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腹腔镜袖状胃切除术联合单吻合口十二指肠空肠旁路术治疗体重指数高于27.5kg/m²但低于32.5kg/m²的2型糖尿病患者。

Laparoscopic sleeve gastrectomy combined with single-anastomosis duodenal-jejunal bypass in the treatment of type 2 diabetes mellitus of patients with body mass index higher than 27.5 kg/m2 but lower than 32.5 kg/m2.

作者信息

Li Ying-Xu, Fang Deng-Hua, Liu Tian-Xi

机构信息

The First Hepatobiliary Section, The Second People's Hospital of Qujing City, China.

出版信息

Medicine (Baltimore). 2018 Aug;97(31):e11537. doi: 10.1097/MD.0000000000011537.

DOI:10.1097/MD.0000000000011537
PMID:30075520
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6081088/
Abstract

This study aimed to introduce this surgical technique laparoscopic sleeve gastrectomy combined with single-anastomosis duodenal-jejunal bypass (LDJB-LSG), and to confirm this new surgical technique was safe in the treatment of type 2 diabetes mellitus (T2DM) of patients with body mass index (BMI) higher than 27.5 kg/m but lower than 32.5 kg/m.A total of 34 T2DM patients with (BMI) higher than 27.5 kg/m but lower than 32.5 kg/m were admitted to our department between January 2014 and October 2016, of whom 25 received laparoscopic gastric bypass surgery (LRYGB) and 9 received LDJB-LSG. The efficacy and safety were compared between the 2 groups.None in both groups died and had severe postoperative complications. All the surgeries were performed by laparoscopy, and none received switching to open surgery. Patients received regular follow-up after surgery and none were lost to follow-up.Our study indicates LDJB-LSG is similar to LRYGB in the improvements of the body weight, blood glucose, insulin resistance, islet β cell function, blood lipid profile and serum uric acid, and thus LDJB-LSG is applicable in T2DM patients with 27.5 kg/m ≤ BMI ≤ 32.5 kg/m and risk for gastric cancer. However, long-term therapeutic effects need to be evaluated by studies with multicenter, large sample size, and long-term follow-ups.

摘要

本研究旨在介绍腹腔镜袖状胃切除术联合单吻合口十二指肠空肠旁路术(LDJB-LSG)这一手术技术,并证实该新手术技术在治疗体重指数(BMI)高于27.5kg/m但低于32.5kg/m的2型糖尿病(T2DM)患者时是安全的。2014年1月至2016年10月期间,共有34例BMI高于27.5kg/m但低于32.5kg/m的T2DM患者入住我科,其中25例接受了腹腔镜胃旁路手术(LRYGB),9例接受了LDJB-LSG。比较了两组的疗效和安全性。两组均无死亡及严重术后并发症发生。所有手术均通过腹腔镜进行,无一例转为开放手术。患者术后接受定期随访,无一例失访。我们的研究表明,LDJB-LSG在改善体重、血糖、胰岛素抵抗、胰岛β细胞功能、血脂谱和血清尿酸方面与LRYGB相似,因此LDJB-LSG适用于BMI为27.5kg/m≤BMI≤32.5kg/m且有胃癌风险的T2DM患者。然而,长期治疗效果需要通过多中心、大样本量和长期随访的研究来评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa88/6081088/ce238ae46d1a/medi-97-e11537-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa88/6081088/eea9462895e3/medi-97-e11537-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa88/6081088/c1de9b917e97/medi-97-e11537-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa88/6081088/f42d85bbedb1/medi-97-e11537-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa88/6081088/ce238ae46d1a/medi-97-e11537-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa88/6081088/eea9462895e3/medi-97-e11537-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa88/6081088/c1de9b917e97/medi-97-e11537-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa88/6081088/f42d85bbedb1/medi-97-e11537-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa88/6081088/ce238ae46d1a/medi-97-e11537-g004.jpg

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