title: Bariatric surgery trends: an 18-year report from the International Bariatric Surgery Registry.
abstract: BACKGROUND
  The epidemic of morbid obesity has increased bariatric procedures performed. Trend analyses provide important information that may impact individual practices.
  
  
  METHODS
  Patient data from 137 surgeons were examined from 1987 to 2004 (41,860 patients) using Cochran-Armitage Trend test and Generalized Linear Model.
  
  
  RESULTS
  Over an 18-year period, surgeon preference for combined restrictive-malabsorptive procedures increased from 33% to 94%, while simple gastric restriction decreased correspondingly (P < .0001). Surgeons per worksite doubled and cases per surgeon increased 71%. Laparoscopic procedures increased to 24%. The percentage of males, mean operative age, and initial body mass index (BMI) increased significantly (P < .0001). Postoperative hospital stay decreased from 5.0 to 3.9 days (P < .0001). The most common procedure in 2004 was Roux-en-Y gastric bypass (RYGB) (59%).
  
  
  CONCLUSIONS
  Bariatric surgery patients are now older and heavier, length of stay is shorter, and the laparoscopic approach is more frequent. From 1987 to 2004, the general trend shows a clear preference for combined restrictive-malabsorptive operations.
authors.affiliation: Department of Surgery, The Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA 52242-1086, USA.
authors.forename: Isaac
authors.initials: I
authors.lastname: Samuel
authors.forename: Edward E
authors.initials: EE
authors.lastname: Mason
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Renquist
authors.forename: Yu-Hui
authors.initials: YH
authors.lastname: Huang
authors.forename: M Bridget
authors.initials: MB
authors.lastname: Zimmerman
authors.forename: Mohammad
authors.initials: M
authors.lastname: Jamal
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends*; D015904:Biliopancreatic Diversion / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D015390:Gastric Bypass / Q000706:statistics & numerical data / Q000639:trends; D015391:Gastroplasty / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D016014:Linear Models; D008297:Male; D012042:Registries; D012189:Retrospective Studies