Ben Gys1,2, Philip Plaeke3, Bas Lamme4, Thierry Lafullarde5, Niels Komen6, Anthony Beunis6, Guy Hubens6. 1. Department of Abdominal Surgery, University Hospital Antwerp, Edegem, Belgium. ben.gys@gmail.com. 2. Department of Surgery, Sint-Dimpna Hospital, Geel, Belgium. ben.gys@gmail.com. 3. Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium. 4. Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands. 5. Department of Surgery, Sint-Dimpna Hospital, Geel, Belgium. 6. Department of Abdominal Surgery, University Hospital Antwerp, Edegem, Belgium.
Abstract
BACKGROUND: No real consensus regarding the definition of dumping syndrome (DS) seems to exist and few subtyping is used in clinical practice. Knowledge is needed for correct design of trials and establishment of uniform treatment strategies. The aim of this study is to explore the distribution of clinical characteristics related to the subtypes of DS. METHODS: A comprehensive search was performed in Cochrane, Google Scholar, PubMed, and ResearchGate. Data were collected on the definition and diagnostics of DS used in each study. RESULTS: Twenty-seven clinical trials were included. Seventeen articles clearly provided a definition of DS and ten of these differentiated between early and late DS. Diagnose of DS was based on clinical symptoms (24 articles), hemodynamic parameters (e.g., tachycardia, hypotension; 9 articles), and biochemical analysis (e.g., blood sugar level; 12 articles). Questionnaires were used in 13 articles. A total of 67 different symptoms were correlated with dumping syndrome. Two symptoms were exclusively correlated with early and nine with late DS. Nine articles differentiated between early and late dumping based on timing since the last meal. Hypoglycemia was correlated with late DS in ten articles. CONCLUSIONS: This study reveals a vast heterogeneity in the definition and clinical characteristics of DS after RYGB. We feel that a standardized definition is required to provide a firm parameter in the evaluation and setup of clinical trials. A better understanding and description of the definition and diagnostic criteria of DS after RYGB is crucial to improve scientific reporting.
BACKGROUND: No real consensus regarding the definition of dumping syndrome (DS) seems to exist and few subtyping is used in clinical practice. Knowledge is needed for correct design of trials and establishment of uniform treatment strategies. The aim of this study is to explore the distribution of clinical characteristics related to the subtypes of DS. METHODS: A comprehensive search was performed in Cochrane, Google Scholar, PubMed, and ResearchGate. Data were collected on the definition and diagnostics of DS used in each study. RESULTS: Twenty-seven clinical trials were included. Seventeen articles clearly provided a definition of DS and ten of these differentiated between early and late DS. Diagnose of DS was based on clinical symptoms (24 articles), hemodynamic parameters (e.g., tachycardia, hypotension; 9 articles), and biochemical analysis (e.g., blood sugar level; 12 articles). Questionnaires were used in 13 articles. A total of 67 different symptoms were correlated with dumping syndrome. Two symptoms were exclusively correlated with early and nine with late DS. Nine articles differentiated between early and late dumping based on timing since the last meal. Hypoglycemia was correlated with late DS in ten articles. CONCLUSIONS: This study reveals a vast heterogeneity in the definition and clinical characteristics of DS after RYGB. We feel that a standardized definition is required to provide a firm parameter in the evaluation and setup of clinical trials. A better understanding and description of the definition and diagnostic criteria of DS after RYGB is crucial to improve scientific reporting.
Authors: Constantine T Frantzides; Mark A Carlson; Valerie K Shostrom; Jacob Roberts; George Stavropoulos; George Ayiomamitis; Alexander Frantzides Journal: Obes Surg Date: 2011-02 Impact factor: 4.129