Sista Federico, Abruzzese Valentina, Guadagni Stefano, Carandina Sergio, Clementi Marco
Dipartimento DISCAB, University of L'Aquila - San Salvatore Hospital, L'Aquila, Italy.
ELSAN, Surgical Obesity Center (CCO), Clinique Saint Michel, Toulon, France.
Ann Med Surg (Lond). 2018 Nov 3;36:142-147. doi: 10.1016/j.amsu.2018.10.034. eCollection 2018 Dec.
Our aim is to evaluate the effects of High Resected Gastric Volume(HRGV) on poorly Type 2 Diabetes Mellitus(DM2) after Laparoscopic Sleeve Gastrectomy(LSG).
256 patients were divided into two groups according to the RGV: < 1500 mL(Group A: 131 pts) and > 1500 mL(Group B: 147 pts). % excess body mass index loss (%EBMIL), Fasting Blood Glucose (FBG), HbA1c, C peptide were assessed before surgery and at the 3rd day, 6th,12th,24th,36th month after LSG.
A significant difference in %EBMIL between the two groups at 24 and 36 months was found. RGV was not significantly associated with DM2 in the multivariate logistic regression. FBG levels showed no differences between the two groups. A significant decrease of Hb1Ac at 6 and 12 months was found in group B. The C-peptide level showed a significant reduction at 6 and 12 months in group B.
The HRGV may play a role in the regulation of the glucose metabolism in the first year after LSG without influence in poorly DM2 control. Further studies are needed to confirm these findings.
我们的目的是评估腹腔镜袖状胃切除术后高切除胃容积（HRGV）对2型糖尿病控制不佳患者（DM2）的影响。
根据切除胃容积（RGV）将256例患者分为两组：<1500 mL（A组：131例）和>1500 mL（B组：147例）。在手术前以及腹腔镜袖状胃切除术后第3天、第6个月、第12个月、第24个月、第36个月评估超重体重指数丢失百分比（%EBMIL）、空腹血糖（FBG）、糖化血红蛋白（HbA1c）、C肽水平。
发现两组在术后24个月和36个月时的%EBMIL存在显著差异。在多因素逻辑回归分析中，RGV与DM2无显著相关性。两组间FBG水平无差异。B组在术后6个月和12个月时Hb1Ac显著降低。B组在术后6个月和12个月时C肽水平显著降低。
HRGV可能在腹腔镜袖状胃切除术后第一年的糖代谢调节中发挥作用，而对DM2控制不佳无影响。需要进一步研究来证实这些发现。
