title: The Peri-operative Bariatric Surgery Care in the Middle East Region.
abstract: Bariatric surgery is common in the Middle East region. However, regional accreditation bodies and guidelines are lacking. We present the current peri-operative practice of bariatric surgery in the Middle East region.
  
  
  
  Public and private practice in the Middle East region.
  
  
  
  A questionnaire was designed to study trends of peri-operative care in bariatric surgery. It was sent to members of the Pan Arab Society for Metabolic and Bariatric Surgery (PASMBS).
  
  
  
  Ninety-three surgeons (88.6%) responded, 63.4% were in private practice, 68.5% have been in practice for more than 5 years, and 61.1% performed more than 125 cases per year. Laparoscopic sleeve gastrectomy (LSG) was the commonest procedure performed, then laparoscopic Roux-en-Y gastric bypass (LRYGB), one anastomosis gastric bypass/mini gastric bypass (OAGB/MGB), and laparoscopic adjustable gastric banding (LAGB). Pre-operatively as a routine, 65% referred patients for dietitian and (78.3%) for smoking cessation. In contrast as a routine, 22.6% referred patients to a psychologist, 30% screened for obstructive sleep apnea (OSA), and when they did, they did not use a questionnaire. For patients 50 years of age, 22% performed a screening colonoscopy and 33.7% referred patients to a cardiologist. Intra-operatively as a routine, 25.3% placed a drain and 42.2% placed urinary catheters. In contrast, 77.1% performed a leak test (82.7% as a methylene blue leak test). Post-operatively, 79.5% used chemoprophylaxis for venous thromboembolism and 89% required patients to take vitamins. In contrast, 25% prescribed ursodeoxycholic acid.
  
  
  
  The wide variation in the peri-operative care of bariatric surgery in the Middle East region highlights the need for regional guidelines based on international guidelines.
authors.affiliation: Bariatric and Metabolic Institute Abu Dhabi, Sheikh Khalifa Medical City, Abu Dhabi, UAE. Nimeri@gmail.com.|Division of General, Thoracic and Vascular Surgery, Sheikh Khalifa Medical City, Abu Dhabi, UAE. Nimeri@gmail.com.
authors.forename: Abdelrahman
authors.identifier: 0000-0001-7844-163X
authors.initials: A
authors.lastname: Nimeri
authors.affiliation: Dr Hadad Health Point Hospital, Abu Dhabi, UAE.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al Hadad
authors.affiliation: Kuwait University, Kuwait City, Kuwait.
authors.forename: Mousa
authors.initials: M
authors.lastname: Khoursheed
authors.affiliation: Bariatric and Metabolic Institute Abu Dhabi, Sheikh Khalifa Medical City, Abu Dhabi, UAE.|Division of General, Thoracic and Vascular Surgery, Sheikh Khalifa Medical City, Abu Dhabi, UAE.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Maasher
authors.affiliation: King Saud University, Riyadh, Saudi Arabia.
authors.forename: Aayed
authors.initials: A
authors.lastname: Al Qahtani
authors.affiliation: Bariatric and Metabolic Institute Abu Dhabi, Sheikh Khalifa Medical City, Abu Dhabi, UAE.|Division of General, Thoracic and Vascular Surgery, Sheikh Khalifa Medical City, Abu Dhabi, UAE.
authors.forename: Talat
authors.initials: T
authors.lastname: Al Shaban
authors.affiliation: Makassed General Hospital, Beirut, Lebanon.
authors.forename: Hayssam
authors.initials: H
authors.lastname: Fawal
authors.affiliation: American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Bassem
authors.initials: B
authors.lastname: Safadi
authors.affiliation: Sulaimania Medical Complex, Beirut, Lebanon.
authors.forename: Amer
authors.initials: A
authors.lastname: Alderazi
authors.affiliation: Mansoura University, Mansoura City, Egypt.
authors.forename: Emad
authors.initials: E
authors.lastname: Abdalla
authors.affiliation: Jordan Hospital, Amman, Jordan.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Bashir
mesh_terms: D015391:Gastroplasty / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D010535:Laparoscopy / Q000379:methods / Q000706:statistics & numerical data*; D008877:Middle East; D009767:Obesity, Morbid / Q000601:surgery*; D019990:Perioperative Care; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Bariatric surgery practice; Middle East; Peri-operative