中国肥胖代谢外科数据库:2021年度报告

Chinese obesity and metabolic surgery database:annual report 2021

目的统计分析2021年中国肥胖代谢外科手术开展情况。方法基于中国肥胖代谢外科数据库(COMES Database),精确统计分析2021年1月1日至2021年12月31日在中国大陆开展的减重手术种类和例数、死亡病例数,以及专职人员、多学科团队(MDT)及院内数据库建设情况;并以此为基础,推算全国减重手术实际总数量。(本次统计未纳入中国香港、中国澳门及中国台湾地区的数据。)结果全国共180家医院或减重中心参与本次统计,地域涵盖29个省(自治区、直辖市),88个城市,录得总手术量23040例。其中腹腔镜手术22331例(96.9%),包括袖状胃切除术18533例(83.0%)、Roux-en-Y胃旁路术1297例(5.8%)、袖状胃联合手术1894例(8.5%)、单吻合口胃旁路/迷你胃旁路术507例(2.3%)、胃底折叠术93例(0.4%)。开腹手术1例(0.004%),内镜减重手术/可吞咽技术58例(0.3%),机器人辅助手术433例(1.9%),修正手术217例(0.9%),死亡5例(0.02%)。推算全国减重手术实际总数量约为25208例。164家(91.1%)医院有专职减重外科医生(共513位),141家(78.3%)医院有专职减重个案管理师(共242位)。146家(81.1%)医院成立了MDT,100家(68.5%)医院建立了院内减重手术数据库。结论本年度全国减重手术量持续大幅度增加,主流手术仍是腹腔镜袖状胃切除术(LSG)和腹腔镜Roux-en-Y胃旁路术(LRYGB)。LSG联合手术、内镜手术/可吞咽技术、机器人辅助手术、修正手术等数量呈上升趋势;专职的减重外科医生及个案管理师人数也较前增加。加强医护人员的继续教育及培训,手术安全质量管理,患者的长期随访,临床数据的完整性,科研成果的产生与转化,国内外的学术交流等,会是未来工作的重点。

Objective To analyze the status and number of metabolic and bariatric surgery(MBS)in China in 2021.Methods Based on the Chinese Obesity and Metabolic Surgery Database(COMES Database),we analyzed the types and numbers of MBS and the mortality rate between January 1 and December 31 in 2021;and the numbers of bariatric surgeons and case managers,multidisciplinary team(MDT),and the database of each hospital.We also attempted to estimate the actual number of MBS in the country.Data from Hong Kong SAR,Macao SAR,and Taiwan region of China were not included in this study.Results A total of 180 hospitals or centers participated in this study,covering 29 provinces(autonomous regions and municipalities)and 88 cities,with 23040 cases.There were 22331(96.9%)laparoscopic surgeries included 18533(83.0%)sleeve gastrectomy,1297(5.8%)Roux-en-Y gastric bypass,1894(8.5%)sleeve plus surgeries,507(2.3%)one-anastomosis gastric bypass/mini gastric bypass,and 93(0.4%)fundoplication.One(0.004%)open surgery,58(0.3%)endoscopic/swallowing technique,433(1.9%)robotic-assisted surgery,217(0.9%)revisional surgery,and 5(0.02%)deaths.The estimated total number of MBS was 25208.There were 164(91.1%)hospitals with 513 full-time bariatric surgeons and 141(78.3%)hospitals with 242 full-time case managers.MDT was established in 146(81.1%)hospitals,and 100(68.5%)hospitals established a local MBS database.Conclusions The number of MBS increased significantly this year.The most popular procedures are laparoscopic sleeve gastrectomy(LSG)and laparoscopic Roux-en-Y gastric bypass(LRYGB).The numbers of LSG plus surgery,endoscopic/swallowing techniques,robotassisted surgery,and revisional surgery are increasing.The numbers of full-time bariatric surgeons and case managers are also growing.Our future priorities will be strengthening the continuing education and training of medical professionals,surgical safety and quality management,long-term follow-up of patients,clinical data integrity,scientific research translation,and local and global academic exchanges.