery Ponderas Academic Hospital Regina Maria Bucharest Romania
Department of Health Management and Health Economics University of Oslo Oslo Norway
Department of Primary Education School of Education University of Ioannina Ioannina Greece
Department of Surgery C Chaim Sheba Medical Center Ramat Gan Israel
Department of Surgery Division of General Surgery Vienna Medical University Vienna Austria
Department of Surgery Maastricht University Medical Centre Maastricht The Netherlands
Department of Surgical Sciences University of Rome Tor Vergata Viale Oxford 81 00133 Rome Italy
Division of General Surgery Castelfranco and Montebelluna Hospitals Treviso Italy
EASO Patient Task Force Middlesex UK
Emergency Department General Hospital of Attica KAT Athens Greece
Faculté de Médecine Université Paris Descartes Paris France
General Surgery Department Consorci Sanitari de L'Anoia Barcelona Spain
Hospital Sant Pau UAB Barcelona Spain
Internal Medicine 3 Department of Medicine DIMED
Medical School European University Cyprus Nicosia Cyprus
PhD Program in Applied Medical Surgical Sciences University of Rome Tor Vergata 00133 Rome Italy
Sackler School of Medicine Tel Aviv University Tel Aviv Israel
Surgical Department Mediterranean Hospital of Cyprus Limassol Cyprus
Citace poskytuje Crossref.org
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- $a BACKGROUND: The European Association for Endoscopic Surgery Bariatric Guidelines Group identified a gap in bariatric surgery recommendations with a structured, contextualized consideration of multiple bariatric interventions. OBJECTIVE: To provide evidence-informed, transparent and trustworthy recommendations on the use of sleeve gastrectomy, Roux-en-Y gastric bypass, adjustable gastric banding, gastric plication, biliopancreatic diversion with duodenal switch, one anastomosis gastric bypass, and single anastomosis duodeno-ileal bypass with sleeve gastrectomy in patients with severe obesity and metabolic diseases. Only laparoscopic procedures in adults were considered. METHODS: A European interdisciplinary panel including general surgeons, obesity physicians, anesthetists, a psychologist and a patient representative informed outcome importance and minimal important differences. We conducted a systematic review and frequentist fixed and random-effects network meta-analysis of randomized-controlled trials (RCTs) using the graph theory approach for each outcome. We calculated the odds ratio or the (standardized) mean differences with 95% confidence intervals for binary and continuous outcomes, respectively. We assessed the certainty of evidence using the CINeMA and GRADE methodologies. We considered the risk/benefit outcomes within a GRADE evidence to decision framework to arrive at recommendations, which were validated through an anonymous Delphi process of the panel. RESULTS: We identified 43 records reporting on 24 RCTs. Most network information surrounded sleeve gastrectomy and Roux-en-Y gastric bypass. Under consideration of the certainty of the evidence and evidence to decision parameters, we suggest sleeve gastrectomy or laparoscopic Roux-en-Y gastric bypass over adjustable gastric banding, biliopancreatic diversion with duodenal switch and gastric plication for the management of severe obesity and associated metabolic diseases. One anastomosis gastric bypass and single anastomosis duodeno-ileal bypass with sleeve gastrectomy are suggested as alternatives, although evidence on benefits and harms, and specific selection criteria is limited compared to sleeve gastrectomy and Roux-en-Y gastric bypass. The guideline, with recommendations, evidence summaries and decision aids in user friendly formats can also be accessed in MAGICapp: https://app.magicapp.org/#/guideline/Lpv2kE CONCLUSIONS: This rapid guideline provides evidence-informed, pertinent recommendations on the use of bariatric and metabolic surgery for the management of severe obesity and metabolic diseases. The guideline replaces relevant recommendations published in the EAES Bariatric Guidelines 2020.
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