Trends in utilization of bariatric surgery, 2010-2014: sleeve gastrectomy dominates
Trends in utilization of bariatric surgery, 2010-2014: sleeve gastrectomy dominates
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DOI：
10.1016/j.soard.2017.01.031
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发表时间：
2017-05-01
影响因子：
3.1
通讯作者：
Schauer, Philip R.
中科院分区：
文献类型：
--
作者：
Khorgami, Zhamak;Shoar, Saeed;Schauer, Philip R.
背景：减肥手术是治疗病态肥胖最有效的方法。此外，在过去20年里，各种减肥手术的比例发生了显著变化。目的：本研究旨在分析2010-2014年间减肥手术应用的变化模式。背景：使用2010-2014年间美国外科医师学会国家外科质量改进计划数据库。方法：我们确定了年龄为18岁、体重指数(BMI)为35 kg/m(2)的患者接受初次减肥手术。结果：共纳入93,328例患者，年龄44.6±11.8岁，体重指数46.2±7.9 kg/m(2例)。Roux-en-Y胃旁路(RYGB)、可调节胃束带和SG分别占2010年的58.4%、28.8%和9.3%，2014年分别为37.6%、3.1%和58.2%。SG患者的基线BMI从47.5 kg/m(2)降至45.6 kg/m(2)(P<；.001)。接受RYGB治疗的糖尿病患者的比例增加(30.4%至33.2%，P<；.001)，但在SG患者中下降(26.6%至22.8%，P=.001)。高血压患者患有RYGB的比例保持不变，而在SG患者中下降(56.2%至47.6%，P<；.001)。SG组的女性患者从73.2%增加到77.7%(P<；.001)。结论：SG在美国已经越来越多地取代可调胃带和RYGB。这一趋势有利于女性，较低的BMI，以及较低的糖尿病和高血压患者比例。需要更多关于SG结果的数据来评估其长期有效性和可信度。(C)2017年美国新陈代谢和减肥外科学会。版权所有。
Background: Bariatric surgery is the most effective treatment for morbid obesity. Furthermore, the proportion of various types of bariatric procedures has significantly changed over the last two decades. Sleeve gastrectomy (SG) has been increasingly chosen as a primary bariatric procedure in recent years.Objectives: This study aimed to analyze the changing pattern of bariatric surgery utilization from 2010 to 2014.Settings: Using the American College of Surgeons National Surgical Quality Improvement Program database from 2010 to 2014.Method: We identified patients aged >= 18 years with a body mass index (BMI) >= 35 kg/m(2) undergoing primary bariatric surgery. The trend of surgical procedures was analyzed from 2010 to 2014.Results: A total of 93,328 patients were included (age of 44.6 +/- 11.8 years and BMI of 46.2 +/- 7.9 kg/m(2)). Roux-en-Y gastric bypass (RYGB), adjustable gastric band, and SG comprised 58.4%, 28.8%, and 9.3% of the procedures in 2010 which changed to 37.6%, 3.1%, and 58.2% in 2014, respectively. Baseline BMI of SG patients decreased from 47.5 to 45.6 kg/m(2) (P < .001). The proportion of diabetic patients undergoing RYGB increased (30.4% to 33.2%, P < .001) but decreased among those having SG (26.6% to 22.8%, P = .001). The proportion of patients with hypertension having RYGB remained unchanged while decreased among SG patients (56.2% to 47.6%, P < .001). Female patients among the SG group increased from 73.2% to 77.7% (P < .001).Conclusion: SG has been increasingly performed in the United States superseding adjustable gastric band and RYGB. The trend is in favor of females, lower BMI, and lower ratio of patients with diabetes and hypertension. More data are needed on outcomes of SG to assess its long-term effectiveness and credibility. (C) 2017 American Society for Metabolic and Bariatric Surgery. All rights reserved.