Publications by authors named "Scott A Shikora"
Article Synopsis
- The study highlights the increasing importance of metabolic and bariatric surgery (MBS) in addressing global obesity, emphasizing the need for rigorous academic and fellowship training for surgeons.
- A Modified Delphi method involving 89 surgeons from 42 countries was used to establish expert consensus on the necessary criteria for surgeons to obtain privileges for performing MBS, reaching agreement on 29 out of 30 statements.
- Key consensus points include the requirement for surgeons to hold a general surgery degree, complete a dedicated fellowship, and adhere to defined learning curves for various MBS procedures, alongside maintaining patient data and collaborating in a multidisciplinary team.
Purpose: There is a lack of evidence for treatment of some conditions including complication management, suboptimal initial weight loss, recurrent weight gain, or worsening of a significant obesity complication after one anastomosis gastric bypass (OAGB). This study was designed to respond to the existing lack of agreement and to provide a valuable resource for clinicians by employing an expert-modified Delphi consensus method.
Methods: Forty-eight recognized bariatric surgeons from 28 countries participated in the modified Delphi consensus to vote on 64 statements in two rounds.
Article Synopsis
- * A study using a consensus method involved 78 bariatric surgeons globally, who agreed on 54 statements regarding when to use MBS for Class I and II obesity, determining a 70% agreement threshold.
- * The experts concluded that MBS is cost-effective for Class II obesity and Class I obesity with inadequate weight loss from non-surgical methods, and identified specific surgical options including intra-gastric balloon, endoscopic sleeve gastroplasty, sleeve gastrectomy, Roux-en-Y gastric bypass, and one
Purpose Of Review: Gastroparesis is a chronic disorder characterized by a constellation of foregut symptoms, including postprandial nausea, vomiting, distension, epigastric pain, and regurgitation in the absence of gastric outlet obstruction. Despite considerable research over the past decades, there remains to be only nominal understanding of disease classification, diagnostic criteria, pathogenesis, and preferred therapy.
Recent Findings: We critically reassess current approaches for disease identification and stratification, theories of causation, and treatment for gastroparesis.
MAJOR UPDATES TO 1991 NATIONAL INSTITUTES OF HEALTH GUIDELINES FOR BARIATRIC SURGERY: Metabolic and bariatric surgery (MBS) is recommended for individuals with a body mass index (BMI) >35 kg/m, regardless of presence, absence, or severity of co-morbidities.MBS should be considered for individuals with metabolic disease and BMI of 30-34.9 kg/m.
View Article and Find Full Text PDFBackground: Hospital readmission (HR) rates following metabolic/bariatric surgery (MBS) are used as a surrogate for quality outcomes and are increasingly tied to reimbursement rates. There are limited data concerning predictors of HR rates with regard to type of bariatric procedure.
Methods: This study is a retrospective review of prospectively collected data from patients who underwent MBS from January 2014 to December 2019 at Brigham and Women's Hospital in Boston, Massachusetts.
Major updates to 1991 National Institutes of Health guidelines for bariatric surgery.
View Article and Find Full Text PDFIntroduction: Previous studies have demonstrated that one anastomosis gastric bypass (OAGB) is not inferior to Roux-en-Y gastric bypass (RYGB) in treating obesity. However, high level evidence comparing the efficacy and safety of both procedures in type 2 diabetes (T2D) treatment is still lacking, which is another main aim of bariatric surgery. The presented trial has been designed to aim at investigating the superiority of OAGB over the reference procedure RYGB in treating T2D as primary endpoint.
View Article and Find Full Text PDFBackground: Laparoscopic surgery has almost replaced open surgery in many areas of Gastro-Intestinal (GI) surgery. There is currently no published expert consensus statement on the principles of laparoscopic GI surgery. This may have affected the training of new surgeons.
View Article and Find Full Text PDFBackground: Obesity is a risk factor for gallstone formation, which can be exacerbated by bariatric surgery-induced rapid weight loss. Current guidelines do not recommend concomitant cholecystectomy (CC) for asymptomatic gallstones during the bariatric surgery procedure. However, long-term follow-up studies have shown that the incidence of post-bariatric surgery symptomatic gallstones necessitating therapeutic cholecystectomy increases to 40%.
View Article and Find Full Text PDFIntroduction: Sleeve gastrectomy (SG) is the commonest bariatric procedure worldwide. Yet there is significant variation in practice concerning its various aspects. This paper report results from the first modified Delphi consensus-building exercise on SG.
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to gather a consensus among 44 expert bariatric surgeons on how to safely resume Bariatric and Metabolic Surgery during the COVID-19 pandemic.
- A modified Delphi method was used, allowing the experts to review and agree on 111 proposed statements across two rounds, with a consensus defined as at least 70% agreement.
- The results include 38 key recommendations that can help medical teams resume surgeries and guide future research in the field.
Background: Laparoscopic sleeve gastrectomy (LSG) is a well-established bariatric procedure. A staple line leak is a recognized complication of LSG. Bougie size has been suggested to impact leak rates.
View Article and Find Full Text PDFBackground: Revisional bariatric surgery (RBS) constitutes a possible solution for patients who experience an inadequate response following bariatric surgery or significant weight regain following an initial satisfactory response. This paper reports results from the first modified Delphi consensus-building exercise on RBS.
Methods: We created a committee of 22 recognised opinion-makers with a special interest in RBS.
Background: Of patients undergoing Roux-en-Y gastric bypass (RYGB), 15-35% of patients fail to achieve "adequate" weight loss or regain significant weight. Multiple solutions have been proposed, but not well studied. We report our experience with limb distalization with lengthening the biliopancreatic (BP) limb and shortening the common channel (CC).
View Article and Find Full Text PDFSleeve gastrectomy is a relatively newer bariatric surgical procedure and has become the most common of all bariatric surgeries performed. Complication rates reported with sleeve gastrectomies are relatively low and are generally due to staple line leaks, hemorrhage, or sleeve stricture. Portal vein thrombosis is an uncommon but potentially dangerous complication.
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