Background

The field of bariatric surgery has seen peaks and troughs in the types of metabolic procedures performed. Our primary aim was to evaluate bariatric case volumes among fellows enrolled in bariatric Fellowship Council (FC)-accredited programs. Our secondary aim was to assess trends in revisional case volumes.

Methods

We reviewed de-identified FC case logs for all bariatric surgery-accredited programs from 2010 through 2019. The number of primary sleeve gastrectomy, gastric band, gastric bypass, biliopancreatic diversion, and major revisional bariatric surgical procedures (defined as a revision with creation of a new anastomosis) were graphed for each academic year. Fellows were stratified into quartiles based on the number of revisional operations per year and graphed over ten years. Volumes of primary gastric bypass, major revisions, and total anastomotic cases were compared over time using ANOVA with p < 0.05 considered significant.

Results

Case volumes for 822 fellows were evaluated. Sleeve gastrectomy had a significant surge in 2010 and plateaued in 2016. The fellows’ number of primary gastric bypasses had a non-significant decrease from 84 to 75 cases/fellow from 2010 to 2019. This decrease was offset by a significant increase in major revisional surgery from 8 to 19 cases/fellow. As a result, the number of anastomotic cases did not change significantly over the study time period. Interestingly, as revisional volume has grown, the gap between quartiles of fellowship programs has widened with the 95th percentile growing at a much faster rate than lower quartiles.

Conclusion

The volume of bariatric procedures performed in the last decade among FC fellows follows similar trends to national data. Major revisional cases have doubled with the most robust growth isolated to a small number of programs. As revisional surgery continues to increase, applicants interested in a comprehensive bariatric practice should seek out training programs that offer strong revisional experience.

中文翻译：

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修复手术的兴起：跟踪减肥认可研究金中指标病例的变化

背景

减肥手术领域在所执行的代谢手术类型中经历了高峰和低谷。我们的主要目标是评估参加减肥研究金委员会 (FC) 认可计划的研究员的减肥病例数量。我们的次要目标是评估修订案例数量的趋势。

方法

我们审查了 2010 年至 2019 年所有减肥手术认证计划的去识别 FC 病例日志。主要袖状胃切除术、胃束带、胃旁路术、胆胰分流术和主要修正减肥手术程序（定义为修订，创建一个新的吻合）被绘制为每个学年。根据每年的修正手术数量，将研究员分为四分位数，并绘制了十年的图表。使用方差分析随时间比较原发性胃旁路术、主要翻修术和全吻合术病例的体积，p  < 0.05 被认为具有显着性。

结果

评估了 822 名研究员的案例量。袖状胃切除术在 2010 年显着激增，并在 2016 年趋于稳定。从 2010 年到 2019 年，研究员的原发性胃旁路手术数量从 84 例/人减少到 75 例/人，但没有显着减少。这一减少被主要修正手术的显着增加所抵消手术8～19例/人。因此，吻合病例的数量在研究期间没有发生显着变化。有趣的是，随着修订量的增长，奖学金计划四分位数之间的差距已经扩大，第 95 个百分位数的增长速度比较低的四分位数快得多。

结论

过去十年在 FC 研究员中进行的减肥手术数量遵循与国家数据相似的趋势。主要修订案例翻了一番，其中最强劲的增长仅限于少数项目。随着修正手术的不断增加，对综合减肥实践感兴趣的申请人应该寻求提供强大修正经验的培训计划。