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Third IFSO Global Registry Report

IFSO publishes Third IFSO Global Registry Report

Global IFSO Registry Project The report is the culmination of years of research and analyses from the IFSO Global Registry Project
This latest report includes 196,188 operation records from 42 countries from five continents
the report states that the average percentage weight loss was 30.1% and after primary surgery 62.4% of those taking medication for type 2 diabetes beforehand were no longer on medication one year after surgery

The Third IFSO Global Registry Report (2017) has been released at the XXII World Congress of the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) in London, UK. Published by Dendrite Clinical Systems, under the auspices of the IFSO, the publication reports data from more than 40 countries on over 196,000 operations including baseline obesity related disease, operation types, operative outcomes and disease status after bariatric surgery.

Global IFSO Registry Project The report is the culmination of years of research and analyses from the IFSO Global Registry Project, which was established in January 2014 to demonstrate that it is possible to merge and analyse bariatric and metabolic surgical data from different countries and centres.

IFSO President, Dr Kelvin Higa

“Bariatric/Metabolic Surgery is unlike any other surgical specialty. We look to the long-term effects and are not satisfied with one or two-year data; even 10 to 20 year data may not be enough to judge if our interventions today should be continued,” said IFSO President, Dr Kelvin Higa. “If we had data from the past 30 years of surgery to analyse and integrate with our current concepts of the pathophysiology of our operations, I think we would be closer to answering many important questions such as What should be the criteria for surgery? How do I choose the right operation for the right patient? What are the long-term consequences of my intervention? Reporting data and participating in a registry such as IFSO Global Registry is indicative of the serious commitment to the long-term care of our patients and the advancement of the universal standards by which we practice.”

This latest report includes 196,188 operation records from 42 countries from five continents, and has detailed information on 106,219 gastric bypass operations (54.1% of all the records submitted), 58,885 sleeve gastrectomy procedures (30.0%) and 19,101 gastric banding operations (9.7%). The publication has some interesting county-tocountry analysis and notes a wide variation of BMI pre-surgery between different contributor countries, ranging from 36.7kg m2 in Peru to 51.1kgm2 in Egypt (43.1 kgm2). The highest proportions of gastric bypass surgery were reported in Venezuela (100.0%) and Sweden (95.6%), compared with Kuwait (100.0%), Australia (100.0%) and Saudi Arabia (100.0%), who reported the highest rates of sleeve gastrectomy operations.

IFSO president-elect, Jacques M Himpens

“We at IFSO are convinced that one of our prime tasks is to provide global guidelines for safe and effective surgery to the benefit of the patient with adiposity. Critical appraisal of what we do is essential to achieve this goal,” IFSO president-elect, Jacques M Himpens. “More than ever we must share our data with the world. More than ever we must contribute to a global and complete registry.”

Prior to surgery, 21.8% of patients were on medication for type 2 diabetes, 31.4% of patients were treated for hypertension, 15.3% of patients were on medication for depression, 20.2% of patients required treatment for musculo-skeletal pain, 20.3% of patients had sleep apnoea and 24.8% of patients had gastro-esophageal reflux disorder.

Outcomes Following surgery, the report states that the average percentage weight loss was 30.1% and after primary surgery 62.4% of those taking medication for type 2 diabetes beforehand were no longer on medication one year after surgery. The proportion of patients no longer treated for diabetes was highly dependent on weight loss achieved. There were also significant reductions in the rates of treatment for depression, hypertension and musculo-skeletal pain, as well as a decline in rates of confirmed sleep apnoea and GERD one year after surgery.

Other highlights of the report show:  

  • 86.7% of patients who had a gastric band inserted were discharged within one day of their operation after gastric bypass n 63.7% of patients were discharged within two days of surgery;
  • 79.4% of sleeve gastrectomy patients went home within three days of their operation n Unsurprisingly, 98.8% of all operations were performed laparoscopically
  • The Obesity Surgery Mortality Risk Score (OSMRS) varied widely by country with Georgia, Hong Kong and Argentina reporting the highest-risk patient populations (OSMRS groups B & C: 88.2%. 75.0% and 62.0% respectively) and Kuwait, Colombia and the Netherlands reporting the least risk patient populations (OSMRS groups B & C: 17.9%, 20.4% and 23.9% respectively).

“Thank you to all those surgeons who have committed their data for inclusion in this second report, your contribution is very much appreciated. I encourage all key stakeholders in bariatric surgery (especially surgeons, providers and commissioners of care) to embrace this data collection and reporting process at individual clinics and hospitals, and onwards/upwards at both national and international levels,” writes Mr Richard Welbourn in the introduction of the report. “It will require widespread involvement tand on-going commitment from all those involved in the care of the bariatric patient to ensure high-quality data can be collected, properly analysed and shared, so that we will be better able to understand shifts in disease patterns, practice and outcomes on a global scale.”

“Together with IFSO, we are delighted to publish this third report. I would like to thank all the contributors for submitting their data,” said Dr Peter Walton, Managing Director of Dendrite Clinical Systems. “I hope this important publication not only suggests many international research projects that could be undertaken, but advances the status and acceptability of bariatric surgery worldwide, helping promote an increase in bariatric and metabolic surgery provision.”

The Global IFSO Registry Project was headed by Kelvin Higa (United States), Jacques Himpens (Belgium), Richard Welbourn (UK), John Dixon (Australia), Peter Walton (Dendrite Clinical Systems) and Robin Kinsman (Dendrite Clinical Systems).

If you are interested in participating in the Fourth IFSO Global Registry Report, please email: ifsoregistry@edendrite.com for more information.

A limited number of copies of The Third IFSO Global Registry Report will be available to IFSO members at XXII IFSO World Congress. To collect your copy, please visit Dendrite Clinical Systems at Stand 20 in the Exhibition Hall.

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