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2019•Zhonghua putong waike zazhiRequires access

A long-term result of laparoscopic Roux-en-Y gastric bypass vs. laparoscopic sleeve gastrectomy in the treatment of obese patients with type 2 diabetes mellitus

Dexiao Du, Ke Gong, Bin Zhu, Dongbo Lian, Qing Fan, Peirong Tian

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Abstract

Objective To compare laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy for the treatment of obese patients with type 2 diabetes mellitus. Methods A retrospective analysis of T2DM patients with LRYGB (28 cases) and LSG (35 cases) was enrolled from Jan 2010 to Jun 2013. Results The indicator such as BMI, fasting glucose, fasting insulin, HbA1c, and insulin resistance were significantly lower in 1 year, 3 years and 5 years after operation [LRYGB group: (37.3±3.7) kg/m2 to (32.3±3.4) kg/m2 to (28.8±3.0) kg/m2 to (25.5±2.8) kg/m2,t=13.670, 15.499, 21.710, P=0.000, 0.000, 0.000; (8.2±1.8) mmol/L to (6.0±1.3) mmol/L to (5.2±0.9) mmol/L to (4.7±0.5) mmol/L, t=6.664, 8.723, 10.282, P=0.000, 0.000, 0.000; (32.2±17.0) μIU/ml to (16.1±12.1) μIU/ml to (8.6 ±5.2) μIU/ml to (5.2±2.8) μIU/ml, t=7.453, 8.218, 8.687, P=0.000, 0.000, 0.000; (7.4%±0.6%) to (6.2%±0.7%) to (5.7%±0.7%) to (5.1%±0.6%), t=11.362, 18.771, 21.186, P=0.000, 0.000, 0.000; (12.0±7.3) to (4.6±4.3) to (2.1±1.7) to (1.1±0.7), t=6.455, 7.667, 8.050, P=0.000, 0.000, 0.000; LSG group: (39.2±5.2) kg/m2 to (34.1±4.5) kg/m2 to (29.3±4.0) kg/m2 to (25.1±2.3) kg/m2,t=11.676, 13.680, 19.161, P=0.000, 0.000, 0.000; (8.0±2.9) mmol/L to (5.8±1.5) mmol/L to (5.1±0.9) mmol/L to (4.6±0.5) mmol/L, t=5.467, 6.921, 7.741, P=0.000, 0.000, 0.000; (29.1±25.2) μIU/ml to (16.4±10.6) μIU/ml to (8.8±5.5) μIU/ml to (5.5±2.0) μIU/ml, t=3.512, 5.232, 5.702, P=0.001, 0.000, 0.000; (7.7%±1.3%) to (6.3%±0.6%) to (5.8%±0.6%) to (5.2%±0.6%), t=8.001, 10.106, 11.922, P=0.000, 0.000, 0.000; (9.8±9.6) to (3.9±2.2) to (1.9±1.0) to (1.1±0.4), t=3.733, 4.972, 5.404, P=0.001, 0.000, 0.000] . There was no significant difference between the two groups in 1 year, 3 year and 5 year post-operation (DM remission: 71% to 69%, 89% to 80%, 93% to 89%) (P>0.05). Conclusion LRYGB and LSG have the same long-term efficacy for T2DM patients. Key words: Diabetes mellitus, type 2; Gastric bypass; Gastrectomy; Laparoscopy

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What this paper is about

Objective To compare laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy for the treatment of obese patients with type 2 diabetes mellitus. Methods A retrospective analysis of T2DM patients with LRYGB (28 cases) and LSG (35 cases) was enrolled from Jan 2010 to Jun 2013. Results The indicator such as BMI, fasting glucose, fasting insulin, HbA1c, and insulin resistance were significantly lower in 1 year, 3 years and 5 years after operation [LRYGB group: (37.3±3.7) kg/m2 to (32.3±3.4) kg/m2 to (28.8±3.0) kg/m2 to (25.5±2.8) kg/m2,t=13.670, 15.499, 21.710, P=0.000, 0.000, 0.000; (8.2±1.8) mmol/L to (6.0±1.3) mmol/L to (5.2±0.9) mmol/L to (4.7±0.5) mmol/L, t=6.664, 8.723, 10.282, P=0.000, 0.000, 0.000; (32.2±17.0) μIU/ml to (16.1±12.1) μIU/ml to (8.6 ±5.2) μIU/ml to (5.2±2.8) μIU/ml, t=7.453, 8.218, 8.687, P=0.000, 0.000, 0.000; (7.4%±0.6%) to (6.2%±0.7%) to (5.7%±0.7%) to (5.1%±0.6%), t=11.362, 18.771, 21.186, P=0.000, 0.000, 0.000; (12.0±7.3) to (4.6±4.3) to (2.1±1.7) to (1.1±0.7), t=6.455, 7.667, 8.050, P=0.000, 0.000, 0.000; LSG group: (39.2±5.2) kg/m2 to (34.1±4.5) kg/m2 to (29.3±4.0) kg/m2 to (25.1±2.3) kg/m2,t=11.676, 13.680, 19.161, P=0.000, 0.000, 0.000; (8.0±2.9) mmol/L to (5.8±1.5) mmol/L to (5.1±0.9) mmol/L to (4.6±0.5) mmol/L, t=5.467, 6.921, 7.741, P=0.000, 0.000, 0.000; (29.1±25.2) μIU/ml to (16.4±10.6) μIU/ml to (8.8±5.5) μIU/ml to (5.5±2.0) μIU/ml, t=3.512, 5.232, 5.702, P=0.001, 0.000, 0.000; (7.7%±1.3%) to (6.3%±0.6%) to (5.8%±0.6%) to (5.2%±0.6%), t=8.001, 10.106, 11.922, P=0.000, 0.000, 0.000; (9.8±9.6) to (3.9±2.2) to (1.9±1.0) to (1.1±0.4), t=3.733, 4.972, 5.404, P=0.001, 0.000, 0.000] . There was no significant difference between the two groups in 1 year, 3 year and 5 year post-operation (DM remission: 71% to 69%, 89% to 80%, 93% to 89%) (P>0.05). Conclusion LRYGB and LSG have the same long-term efficacy for T2DM patients. Key words: Diabetes mellitus, type 2; Gastric bypass; Gastrectomy; Laparoscopy

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Available abstract

Objective To compare laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy for the treatment of obese patients with type 2 diabetes mellitus. Methods A retrospective analysis of T2DM patients with LRYGB (28 cases) and LSG (35 cases) was enrolled from Jan 2010 to Jun 2013. Results The indicator such as BMI, fasting glucose, fasting insulin, HbA1c, and insulin resistance were significantly lower in 1 year, 3 years and 5 years after operation [LRYGB group: (37.3±3.7) kg/m2 to (32.3±3.4) kg/m2 to (28.8±3.0) kg/m2 to (25.5±2.8) kg/m2,t=13.670, 15.499, 21.710, P=0.000, 0.000, 0.000; (8.2±1.8) mmol/L to (6.0±1.3) mmol/L to (5.2±0.9) mmol/L to (4.7±0.5) mmol/L, t=6.664, 8.723, 10.282, P=0.000, 0.000, 0.000; (32.2±17.0) μIU/ml to (16.1±12.1) μIU/ml to (8.6 ±5.2) μIU/ml to (5.2±2.8) μIU/ml, t=7.453, 8.218, 8.687, P=0.000, 0.000, 0.000; (7.4%±0.6%) to (6.2%±0.7%) to (5.7%±0.7%) to (5.1%±0.6%), t=11.362, 18.771, 21.186, P=0.000, 0.000, 0.000; (12.0±7.3) to (4.6±4.3) to (2.1±1.7) to (1.1±0.7), t=6.455, 7.667, 8.050, P=0.000, 0.000, 0.000; LSG group: (39.2±5.2) kg/m2 to (34.1±4.5) kg/m2 to (29.3±4.0) kg/m2 to (25.1±2.3) kg/m2,t=11.676, 13.680, 19.161, P=0.000, 0.000, 0.000; (8.0±2.9) mmol/L to (5.8±1.5) mmol/L to (5.1±0.9) mmol/L to (4.6±0.5) mmol/L, t=5.467, 6.921, 7.741, P=0.000, 0.000, 0.000; (29.1±25.2) μIU/ml to (16.4±10.6) μIU/ml to (8.8±5.5) μIU/ml to (5.5±2.0) μIU/ml, t=3.512, 5.232, 5.702, P=0.001, 0.000, 0.000; (7.7%±1.3%) to (6.3%±0.6%) to (5.8%±0.6%) to (5.2%±0.6%), t=8.001, 10.106, 11.922, P=0.000, 0.000, 0.000; (9.8±9.6) to (3.9±2.2) to (1.9±1.0) to (1.1±0.4), t=3.733, 4.972, 5.404, P=0.001, 0.000, 0.000] . There was no significant difference between the two groups in 1 year, 3 year and 5 year post-operation (DM remission: 71% to 69%, 89% to 80%, 93% to 89%) (P>0.05). Conclusion LRYGB and LSG have the same long-term efficacy for T2DM patients. Key words: Diabetes mellitus, type 2; Gastric bypass; Gastrectomy; Laparoscopy

Key concepts: Medicine, Roux-en-Y anastomosis, Gastric bypass, Gastroenterology, Internal medicine, Type 2 Diabetes Mellitus, Insulin resistance, Sleeve gastrectomy

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A long-term result of laparoscopic Roux-en-Y gastric bypass vs. laparoscopic sleeve gastrectomy in the treatment of obese patients with type 2 diabetes mellitus — Research Paper | ScholarLens