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Outcome After Curative Surgery for Gastric Cancer Patients with Type 2 Diabetes.
MedLine Citation:
PMID:  24132827     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Bariatric surgery has been adapted to the management of morbid obesity, leading to not only loss of body weight but also improvement of type 2 diabetes mellitus (DM). The goal of our study was to evaluate the effect of gastrectomy in gastric cancer patients with type 2 DM.
METHODS: From 1989 to 2011, a total of 69 gastric cancer patients receiving curative surgery were enrolled in this study. They were diagnosed with type 2 DM preoperatively and all are alive without tumor recurrence. The clinical characteristics were compared between groups with improved or unimproved DM, and groups were also analyzed based on the extent of gastrectomy and different reconstruction methods.
RESULTS: Of the 69 patients, 58 received subtotal gastrectomy and 11 received total gastrectomy. The frequency of DM improvement was significantly higher after total gastrectomy than subtotal gastrectomy (81.8 vs. 36.2 %; p = 0.007). Patients with DM duration of less than 5 years tended to experience DM improvement after surgery more frequently than patients with DM duration of more than 5 years (p = 0.028). Roux-en-Y esophagojejunostomy (R-Ye) led to a higher rate of DM improvement than did R-Y gastrojejunostomy (R-Yg), especially in patients with DM duration more than 5 years. Among patients receiving duodenal bypass after gastrectomy, R-Ye was associated with a higher frequency of DM improvement than R-Yg and B-II.
CONCLUSIONS: The extent of gastrectomy rather than the reconstruction method played an important role in DM improvement after curative surgery for gastric cancer.
Authors:
Kuo-Chung Wang; Kuo-Hung Huang; Yuan-Tzu Lan; Wen-Liang Fang; Su-Shun Lo; Anna Fen-Yau Li; Chew-Wun Wu
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-17
Journal Detail:
Title:  World journal of surgery     Volume:  -     ISSN:  1432-2323     ISO Abbreviation:  World J Surg     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, 201 Section 2 Shih-Pai Road, Taipei, 11217, Taiwan.
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