Department of General Surgery, NO.1 People's Hospital of Dali City, Dali, 671000, China,
Obes Surg. 2014 Feb;24(2):171-8. doi: 10.1007/s11695-013-1102-0.
Despite the beneficial hypoglycemic and potentially curative effects in type 2 diabetes, large stomach volume deficits caused by Roux-en-Y gastrointestinal bypass (RYGB) surgery increase complications. Hypoglycemic effects of Braun surgery and RYGB surgery, both modified to maximally preserve stomach volume, were compared in rat type 2 diabetes models.
Three-month-old, male Goto-Kakizaki (GK) rats (n = 40) were randomly divided into equal groups and not treated (control) or treated with sham surgery (sham group), modified stomach-preserving Braun gastrointestinal bypass (Braun group), or modified RYGB (RYGB group). Pre- and postoperative body weight and water intake were recorded, along with operative and defecation times. Fasting blood glucose at 12 h, and blood glucose 180 min after intragastric glucose administration, were measured at weeks 1, 2, 3, 4, 10, and 11 along with glycosylated hemoglobin (preoperatively, week 11).
Statistically similar (P > 0.05) increased body weight and decreased water intake, fasting blood glucose, blood glucose after intragastric glucose administration, and glycosylated hemoglobin were observed in Braun and RYGB groups compared with control and sham groups (P < 0.05). By week 1, RYGB and Braun groups exhibited sustained reductions in fasting blood glucose from 13.0 ± 4.1 to 6.9 ± 1.4 mmol/L and 12.4 ± 4.4 to 7.3 ± 0.9 mmol/L, respectively (P < 0.05); mean operative times were 139.1 ± 4.9 and 81.6 ± 6.4 min, respectively; and postoperative defecation times were 74.3 ± 3.1 and 29.4 ± 4.1 h, respectively (P < 0.05).
Stomach volume-preserving Braun gastrointestinal bypass surgery was faster and produced hypoglycemic effects similar to RYGB bypass surgery, potentially minimizing metabolic disruption.
尽管 Roux-en-Y 胃肠旁路(RYGB)手术在 2 型糖尿病患者中具有有益的降血糖作用,并且可能具有治愈作用,但由于胃体积大量减少,导致并发症增加。在 2 型糖尿病大鼠模型中比较了经过改良以最大限度保留胃体积的 Braun 手术和 RYGB 手术的降血糖作用。
将 3 月龄雄性 Goto-Kakizaki(GK)大鼠(n=40)随机分为相等的组,不进行治疗(对照组)或进行假手术(假手术组)、改良保留胃的 Braun 胃肠旁路(Braun 组)或改良 RYGB(RYGB 组)治疗。记录术前和术后的体重和饮水量,以及手术和排便时间。在第 1、2、3、4、10 和 11 周测量空腹 12 小时后的血糖和胃内葡萄糖给药后 180 分钟的血糖,并测量术前(第 11 周)的糖化血红蛋白。
与对照组和假手术组相比,Braun 组和 RYGB 组的体重增加和水摄入量减少、空腹血糖、胃内葡萄糖给药后的血糖和糖化血红蛋白均有统计学意义(P<0.05)。第 1 周时,RYGB 和 Braun 组的空腹血糖分别从 13.0±4.1 降至 6.9±1.4mmol/L 和从 12.4±4.4 降至 7.3±0.9mmol/L(P<0.05);平均手术时间分别为 139.1±4.9 和 81.6±6.4 分钟;术后排便时间分别为 74.3±3.1 和 29.4±4.1 小时(P<0.05)。
保留胃体积的 Braun 胃肠旁路手术更快,并且产生与 RYGB 旁路手术相似的降血糖作用,可能最大限度地减少代谢紊乱。