Spaniolas Konstantinos, Pories Walter J
Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, North Carolina.
Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, North Carolina.
Surg Obes Relat Dis. 2016 Jul;12(6):1220-4. doi: 10.1016/j.soard.2016.02.036. Epub 2016 Mar 2.
The Roux-en-Y gastric bypass (RYGB) has traditionally been the most common bariatric procedure. Long-term data on the efficacy of RYGB demonstrate a long-lasting benefit in weight loss and control of the metabolic syndrome. Although observations of type 2 diabetes (T2D) resolution after RYGB have been reported for 3 decades, it was not until recently that multiple randomized trials comparing RYGB to medical therapy verified the same thing: RYGB leads to significantly greater diabetes control and remission. Even though T2D can relapse, there remains a significant overall benefit of bariatric surgery regarding the downstream effects of T2D: cardiovascular risk and micro- and macrovascular complications. Limited data are available on the comparative effectiveness of RYGB and sleeve gastrectomy in improving glucose homeostasis, but studies including both surgical procedures suggest that the benefit of RYGB in T2D may be more profound. Although further research is needed to examine closely any differences between these 2 procedures, multiple studies underscore the unprecedented value of bariatric surgery for the control and remission of T2D.
传统上，Roux-en-Y胃旁路术（RYGB）一直是最常见的减肥手术。关于RYGB疗效的长期数据表明，其在减肥和控制代谢综合征方面具有持久的益处。尽管在过去30年里一直有关于RYGB术后2型糖尿病（T2D）缓解的报道，但直到最近，多项比较RYGB与药物治疗的随机试验才证实了同样的事情：RYGB能显著更好地控制糖尿病并实现缓解。即使T2D可能复发，但减肥手术对于T2D的下游影响（心血管风险以及微血管和大血管并发症）仍具有显著的总体益处。关于RYGB和袖状胃切除术在改善葡萄糖稳态方面的比较有效性，现有数据有限，但包括这两种手术的研究表明，RYGB对T2D的益处可能更为显著。尽管需要进一步研究来仔细考察这两种手术之间的任何差异，但多项研究强调了减肥手术在控制和缓解T2D方面前所未有的价值。
