3yearsleeve
CMS VS ASMBS STATEMENTS?? http://www.cms.gov/medicare-coverage-
Oct 05, 2012
CMS STATEMENT:
The Centers for Medicare & Medicaid Services (CMS) proposes that the currently available evidence is insufficient to conclude that the bariatric surgery known as laparoscopic sleeve gastrectomy (LSG) for the treatment of obesity (BMI ≥ 35 kg/m2) improves long-term beneficiary health outcomes. We therefore propose that coverage for LSG is not reasonable and necessary under § 1862 (a) (1) (A) of the Social Security Act.
The Centers for Medicare & Medicaid Services (CMS) proposes that the currently available evidence is insufficient to conclude that the bariatric surgery known as laparoscopic sleeve gastrectomy (LSG) for the treatment of obesity (BMI ≥ 35 kg/m2) improves long-term beneficiary health outcomes. We therefore propose that coverage for LSG is not reasonable and necessary under § 1862 (a) (1) (A) of the Social Security Act.
ASMBS STATEMENT:
The American Society for Metabolic and Bariatric Surgery (ASMBS) posted an update of their position statement:
Summary and Recommendations.
“Substantial comparative and long-term data are now published in the peer-reviewed literature demonstrating durable weight loss, improved medical comorbidities, long-term patient satisfaction, and improved quality of life after SG. The ASMBS therefore recognizes SG as an acceptable option as a primary bariatric procedure and as a first stage procedure in high risk patients as part of a planned staged approach.
Based on the current published literature, SG has a risk/benefit profile that lies between the laparoscopic adjustable gastric band and the laparoscopic Roux-en-Y gastric bypass. As with any bariatric procedure, long-term weight regain can occur and, in the case of SG, this could be managed effectively with re-intervention. Informed consent for SG used as a primary procedure should be consistent with consent provided for other bariatric procedures and should include the risk of long-term weight gain. Surgeons performing SG are encouraged to continue to prospectively collect and report outcome data in the peer-reviewed scientific literature.”
This update was posted on the ASMBS site but has not yet been published in a peer reviewed journal. Long term data were extracted from 6 single site observational studies all with small sample sizes (n < 50), high loss to follow-up (20 - 90%) and/or high rate of revisional surgery (> 20%).