Comparative analysis of LSG versus LRYGBP bariatric surgery in management of morbid obesity and type 2 diabetes mellitus in terms of percentage weight loss and T2DM resolution

Authors

  • Rajesh Sharma Department of Surgery, Sri Aurobindo Medical College & PG Institute, Indore, MP
  • Manoj Kela Department of Surgery, Sri Aurobindo Medical College & PG Institute, Indore, MP
  • Yashasvi Khare Department of Surgery, Sri Aurobindo Medical College & PG Institute, Indore, MP
  • Arun Mishra Department of Surgery, Sri Aurobindo Medical College & PG Institute, Indore, MP
  • Mohit Bhandari Mohak Hightech Laparoscopic & Robotic Bariatric Surgery Centre, SAMC & PGI, Indore, M.P.

DOI:

https://doi.org/10.18203/2349-2902.isj20151094

Keywords:

Morbid, Obesity, T2DM, Bariatric surgery

Abstract

Background:Obesity is a major health problem worldwide and in India also & is a major risk factor associated with significant morbidity and mortality due to comorbid conditions. Surgery is the only effective modality for significant and sustained weight loss & in resolution of associated diabetes, hypertension, sleep apnea and osteoarthritis. Laparoscopic Bariatric surgery is a unique field, this proven surgical approach provide marked improvement in quality of life with quick recovery.

Methods: Retrospective data analysis of 145 laparoscopic bariatrics surgery 123 LSG & 22 RYGBP done in patients of morbid obesity alone or with T2DM , HT was analyzed in the study Over a period of three years with mean follow up period of 1-2 years. Patients were evaluated in terms of resolution of percentage weight loss & T2DM.

Results:In Present study 145 cases of bariatric surgery (mainly SG & RYGB) were included. Significant weight control of around 40-60 kgs was observed. BMI reduction shift from 29-77 to 21.1-46.6kg/m2 was recorded. In all diabetes pt, post op reduction in HbA1c <6 (<6 normal value) 40% pt & near normal range in 35 % proves significant resolution in status of T2DM. Finally LSG & RYGBP showed almost similar result in % weight reduction & glycemic control.

Conclusions:Thus I conclude bariatric LSG / LRYGBP are a definite choice for patient of only morbid obesity & morbid Obesity with T2DM & give adequate resolution of problem & adds to quality of life of patient with cosmetic & therapeutic benefits

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References

Pereira JA, Claro BM, Pareja JC, Chaim EA, Astiarraga BD, Saad MJA et al. Restored insulin inhibition on insulin secretion in nondiabetic severely obese patients after weight loss induced by bariatric surgery. International Journal of Obesity. 2003;27:219-26.

Velasquez-Mieyer PA, Cowan PA, Arheart KL, Buffington CK, Spencer KA, Connelly BE, et al. Suppression of insulin secretion is associated with weight loss and altered macronutrient intake and preference in a subset of obese adults. International Journal of Obesity. 2006;30:1104-10.

Karlsson J, Taft C, Rydén A, Sjöström L, Sullivan M. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. International Journal of Obesity. 2009;33:S33-40.

Cummings DE. Endocrine mechanisms mediating remission of diabetes after gastric bypass surgery Anti-diabetic mechanisms of gastric bypass. International Journal of Obesity. 2009;33:S28-32.

Tadross JA, le Roux CW. The mechanisms of weight loss after bariatric surgery. 2009;35(6):564-8.

Renard E. Bariatric surgery in patients with late-stage type 2 diabetes: expected beneficial effects on risk ratio and outcomes. Can J Surg. 2009;52(6):E249-58.

Christou N, Efthimiou E. Five-year outcomes of laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass in a comprehensive bariatric surgery program in Canada. 2009;52(6):E249-58.

Kashyap SR, Gatmaitan P, Brethauer S, Schauer P. Bariatric surgery for type 2 diabetes: Weighing the impact for obese patients. Diabetes Technol Ther. 2010;12(8):671-7.

Nandagopal R, Brown RJ, Rother KI. Resolution of Type 2 Diabetes Following Bariatric Surgery: Implications for Adults and Adolescents. Nat Rev Endocrinol. 2010;6(2):102-9.

Rubino F, R’bibo SL, del Genio F, Mazumdar M, McGraw TE. Metabolic surgery: the role of the gastrointestinal tract in diabetes mellitus. Surg Obes Relat Dis. 2012;8(5):641-7.

Ceppa EP, Ceppa DP, Omotosho PA, Dickerson JA, Park CW, Portenier DD. Algorithm to diagnose etiology of hypoglycemia after Roux-en-Y gastric bypass for morbid obesity: case series and review of the literature. J Diabetes Sci Technol. 2011;5(5):1263-82.

Ionut V, Bergman RN. Mechanisms responsible for excess weight loss after bariatric surgery. International Journal of Obesity. 2012;36:348-55.

Laurenius A, Larsson I, Bueter M, Melanson KJ, Bosaeus I, Forslund BH, et al. Changes in eating behaviour and meal pattern following Roux-en-Y gastric bypass. Int J Obes. 2012;36(3):348-55.

Toghaw P, Matone A, Lenbury Y, De Gaetano A. Bariatric surgery and T2DM improvement mechanisms: a mathematical model. Theor Biol Med Model. 2012;9:16.

Dirksen C, Jørgensen NB, Bojsen-Møller KN, Kielgast U, Jacobsen SH, Clausen TR, et al. Gut hormones, early dumping and resting energy expenditure in patients with good and poor weight loss response after Roux-en-Y gastric bypass. Ann Surg. 2013;257(1):87-94.

Yip S, Plank LD, Murphy R. Gastric bypass and sleeve gastrectomy for type 2 diabetes: a systematic review and meta-analysis of outcomes. Curr Atheroscler Rep. 2013;15(11):366.

Via MA, Mechanick JI. The role of bariatric surgery in the treatment of type 2 diabetes: current evidence and clinical guidelines. J Hepatol. Curr Atheroscler Rep. 2013;15(11):366.

Immonen H, Hannukainen JC, Iozzo P, Soinio M, Salminen P, Lepomäki V, et al. Effect of bariatric surgery on liver glucose metabolism in morbidly obese diabetic and non-diabetic patients. J Hepatol. 2014;60(2):377-83.

Catheline JM, Fysekidis M, Bachner I, Bihan H, Kassem A, Dbouk R, et al. Five-year results of sleeve gastrectomy. J Visc Surg. 2013;150(5):307-12.

Nannipieri M, Baldi S, Mari A, Colligiani D, Guarino D, Camastra S, et al. Roux-en-Y gastric bypass and sleeve gastrectomy: mechanisms of diabetes remission and role of gut hormones. Metab Syndr Relat Disord. J Clin Endocrinol Metab. 2013;98(11):4391-9.

Nestvold TK, Nielsen EW, Lappegård KT. Bariatric surgery reduces risk factors for development of type 2 diabetes mellitus in morbidly obese, nondiabetic patients. Curr Pharm Des. Metab Syndr Relat Disord. 2013;11(6):441-6.

Kalyvas AV, Vlachos K, Abu-Amara M, Sampalis JS, Glantzounis G. Bariatric surgery as metabolic surgery for diabetic patients. Obes Surg. 2013;23(3):292-9.

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Published

2016-12-14

How to Cite

Sharma, R., Kela, M., Khare, Y., Mishra, A., & Bhandari, M. (2016). Comparative analysis of LSG versus LRYGBP bariatric surgery in management of morbid obesity and type 2 diabetes mellitus in terms of percentage weight loss and T2DM resolution. International Surgery Journal, 2(4), 641–646. https://doi.org/10.18203/2349-2902.isj20151094

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Original Research Articles