A Matched Comparative Analysis of Type-2 Diabetes Mellitus Remission Between Roux-en-Y Gastric Bypass and Sleeve Gastrectomy.

IF 1.2 4区医学 Q3 SURGERY

Surgical Innovation Pub Date : 2024-04-01 Epub Date: 2024-01-22 DOI:10.1177/15533506241229040

Karl Hage, Pearl Ma, Wissam Ghusn, Kayla Ikemiya, Andres Acosta, Robert A Vierkant, Barham K Abu Dayyeh, Kelvin D Higa, Omar M Ghanem

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引用次数: 0

Abstract

Objective: Multiple scores validate long-term type-2 diabetes mellitus (T2DM) remission after metabolic and bariatric surgery (MBS). However, studies comparing Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) have not adequately controlled for certain parameters, which may influence procedure selection.

Methods: We conducted a multicenter retrospective review of patients with T2DM who underwent RYGB or SG between 2008 and 2017. Data on demographics, clinical, laboratory, and metabolic values were collected annually for up to 14 years. Each eligible RYGB patient was individually matched to an eligible SG patient based on diabetes severity, weight loss, and follow-up duration.

Results: Among 1149 T2DM patients, 467 were eligible for matching. We found 97 matched pairs who underwent RYGB or SG. RYGB showed significantly higher T2DM remission rates (46.4%) compared to SG (33.0%) after matching. SG patients had higher insulin usage (35.1%) than RYGB patients (20.6%). RYGB patients also experienced greater decreases in HbA1c levels and diabetes medication usage than SG patients.

Conclusions: RYGB demonstrates higher efficacy for T2DM remission compared to SG, regardless of baseline characteristics, T2DM severity, weight loss, and follow-up duration. Further studies are needed to understand the long-term metabolic effects of MBS and the underlying pathophysiology of T2DM remission after MBS.

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Roux-en-Y胃旁路术与袖状胃切除术对2型糖尿病缓解情况的匹配比较分析。

目的：多项评分验证了代谢和减肥手术（MBS）后2型糖尿病（T2DM）的长期缓解。然而，比较 Roux-en-Y 胃旁路术（RYGB）和袖状胃切除术（SG）的研究并未充分控制某些参数，而这些参数可能会影响手术选择：我们对2008年至2017年间接受RYGB或SG手术的T2DM患者进行了多中心回顾性研究。在长达 14 年的时间里，我们每年都会收集有关人口统计学、临床、实验室和代谢值的数据。根据糖尿病严重程度、体重减轻情况和随访时间，将每位符合条件的RYGB患者与符合条件的SG患者进行单独匹配：在 1149 名 T2DM 患者中，有 467 人符合配对条件。我们发现有 97 对配对患者接受了 RYGB 或 SG 治疗。配对后，RYGB 的 T2DM 缓解率（46.4%）明显高于 SG（33.0%）。SG 患者的胰岛素使用率（35.1%）高于 RYGB 患者（20.6%）。与 SG 患者相比，RYGB 患者的 HbA1c 水平和糖尿病药物用量的下降幅度也更大：无论基线特征、T2DM 严重程度、体重减轻程度和随访时间长短如何，与 SG 相比，RYGB 对 T2DM 缓解的疗效更高。要了解 MBS 的长期代谢效应以及 MBS 后 T2DM 缓解的潜在病理生理学，还需要进一步的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical Innovation 医学-外科

CiteScore

2.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Surgical Innovation (SRI) is a peer-reviewed bi-monthly journal focusing on minimally invasive surgical techniques, new instruments such as laparoscopes and endoscopes, and new technologies. SRI prepares surgeons to think and work in "the operating room of the future" through learning new techniques, understanding and adapting to new technologies, maintaining surgical competencies, and applying surgical outcomes data to their practices. This journal is a member of the Committee on Publication Ethics (COPE).