Document Detail


Clinical efficacy of laparoscopic sleeve gastrectomy vs laparoscopic gastric bypass in obese type 2 diabetic patients: a retrospective comparison.
MedLine Citation:
PMID:  22960950     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are performed in patients with obesity and type 2 diabetes mellitus (T2DM). The aim of this study is to evaluate retrospectively the clinical efficacy of RYGB and SG in two groups of obese T2DM patients.
METHODS: From the hospital database, we extracted the clinical records of 31 obese T2DM patients, of whom 15 (7 F/8 M) had undergone laparoscopic SG (LSG) and 16 (7 F/9 M) laparoscopic RYGB (LRYGB) in the period 2005-2008. The groups were comparable for age (range 33-59 years) and BMI (range 38-57 kg/m(2)). LRYGB alimentary limb was 150 cm, and biliopancreatic limb was 150 cm from the Treitz ligament. LSG vertical transection was calibrated on a 40-Fr orogastric bougie. Data were analysed at 6, 12 and 18-24 months with reference to weight loss and remission of comorbidities.
RESULTS: The reduction in body weight was comparable in the two groups. At 18-24 months the percent BMI reduction was 29 ± 8 and 33 ± 11 % in LSG and LRYGB, respectively. Percent excess weight loss was 53 ± 16 and 52 ± 19 % in LSG and LRYGB, respectively. Thirteen patients in LSG and 14 patients in LRYGB discontinued their hypoglycaemic medications. Five (55 %) patients in LSG and eight (89 %) in LRYGB discontinued antihypertensive drugs. Three out of five patients in LSG and one out of two patients in LRYGB withdrew lipid-lowering agents.
CONCLUSIONS: LSG and LRYGB are equally effective in terms of weight loss and remission of obesity-related comorbidities. Controlled long-term comparisons are needed to establish the optimal procedure in relation to patients' characteristics.
Authors:
P P Cutolo; G Nosso; G Vitolo; V Brancato; B Capaldo; L Angrisani
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Obesity surgery     Volume:  22     ISSN:  1708-0428     ISO Abbreviation:  Obes Surg     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-10     Completed Date:  2013-01-23     Revised Date:  2013-03-07    
Medline Journal Info:
Nlm Unique ID:  9106714     Medline TA:  Obes Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1535-9     Citation Subset:  IM    
Affiliation:
General and Laparoscopic Surgery Unit, S. Giovanni Bosco Hospital, Naples, Italy. pierpaolo@cutolo.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Glucose / metabolism
Comorbidity
Diabetes Mellitus, Type 2 / metabolism,  physiopathology
Dyslipidemias / metabolism,  physiopathology
Female
Gastric Bypass* / methods
Gastroplasty* / methods
Hemoglobin A, Glycosylated / metabolism
Humans
Hypertension / metabolism,  physiopathology
Italy / epidemiology
Laparoscopy*
Male
Middle Aged
Obesity, Morbid / metabolism,  physiopathology,  surgery*
Patient Selection
Remission Induction
Retrospective Studies
Sleep Apnea Syndromes
Treatment Outcome
Weight Loss
Grant Support
ID/Acronym/Agency:
1KL2RR025757-01/RR/NCRR NIH HHS; KL2 RR025757/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 0/hemoglobin A1c protein, human

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