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Secondo un articolo pubblicato sul Journal of American College of Surgeons, nei centri Accademici degli Stati Uniti, l’intervento laparoscopico di gastrectomia verticale (Sleeve gastrectomy) ha ormai ampiamente sostituito, come procedura bariatrica, il bendaggio gastrico

The study examined the popularity of procedures between October 1 2008 and September 30 2012. It found that by 2012, gastric banding made up 4.8% of all bariatric operations performed in US academic hospitals, a drop from 23.8% four years earlier. Over the same time period, sleeve gastrectomy rose from 0.9% to 36.3%.

Despite remaining the most popular operation, the number of laparoscopic gastric bypasses also decreased over the same period, from 66.8% of all operations in the fourth quarter of 2008 to 56.4% in the third quarter of 2012. The number of open gastric bypasses continued to decline, from 8.6% in 2008 to 3.2% in 2012.

The paper took data from the University HealthSystem Consortium Clinical Database, which collects data from all US academic health centres and affiliate community hospitals. It included data from 60,738 patients.

The authors say that it is the first paper to demonstrate the national trend in the increased use of laparoscopic sleeve gastrectomy in the USA. However, they note that their data did not include operations performed in private medical centres, which means that the numbers reported may not be completely accurate as a picture of bariatric surgery across the country.

The paper notes a number of factors which potentially led to the speedy acceptance of sleeve gastrectomy as a primary operation, at the expense of gastric bands – most notably, the support of the operation as a primary procedure by the ASMBS.

Other factors included the sleeve gastrectomy being found to engender greater weight loss than the gastric band; the willingness of third-party payors to fund the operation; and the perception that failed gastric bands were leading to an unacceptably high rate of explantation.

The paper also published the number of centres performing each type of operation, finding that while the number of centres performing bariatric procedures remained steady, the number of centres performing sleeve gastrectomy had risen by late 2012 to the point where there were over 80 centres identified as performing the operation in the sample, matching the number of centres performing gastric bypass. Conversely, the number of centres performing gastric banding dropped from almost 60 in 2010 to just over 20 in 2012.

Friday, March 1, 2013 
Pete Myall – Online editor, Bariatric News
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