Clinical Practice Guidelines For The Perioperative Nutritional,Metabolic, And Nonsurgical Support Of The Bariatric Surgery Patient2013 Update: Cosponsored By American Association Of Clinical Endocrinologists,The Obesity Society,And American Society For Metabolic & Bariatric Surgery |
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| Institution: | 1. Icahn School of Medicine at Mount Sinai, New York, New York;2. Cedars Sinai Medical Center, Los Angeles, California;3. Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts;4. Birmingham VA Medical Center, University of Alabama at Birmingham, Birmingham, Alabama;5. Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota;6. Cleveland Clinic Lerner College of Medicine, Behavioral Services, Cleveland, Ohio;7. Feinberg School of Medicine, Northwestern University, Chicago, Illinois;8. Health & Fitness Institute, Intermountain Healthcare and Cardiovascular Genetics Division, University of Utah School of Medicine, Salt Lake City, Utah;9. Harvard Medical School, Center for Metabolic Health and Bariatric Surgery, Brigham and Women''s Hospital, Boston, Massachusetts;10. Baker IDI Heart and Diabetes Institute, Head of Obesity Research, Monash University, Melbourne, Australia;11. Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio;2. Center for Advanced Laparoscopic General & Bariatric Surgery, MedStar-Washington Hospital Center and Georgetown University School of Medicine, Washington, DC 20010, USA |
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| Abstract: | The development of these updated guidelines was commissioned by the AACE, TOS, and ASMBS Board of Directors and adheres to the AACE 2010 protocol for standardized production of clinical practice guidelines (CPG). Each recommendation was re-evaluated and updated based on the evidence and subjective factors per protocol. Examples of expanded topics in this update include: the roles of sleeve gastrectomy, bariatric surgery in patients with type-2 diabetes, bariatric surgery for patients with mild obesity, copper deficiency, informed consent, and behavioral issues. There are 74 recommendations (of which 56 are revised and 2 are new) in this 2013 update, compared with 164 original recommendations in 2008. There are 403 citations, of which 33 (8.2%) are EL 1, 131 (32.5%) are EL 2, 170 (42.2%) are EL 3, and 69 (17.1%) are EL 4. There is a relatively high proportion (40.4%) of strong (EL 1 and 2) studies, compared with only 16.5% in the 2008 AACETOS-ASMBS CPG. These updated guidelines reflect recent additions to the evidence base. Bariatric surgery remains a safe and effective intervention for select patients with obesity. A team approach to perioperative care is mandatory with special attention to nutritional and metabolic issues. |
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