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Browsing by Author "Mahawar, K"

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  • Criteria for Inclusion of Newer Bariatric and Metabolic Procedures into the Mainstream: a Survey of 396 Bariatric Surgeons
    Publication . Mahawar, K; Borg, CM; Agarwal, S; Ribeiro, R; De Luca, M; Small, PK
    BACKGROUND: There is currently no consensus on the criteria for inclusion of new bariatric procedures into routine clinical practice. This study canvasses bariatric surgeons in an attempt to define these criteria. METHODS: Bariatric Surgeons from around the world were invited to participate in a questionnaire-based survey on SurveyMonkey ®. RESULTS: 396 bariatric surgeons, 337 International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) members, took the survey. Five clinical studies conducted under the strict monitoring of an Institutional Review Board would satisfy most surgeons (67.7 %, n = 266). When asked regarding the number of patients in these studies, a cumulative number of 500 patients would satisfy 64.5 % (n = 255) of the surgeons. Most respondents regarded endorsement by their national society and IFSO as 'very important' or 'extremely important'. An overwhelming 74.4 % (n = 294) felt that every new procedure should undergo a randomized comparison against one of the established alternatives like Roux-en-Y Gastric Bypass or Sleeve Gastrectomy. CONCLUSION: Evaluation of a new bariatric procedure in at least 5 adequately supervised clinical studies (four of which must be randomized comparisons with one of the existing alternatives) reporting at least 5 years results on a minimum of 500 patients would satisfy majority of bariatric surgeons for the inclusion of a new bariatric procedure into clinical practice. The findings of this survey are simply aimed at starting a discussion on this topic and cannot be used to influence the ground reality until an international consensus can be reached amongst experts.
    2017-04Journal article Open access Show more
  • Esophageal and Gastric Malignancies After Bariatric Surgery: a Retrospective Global Study
    Publication . Parmar, C; Zakeri, R; Abouelazayem, M; Shin, T; Aminian, A; Mahmoud, T; Abu Dayyeh, B; Wee, M; Fischer, L; Daams, F; Mahawar, K; Gallardo, C; Agustin, C; Wright, F; Fuente, I; Carbajo, M; Cal, P; Chisholm, J; Kow, L; Tan, M; Gan, P; Gananadha, S; Felsenreich, D; Prager, G; Matthys, C; Himpens, J; Focquet, M; Ramos, A; Nato, M; Vidal, T; Andalib, A; Siblini, A; Ferri, L; Abdarabo, L; Nevo, Y; Pescarus, R; Yang, W; Hamed, H; Liagre, A; Bergeat, D; Marie, De M; Martini, F; Regis, F; Genser, L; Skalli, M; Nedelcu, M; Smejkal, M; Kassir, R; Nicolas, R; Stier, C; Nedelcut, DS; Christodoulidis, G; Vennapusa, A; Kermansaravi, M; Raziel, A; Sakran, N; Oldani, A; Boru, C; Mécheri, F; Ciccarese, F; Cesana, G; Musella, M; Uccelli, M; Foletto, M; Auricchio, P; Olmi, S; Seki, Y; Kasteleijn, A; Van 'T Hof, G; Apers, J; Hart, J; Van De Sande, J; Takkenberg, M; Feskens, P; Snoekx, R; Plat, V; Sandvik, J; Kalinowski, P; Nabais, C; Al-Bahrani, A; Al Zoubi, M; Bettonica, C; Osorio, J; Tejedor-Tejada, J; Sanz, L; Cuadrado, M; Moorjani, R; Yannick, F; Suter, M; Borbély, Y; Joerg, Z; Barajas-Gamboa, J; Kroh, M; Kisiel, A; Kamocka, A; Immanuel, A; Sgromo, B; Gopinath, B; Khoo, D; Mukherjee, S; Pournaras, D; Underwood, T; Griffiths, E; Miller, G; Jaretzke, H; Dmitrewski, J; Wadley, M; Al-Housni, R; Gillies, R; Singhal, R; Preston, S; Robinson, S; Hawkins, W; Adamo, M; El Kalaawy, M; Gossage, J; Crawford, C; Jaruvongvanich, V
    Background: Bariatric surgery can influence the presentation, diagnosis, and management of gastrointestinal cancers. Esophagogastric (EG) malignancies in patients who have had a prior bariatric procedure have not been fully characterized. Objective: To characterize EG malignancies after bariatric procedures. Setting: University Hospital, United Kingdom. Methods: We performed a retrospective, multicenter observational study of patients with EG malignancies after bariatric surgery to characterize this condition. Results: This study includes 170 patients from 75 centers in 25 countries who underwent bariatric procedures between 1985 and 2020. At the time of the bariatric procedure, the mean age was 50.2 ± 10 years, and the mean weight 128.8 ± 28.9 kg. Women composed 57.3% (n = 98) of the population. Most (n = 64) patients underwent a Roux-en-Y gastric bypass (RYGB) followed by adjustable gastric band (AGB; n = 46) and sleeve gastrectomy (SG; n = 43). Time to cancer diagnosis after bariatric surgery was 9.5 ± 7.4 years, and mean weight at diagnosis was 87.4 ± 21.9 kg. The time lag was 5.9 ± 4.1 years after SG compared to 9.4 ± 7.1 years after RYGB and 10.5 ± 5.7 years after AGB. One third of patients presented with metastatic disease. The majority of tumors were adenocarcinoma (82.9%). Approximately 1 in 5 patients underwent palliative treatment from the outset. Time from diagnosis to mortality was under 1 year for most patients who died over the intervening period. Conclusion: The Oesophago-Gastric Malignancies After Obesity/Bariatric Surgery study presents the largest series to date of patients developing EG malignancies after bariatric surgery and attempts to characterize this condition.
    2022-04Journal article Open access Show more