Surgical Treatment of Type 2 Diabetes in Patients with BMI Below 35: Mid-term Outcomes of the Laparoscopic Ileal Interposition Associated with a Sleeve Gastrectomy in 202 Consecutive Cases
Contribuinte(s) |
UNIVERSIDADE DE SÃO PAULO |
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Data(s) |
29/10/2013
29/10/2013
2012
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Resumo |
The objective of this study was to evaluate the mid-term outcomes of the laparoscopic ileal interposition into the jejunum (JII-SG) or into the duodenum (DII-SG) associated with sleeve gastrectomy for type 2 diabetes mellitus (T2DM) patients with BMI below 35. The procedures were performed on 202 consecutive patients. Mean age was 52.2 +/- 7.5. Mean duration of T2DM was 9.8 +/- 5.2 years. Insulin therapy was used by 41.1%. Dyslipidemia was observed in 78.2%, hypertension in 67.3%, nephropathy in 49.5%, retinopathy in 31.2%, coronary heart disease in 11.9%, and other cardiovascular events in 12.9%. Mean follow-up was 39.1 months (range, 25-61). Early and late mortality was 0.99% and 1.0%, respectively. Early reoperation was performed in 2.5%. Early and late major complications were 8.4% and 3.5%. Early most frequent complications were pneumonia and ileus. Intestinal obstruction was diagnosed in 1.5%. Mean BMI decreased from 29.7 to 23.5 kg/m(2), mean fasting glucose from 202.1 to 112.2 mg/dl, and mean postprandial glucose from 263.3 to 130 mg/dl. Triglycerides diminished from a mean of 273.4 to 110.3 mg/dl and cholesterol from a mean of 204.7 to 160.1 mg/dl. Hypertension was resolved in 87.5%. Mean hemoglobin A(1c) (HbA(1c)) decreased from 8.7 to 6.2% after the JII-SG and to 5.9% following the DII-SG. HbA(1c) below 7% was seen in 89.9% of the patients and below 6.5% in 78.3%. Overall, 86.4% of patients were off antidiabetic medications. Both JII-SG and DII-SG demonstrated to be safe, effective, and long-lasting alternatives for the treatment of T2DM patients with BMI < 35. Beyond glycemic control, other benefits were achieved. |
Identificador |
JOURNAL OF GASTROINTESTINAL SURGERY, NEW YORK, v. 16, n. 5, supl. 1, Part 2, pp. 967-976, MAY, 2012 1091-255X http://www.producao.usp.br/handle/BDPI/36326 10.1007/s11605-011-1807-0 |
Idioma(s) |
eng |
Publicador |
SPRINGER NEW YORK |
Relação |
JOURNAL OF GASTROINTESTINAL SURGERY |
Direitos |
closedAccess Copyright SPRINGER |
Palavras-Chave | #TYPE 2 DIABETES #ILEAL INTERPOSITION #SLEEVE GASTRECTOMY #METABOLIC SURGERY #SURGICAL TREATMENT OF DIABETES #BLOOD-GLUCOSE CONTROL #GASTRIC BYPASS #CARDIOVASCULAR-DISEASE #MELLITUS PATIENTS #CELL FUNCTION #MORTALITY #RISK #SURGERY #COMPLICATIONS #REDUCTION #GASTROENTEROLOGY & HEPATOLOGY #SURGERY |
Tipo |
article original article publishedVersion |