New results on the safety of laparoscopic sleeve gastrectomy bariatric procedure for type 2 diabetes patients  

作　　者：Ohad Guetta Alex Vakhrushev Oleg Dukhno Amnon Ovnat Gilbert Sebbag 

机构地区：[1]Department General Surgery B, Soroka University Medical Center

出　　处：《World Journal of Diabetes》2019年第2期78-86,共9页世界糖尿病杂志（英文版）（电子版）

摘　　要：BACKGROUND It has been established that bariatric surgery,including laparoscopic sleeve gastrectomy(LSG),has a positive impact on type 2 diabetes mellitus(T2DM).However,less frequently T2DM is reported as a risk factor for complications with this type of surgery.AIM To evaluate the safety of LSG in T2DM.METHODS A retrospective cohort study was conducted over patients admitted for LSG from January 2008 to May 2015.Data was collected through digitized records.Any deviation from normal postoperative care within the first 60 d was defined as an early complication,and further categorized into mild or severe.RESULTS Nine hundred eighty-four patients underwent LSG,among these 143(14.5%)were diagnosed with T2DM.There were 19 complications in the T2DM group(13.3%)compared to 59 cases in the non-T2DM(7.0%).Out of 19 complications in the T2DM group,12 were mild(8.4%)and 7 were severe(4.9%).Compared to the non-T2DM group,patients had a higher risk for mild complications(Odds-ratio 2.316,CI:1.163-4.611,P=0.017),but not for severe ones(P=0.615).An increase of 1% in hemoglobin A1c levels was associated with a 40.7% increased risk for severe complications(P=0.013,CI:1.074-1.843)but not for mild ones.CONCLUSION Our data suggest that LSG is relatively safe for patients with T2DM.Whether preoperative control of hemoglobin A1c level will lower the complications rate has to be prospectively studied.BACKGROUND It has been established that bariatric surgery, including laparoscopic sleeve gastrectomy(LSG), has a positive impact on type 2 diabetes mellitus(T2 DM).However, less frequently T2 DM is reported as a risk factor for complications with this type of surgery.AIM To evaluate the safety of LSG in T2 DM.METHODS A retrospective cohort study was conducted over patients admitted for LSG from January 2008 to May 2015. Data was collected through digitized records. Any deviation from normal postoperative care within the first 60 d was defined as an early complication, and further categorized into mild or severe.RESULTS Nine hundred eighty-four patients underwent LSG, among these 143(14.5%)were diagnosed with T2 DM. There were 19 complications in the T2 DM group(13.3%) compared to 59 cases in the non-T2 DM(7.0%). Out of 19 complications in the T2 DM group, 12 were mild(8.4%) and 7 were severe(4.9%). Compared to the non-T2 DM group, patients had a higher risk for mild complications(Odds-ratio2.316, CI: 1.163-4.611, P = 0.017), but not for severe ones(P = 0.615). An increase of 1% in hemoglobin A1 c levels was associated with a 40.7% increased risk for severe complications(P = 0.013, CI: 1.074-1.843) but not for mild ones.CONCLUSION Our data suggest that LSG is relatively safe for patients with T2 DM. Whether preoperative control of hemoglobin A1 c level will lower the complications rate has to be prospectively studied.

关 键 词：BARIATRIC surgery Laparoscopic sleeve GASTRECTOMY Type 2 diabetes Complications MORBIDITY HEMOGLOBIN A1C FASTING plasma glucose Clavien-Dindo classification 

分 类 号：R[医药卫生]