Sleeve gastrectomy appears to be replacing other types of bariatric surgery in Michigan, even among subgroups of patients in whom its use is controversial, according to a Research Letter to the Editor published in the Sept. 3 issue of JAMA.
To examine time trends in the use of various bariatric procedures, investigators reviewed the medical records of 43,732 adults who had bariatric surgery and were enrolled in a statewide database between June 2006 and December 2013. They found that the relative use of sleeve gastrectomy rose from 6.0% of all procedures in 2008 to 67.3% 5 years later, which represents an increase of 61%, said Dr. Bradley N. Reames of the department of surgery and the Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, and his associates.
Dr. Bradley N. Reames
At the same time, the use of Roux-en-Y gastric bypass dropped from 58.0% to 27.4% of all procedures, and the use of laparoscopic adjustable gastric banding decreased from 34.5% to 4.6%, they said (JAMA 2014;312:959-61).
"Moreover, despite controversy regarding the optimal procedure for patients with gastroesophageal reflux disease and type 2 diabetes, sleeve gastrectomy has become the predominant procedure in both groups," Dr. Reames and his associates said.
The long-term outcomes after sleeve gastrectomy are not yet clear, so this trend "may reflect the favorable perioperative safety profile and emerging evidence of successful weight loss at 2-3 years after" the procedure, they added.
Dr. Reames’s work is supported by the National Cancer Institute. He and his associates reported no relevant financial conflicts of interest.