全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Five Year Follow up after Surgical Treatment of Type 2 Diabetes with Laparoscopic Sleeve Gastrectomy Associated with a Duodenal Ileal Interposition

DOI: 10.4236/ss.2024.156036, PP. 396-408

Keywords: Diabetes, Surgery, Metabolic Syndrome, Dyslipidemia, Ileal Interposition, Metabolic Surgery, Bariatric Surgery, Obesity

Full-Text   Cite this paper   Add to My Lib

Abstract:

Introduction: Type 2 diabetes mellitus (T2D) is a chronic disease, primarily caused by a combination of defective insulin secretion and the inability of insulin-sensitive tissues to respond to insulin. Laparoscopic sleeve gastrectomy associated with duodenal ileal interposition (SGDII) has been shown to be a feasible treatment option for patients with T2D, as it provides improvement and control of glycemia, dyslipidemia and arterial hypertension. The aim of this study was to evaluate the mid and long-term results of SGDII for the treatment of diabetic patients, considering diabetic remission, weight loss and postoperative complications. Materials and Methods: Retrospective study with 96 patients with T2D submitted to SGDII, between 2010 and 2016. The glycated hemoglobin (HbA1c) value < 6.5%, without the use of hypoglycemic agents, was considered as remission of T2D. The research was approved by the Ethics and Research Committee of Hospital S?o José do Avaí and The National Research Ethics Commission (CONEP)—CAEE 0023.0.316.000-10. Written informed consent was obtained from all subjects prior to their inclusion in the study, in accordance with the Declaration of Helsinki. Results: Sixty-one patients (62.8%) were male, and 36 patients (37.2%) were female. The average age was 50.9 years. Median BMI was 33.43 kg/m2. The incidence of major postoperative complications in the first 30 days was 2.1%, with no mortality. Dyslipidemia control was sustained, after five years, in 62% of the patients. The five years follow-up demonstrated that 80% of patients had T2D remission at one year, 74.5% at three years and 61.8% at five years. Univariate analysis demonstrated that preoperative values of HbA1c and BMI, preoperative use of insulin, gender, and 30-day complication were not predictors of remission at all study intervals. The average duration of the disease was nine years and the mean glycated hemoglobin before surgery was 8.95%. Conclusion: SGDII resulted in good glycemic control at 5-years follow-up and represents a valid alternative for the treatment of T2D.

References

[1]  International Diabetes Federation (2021) IDF Diabetes Atlas. 10th Edition.
[2]  Rubino, F., Nathan, D.M., Eckel, R.H., et al. (2016) Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations. Diabetes Care, 39, 861-877.
https://doi.org/10.2337/dc16-0236
[3]  Courcoulas, A.P., Goodpaster, B.H., Eagleton, J.K., Belle, S.H., Kalarchian, M.A., Lang, W., et al. (2014) Surgical vs Medical Treatments for Type 2 Diabetes Mellitus. JAMA Surgery, 149, 707-715.
https://doi.org/10.1001/jamasurg.2014.467
[4]  Schauer, P.R., Kashyap, S.R., Wolski, K., Brethauer, S.A., Kirwan, J.P., Pothier, C.E., et al. (2012) Bariatric Surgery versus Intensive Medical Therapy in Obese Patients with Diabetes. New England Journal of Medicine, 366, 1567-1576.
https://doi.org/10.1056/nejmoa1200225
[5]  Kirwan, J.P., Courcoulas, A.P., Cummings, D.E., Goldfine, A.B., Kashyap, S.R., Simonson, D.C., et al. (2022) Diabetes Remission in the Alliance of Randomized Trials of Medicine versus Metabolic Surgery in Type 2 Diabetes (ARMMS-T2D). Diabetes Care, 45, 1574-1583.
https://doi.org/10.2337/dc21-2441
[6]  Baskota, A., Li, S., Dhakal, N., Liu, G. and Tian, H. (2015) Bariatric Surgery for Type 2 Diabetes Mellitus in Patients with BMI<30 kg/m2: A Systematic Review and Meta-Analysis. PLOS ONE, 10, e0132335.
https://doi.org/10.1371/journal.pone.0132335
[7]  Scopinaro, N., Adami, G.F., Papadia, F.S., Camerini, G., Carlini, F., Briatore, L., et al. (2014) Effects of Gastric Bypass on Type 2 Diabetes in Patients with BMI 30 to 35. Obesity Surgery, 24, 1036-1043.
https://doi.org/10.1007/s11695-014-1206-1
[8]  Xu, G. and Song, M. (2021) Recent Advances in the Mechanisms Underlying the Beneficial Effects of Bariatric and Metabolic Surgery. Surgery for Obesity and Related Diseases, 17, 231-238.
https://doi.org/10.1016/j.soard.2020.08.028
[9]  Dindo, D., Demartines, N. and Clavien, P. (2004) Classification of Surgical Complications. Annals of Surgery, 240, 205-213.
https://doi.org/10.1097/01.sla.0000133083.54934.ae
[10]  Eisenberg, D., Shikora, S.A., Aarts, E., Aminian, A., Angrisani, L., Cohen, R.V., et al. (2022) 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): Indications for Metabolic and Bariatric Surgery. Surgery for Obesity and Related Diseases, 18, 1345-1356.
https://doi.org/10.1016/j.soard.2022.08.013
[11]  Cheng, Y.J., Kanaya, A.M., Araneta, M.R.G., Saydah, S.H., Kahn, H.S., Gregg, E.W., et al. (2019) Prevalence of Diabetes by Race and Ethnicity in the United States, 2011-2016. JAMA, 322, 2389-2398.
https://doi.org/10.1001/jama.2019.19365
[12]  Campos, J.S., Santos, K.F., Costa, C.C.P., Barros, J.B.S., Gonçalves, V.S.S., Assunção, L.P., et al. (2022) Research Article Genetic Epidemiology of Type 2 Diabetes Mellitus and Complications in the Brazilian Population. Genetics and Molecular Research, 21, gmr18969.
https://doi.org/10.4238/gmr18969
[13]  Zhang, Y., Guo, Y., Shen, X., Zhao, F. and Yan, S. (2019) Lower Body Mass Index Is Not of More Benefit for Diabetic Complications. Journal of Diabetes Investigation, 10, 1307-1317.
https://doi.org/10.1111/jdi.13003
[14]  Nannipieri, M., Mari, A., Anselmino, M., Baldi, S., Barsotti, E., Guarino, D., et al. (2011) The Role of Β-Cell Function and Insulin Sensitivity in the Remission of Type 2 Diabetes after Gastric Bypass Surgery. The Journal of Clinical Endocrinology & Metabolism, 96, E1372-E1379.
https://doi.org/10.1210/jc.2011-0446
[15]  Bojsen-Møller, K.N., Dirksen, C., Jørgensen, N.B., Jacobsen, S.H., Serup, A.K., Albers, P.H., et al. (2014) Early Enhancements of Hepatic and Later of Peripheral Insulin Sensitivity Combined with Increased Postprandial Insulin Secretion Contribute to Improved Glycemic Control after Roux-en-Y Gastric Bypass. Diabetes, 63, 1725-1737.
https://doi.org/10.2337/db13-1307
[16]  Liu, T., Zou, X., Ruze, R. and Xu, Q. (2023) Bariatric Surgery: Targeting Pancreatic β Cells to Treat Type II Diabetes. Frontiers in Endocrinology, 14, Article 1031610.
https://doi.org/10.3389/fendo.2023.1031610
[17]  Yu, Z., Li, P., Li, P., Zhang, H. and Zhang, Y. (2021) Meta-analysis of Long-Term Relapse Rate of Type 2 Diabetes Following Initial Remission after Roux-en-Y Gastric Bypass. Obesity Surgery, 31, 5034-5043.
https://doi.org/10.1007/s11695-021-05692-4
[18]  Ke, Z., Li, F., Chen, J., Gao, Y., Zhou, X., Sun, F., et al. (2017) Effects of Laparoscopic Roux-en-Y Gastric Bypass for Type 2 Diabetes Mellitus: Comparison of BMI>30 and <30 kg/m2. Obesity Surgery, 27, 3040-3047.
https://doi.org/10.1007/s11695-017-2926-9
[19]  Lafarge, J., Aron-Wisnewsky, J., Pattou, F., Cucherat, M., Blondet, E., Lascols, S., et al. (2024) French National Authority for Health Assessment of Metabolic Surgery for Type 2 Diabetes Remission—A Meta-Analysis in Patients with Class I to III Obesity. Diabetes & Metabolism, 50, Article 101495.
https://doi.org/10.1016/j.diabet.2023.101495
[20]  Astiarraga, B., Gastaldelli, A., Muscelli, E., Baldi, S., Camastra, S., Mari, A., et al. (2013) Biliopancreatic Diversion in Nonobese Patients with Type 2 Diabetes: Impact and Mechanisms. The Journal of Clinical Endocrinology & Metabolism, 98, 2765-2773.
https://doi.org/10.1210/jc.2013-1476
[21]  De Paula, A.L., Macedo, A.L.V., Prudente, A.S., Queiroz, L., Schraibman, V. and Pinus, J. (2006) Laparoscopic Sleeve Gastrectomy with Ileal Interposition (“Neuroendocrine Brake”)—Pilot Study of a New Operation. Surgery for Obesity and Related Diseases, 2, 464-467.
https://doi.org/10.1016/j.soard.2006.03.005
[22]  Koopmans, H., Sclafani, A., Fichtner, C. and Aravich, P. (1982) The Effects of Ileal Transposition on Food Intake and Body Weight Loss in VMH-Obese Rats. The American Journal of Clinical Nutrition, 35, 284-293.
https://doi.org/10.1093/ajcn/35.2.284
[23]  Van Citters, G.W. and Lin, H.C. (2006) Ileal Brake: Neuropeptidergic Control of Intestinal Transit. Current Gastroenterology Reports, 8, 367-373.
https://doi.org/10.1007/s11894-006-0021-9
[24]  Barreto, S.G. and Windsor, J.A. (2016) Does the Ileal Brake Contribute to Delayed Gastric Emptying after Pancreatoduodenectomy? Digestive Diseases and Sciences, 62, 319-335.
https://doi.org/10.1007/s10620-016-4402-0
[25]  De Paula, A.L., Stival, A.R., Macedo, A., Ribamar, J., Mancini, M., Halpern, A., et al. (2010) Prospective Randomized Controlled Trial Comparing 2 Versions of Laparoscopic Ileal Interposition Associated with Sleeve Gastrectomy for Patients with Type 2 Diabetes with BMI 21-34 kg/m2. Surgery for Obesity and Related Diseases, 6, 296-304.
https://doi.org/10.1016/j.soard.2009.10.005
[26]  Nie, L., Yan, Q., Zhang, S., Cao, Y. and Zhou, X. (2023) Duodenal Mucosa: A New Target for the Treatment of Type 2 Diabetes. Endocrine Practice, 29, 53-59.
https://doi.org/10.1016/j.eprac.2022.10.177
[27]  DePaula, A.L., Macedo, A.L.V., Schraibman, V., Mota, B.R. and Vencio, S. (2008) Hormonal Evaluation Following Laparoscopic Treatment of Type 2 Diabetes Mellitus Patients with BMI 20-34. Surgical Endoscopy, 23, 1724-1732.
https://doi.org/10.1007/s00464-008-0168-6
[28]  Tinoco, A., El‐Kadre, L., Aquiar, L., Tinoco, R. and Savassi‐Rocha, P. (2011) Short‐Term and Mid‐Term Control of Type 2 Diabetes Mellitus by Laparoscopic Sleeve Gastrectomy with Ileal Interposition. World Journal of Surgery, 35, 2238-2244.
https://doi.org/10.1007/s00268-011-1188-2
[29]  De Paula, A.L., Stival, A.R., Halpern, A., DePaula, C.C.L., Mari, A., Muscelli, E., et al. (2011) Improvement in Insulin Sensitivity and Β-Cell Function Following Ileal Interposition with Sleeve Gastrectomy in Type 2 Diabetic Patients: Potential Mechanisms. Journal of Gastrointestinal Surgery, 15, 1344-1353.
https://doi.org/10.1007/s11605-011-1550-6
[30]  Centers for Disease Control and Prevention (2018) About Underlying Cause of Death 1999-2020.
https://wonder.cdc.gov/ucd-icd10.html
[31]  Foschi, D., Sorrentino, L., Tubazio, I., Vecchio, C., Vago, T., Bevilacqua, M., et al. (2018) Ileal Interposition Coupled with Duodenal Diverted Sleeve Gastrectomy versus Standard Medical Treatment in Type 2 Diabetes Mellitus Obese Patients: Long-Term Results of a Case-Control Study. Surgical Endoscopy, 33, 1553-1563.
https://doi.org/10.1007/s00464-018-6443-2
[32]  Parikh, M., Issa, R., Vieira, D., McMacken, M., Saunders, J.K., Ude-Welcome, A., et al. (2013) Role of Bariatric Surgery as Treatment for Type 2 Diabetes in Patients Who Do Not Meet Current NIH Criteria: A Systematic Review and Meta-Analysis. Journal of the American College of Surgeons, 217, 527-532.
https://doi.org/10.1016/j.jamcollsurg.2013.04.023
[33]  Soggia, A.P., Salem, M., Abdalla, R., et al. (2016) OR12-5: Bariatric Bypass Surgery versus Sleeve with Ileal Transposition Surgery versus Clinical Treatment in Obese Class I Patients with Diabetes. ENDO, Boston, MA.
[34]  Oh, J.S., Lee, H.G., Chun, H.J., Choi, B.G., Lee, S.H., Hahn, S.T., et al. (2013) Percutaneous Management of Postoperative Duodenal Stump Leakage with Foley Catheter. CardioVascular and Interventional Radiology, 36, 1344-1349.
https://doi.org/10.1007/s00270-012-0518-6
[35]  Conner, J., Nottingham, J.M. (2022) Biliopancreatic Diversion with Duodenal Switch. StatPearls, Treasure Island.
https://www.ncbi.nlm.nih.gov/books/NBK563193/
[36]  Komen, N., Klitsie, P., Dijk, J.W., Slieker, J., Hermans, J., Havenga, K., et al. (2011) Calcium Score: A New Risk Factor for Colorectal Anastomotic Leakage. The American Journal of Surgery, 201, 759-765.
https://doi.org/10.1016/j.amjsurg.2010.01.033

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133