Khorgami Zhamak, Shoar Saeed, Andalib Amin, Aminian Ali, Brethauer Stacy A, Schauer Philip R
Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
Department of Bariatric and Metabolic Surgery, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, New York, New York.
Surg Obes Relat Dis. 2017 May;13(5):774-778. doi: 10.1016/j.soard.2017.01.031. Epub 2017 Jan 25.
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.
This study aimed to analyze the changing pattern of bariatric surgery utilization from 2010 to 2014.
Using the American College of Surgeons National Surgical Quality Improvement Program database from 2010 to 2014.
We identified patients aged≥18 years with a body mass index (BMI)≥35 kg/m undergoing primary bariatric surgery. The trend of surgical procedures was analyzed from 2010 to 2014.
A total of 93,328 patients were included (age of 44.6±11.8 years and BMI of 46.2±7.9 kg/m). 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 (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).
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.
减肥手术是治疗病态肥胖最有效的方法。此外，在过去二十年中，各种减肥手术的比例发生了显著变化。近年来，袖状胃切除术（SG）越来越多地被选作主要的减肥手术。
本研究旨在分析2010年至2014年减肥手术使用情况的变化模式。
使用美国外科医师学会2010年至2014年的国家外科质量改进计划数据库。
我们确定年龄≥18岁、体重指数（BMI）≥35kg/m²且接受初次减肥手术的患者。分析2010年至2014年手术方式的趋势。
共纳入93328例患者（年龄44.6±11.8岁，BMI46.2±7.9kg/m²）。2010年，胃旁路术（RYGB）、可调节胃束带术和SG分别占手术的58.4%、28.8%和9.3%，2014年分别变为37.6%、3.1%和58.2%。SG患者的基线BMI从47.5降至45.6kg/m²（P<0.001）。接受RYGB的糖尿病患者比例增加（从30.4%增至33.2%，P<0.001），但接受SG的患者中这一比例下降（从26.6%降至22.8%，P = 0.001）。接受RYGB的高血压患者比例保持不变，而接受SG的患者中这一比例下降（从56.2%降至47.6%，P<0.001）。SG组中的女性患者从73.2%增至77.7%（P<0.001）。
在美国，SG的实施越来越多，已取代可调节胃束带术和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结局的数据来评估其长期有效性和可信度。
