Alsuhibani Abdulrahman, Thompson Jonathan R, Wigle Patricia R, Guo Jeff Jianfei, Lin Alex C, Rao Marepalli B, Hincapie Ana L
From the Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, Saudi Arabia.
Department of Health outcome, James L. Winkle College of Pharmacy, University of Cincinnati Academic Health Center, Cincinnati, OH.
Ann Surg Open. 2023 Dec 4;4(4):e317. doi: 10.1097/AS9.0000000000000317. eCollection 2023 Dec.
Bariatric surgery has evolved over the past 2 decades yet assessing trends of bariatric surgery utilization in the growing eligible population is lacking.
This study aimed to update the trends in bariatric surgery utilization, changes in types of procedures performed, and the characteristics of patients who underwent bariatric surgery in the United States, using real-world data.
This retrospective descriptive observational study was conducted using the TriNetX, a federated electronic medical records network from 2012 to 2021, for adult patients 18 years old or older who had bariatric surgery. Descriptive statistical analysis was conducted to assess patients' demographics and characteristics. Annual secular trend analyses were conducted for the annual rate of bariatric surgery, and the specific procedural types and proportions of laparoscopic surgeries.
A steady increase in the number of procedures performed in the United States over the first 6 years of the study, a plateau for the following 2 years, and then a decline in 2020 and 2021 (during the coronavirus disease 2019 pandemic). The annual rate of bariatric surgery was lowest in 2012 at 59.2 and highest in 2018 at 79.6 surgeries per 100,000 adults. During the study period, 96.2% to 98.8% of procedures performed annually were conducted laparoscopically as opposed to the open technique. Beginning in 2012, the Roux-en-Y gastric bypass (RYGB) procedure fell to represent only 17.1% of cases in 2018, along with a sharp decline in the adjustable gastric band (AGB) procedure, replaced by a sharp increase in the sleeve gastrectomy (SG) procedure to represent over 74% of cases in 2018.
Bariatric surgery utilization in the United States showed a moderate decline in the number of RYGB procedures, which was offset by a substantial increase in the number of SG procedures and a precipitous drop in the annual number of AGB procedures.
在过去20年里，减肥手术不断发展，但在不断增加的符合条件的人群中，评估减肥手术的使用趋势的研究尚属空白。
本研究旨在利用真实世界数据，更新美国减肥手术的使用趋势、所实施手术类型的变化以及接受减肥手术患者的特征。
本回顾性描述性观察性研究使用TriNetX（一个联合电子病历网络），研究对象为2012年至2021年间接受减肥手术的18岁及以上成年患者。进行描述性统计分析以评估患者的人口统计学和特征。对减肥手术的年发生率、特定手术类型以及腹腔镜手术的比例进行年度长期趋势分析。
在研究的前6年中，美国实施的手术数量稳步增加，随后2年趋于平稳，然后在2020年和2021年（2019冠状病毒病大流行期间）下降。减肥手术的年发生率在2012年最低，为每10万成年人中有59.2例，在2018年最高，为每10万成年人中有79.6例。在研究期间，每年进行的手术中有96.2%至98.8%是通过腹腔镜进行的，而非开放手术技术。从2012年开始，胃旁路术（RYGB）在2018年仅占病例的17.1%，同时可调节胃束带术（AGB）急剧下降，取而代之的是袖状胃切除术（SG）急剧增加，在2018年占病例的74%以上。
美国减肥手术的使用情况显示，RYGB手术数量适度下降，这被SG手术数量的大幅增加和AGB手术年度数量的急剧下降所抵消。
