中国实用外科杂志

中国实用外科杂志 ›› 2024, Vol. 44 ›› Issue (08): 900-905.DOI: 10.19538/j.cjps.issn1005-2208.2024.08.13

• 论著 • 上一篇    下一篇

上海市减重代谢手术质量控制2012—2023年数据分析

上海市普通外科临床质量控制中心减重及代谢外科专家组，上海市医师协会外科医师分会减重代谢外科工作组   

  • 出版日期:2024-08-01 发布日期:2024-08-23

  • Online:2024-08-01 Published:2024-08-23

摘要： 目的    基于上海市减重代谢手术质量控制数据库，分析2012—2023年上海市减重代谢手术的趋势和进展。方法    回顾性分析2012—2023年上海市开展减重代谢外科手术相关数据，按人口学特征、手术类型、围手术期变量等分别分析，反映既往12年上海市减重代谢手术的发展趋势。结果    2012—2023年上海市共开展9282例减重代谢手术，12年间年手术例数从2012年的100例增至2023年的1430例。12年间本数据库总体人口学特征为女性∶男性病人比例为2.16∶1；基线平均BMI为38.7±7.3；术前合并2型糖尿病比例32.4%；术后严重并发症占比0.4%，30 d内再手术率0.2%。病人主要来源于上海本地，占比66.5%。自2014年起，主要开展术式为胃袖状切除术（SG）；12年间SG总占比为87.9%（8162例），Roux-en-Y胃旁路术（RYGB）占比7.7%（717例），各类探索性手术占比3.7%（348例）。2019—2023年有施行修正手术的记录，共55例，以SG术后病人为主，首选修正方案为修正为胃袖状切除联合单吻合口十二指肠-回肠旁路术（r-SADI-S），占比32.7%；其次为修正为单吻合口胃旁路术（r-OAGB），占比21.8%；第三位r-RYGB，占比18.2%。术后严重并发症共26例，占比0.4%。结论    12年来，上海市减重代谢手术手术量稳步增加。自2014年以来，SG已成为最主要的手术术式，RYGB手术量仍居第二位。自2021年起，SADI-S与OAGB是上海市主要开展的修正手术方案。在良好的质量控制管理下，围手术期并发症发生率较低。

关键词: 减重代谢手术, 上海, 胃袖状切除术, Roux-en-Y胃旁路术, 质量控制

Abstract: Based on the quality control database for bariatric and metabolic surgery in Shanghai, this study analyzes the trends and advancements in bariatric and metabolic surgeries in Shanghai from 2012 to 2023. Methods    A retrospective analysis of data on bariatric and metabolic surgeries conducted in Shanghai from 2012 to 2023 was performed. The data were analyzed by demographic characteristics, types of bariatric & metabolic surgeries, and perioperative variables to reflect the development trends of these surgeries over the past 12 years. Results    From 2012 to 2023, a total of 9282 bariatric and metabolic surgeries were performed in Shanghai. The number of surgeries per year increased from 100 in 2012 to 1430 in 2023. The overall demographic characteristics of this database during the 12 years are as follows: the female-to-male patient ratio was 2.16∶1. The baseline average BMI was 38.7±7.3. Preoperative comorbidity of type 2 diabetes was present in 32.4% of patients. Postoperative severe complications occurred in 0.4% of cases, and the reoperation rate within 30 days was 0.2%. Most patients (66.5%) were from Shanghai. Since 2014, sleeve gastrectomy (SG) has been the predominant surgical method, with a total of 8162 SG procedures, representing 87.5% of the cases. Roux-en-Y gastric bypass (RYGB) accounted for 7.7% (717 cases), and exploratory surgeries comprised 3.7% (348 cases). Between 2019 and 2023, 55 corrective surgeries were recorded, primarily among patients who had undergone SG. The most common corrective procedure was r-SADI-S (32.7%), followed by r-OAGB (21.8%) and r-RYGB (18.2%). There were 26 cases of severe postoperative complications, accounting for 0.4%. Conclusion    Over the past twelve years, the number of bariatric and metabolic surgeries in Shanghai has steadily increased. Since 2014, SG has become the primary surgical method, with RYGB remaining the second most common procedure. Since 2021, SADI-S and OAGB have been the main corrective surgical options in Shanghai. With effective quality control management, the incidence of perioperative complications remains very low.

Key words: bariatric and metabolic surgery, Shanghai, sleeve gastrectomy, Roux-en-Y gastric bypass, quality control