Guetta Ohad, Vakhrushev Alex, Dukhno Oleg, Ovnat Amnon, Sebbag Gilbert
Department General Surgery B, Soroka University Medical Center, Be'er Sheva 8457108, Israel.
World J Diabetes. 2019 Feb 15;10(2):78-86. doi: 10.4239/wjd.v10.i2.78.
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.
To evaluate the safety of LSG in T2DM.
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.
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, = 0.017), but not for severe ones ( = 0.615). An increase of 1% in hemoglobin A1c levels was associated with a 40.7% increased risk for severe complications ( = 0.013, CI: 1.074-1.843) but not for mild ones.
Our data suggest that LSG is relatively safe for patients with T2DM. Whether pre-operative control of hemoglobin A1c level will lower the complications rate has to be prospectively studied.
已证实包括腹腔镜袖状胃切除术（LSG）在内的减肥手术对2型糖尿病（T2DM）有积极影响。然而，较少有报道称T2DM是这类手术并发症的危险因素。
评估LSG在T2DM患者中的安全性。
对2008年1月至2015年5月因LSG入院的患者进行回顾性队列研究。通过数字化记录收集数据。术后60天内任何偏离正常术后护理的情况被定义为早期并发症，并进一步分为轻度或重度。
984例患者接受了LSG，其中143例（14.5%）被诊断为T2DM。T2DM组有19例并发症（13.3%），非T2DM组有59例（7.0%）。在T2DM组的19例并发症中，12例为轻度（8.4%），7例为重度（4.9%）。与非T2DM组相比，患者发生轻度并发症的风险更高（优势比2.316，CI：1.163 - 4.611，P = 0.017），但重度并发症风险无差异（P = 0.615）。糖化血红蛋白水平每升高1%，严重并发症风险增加40.7%（P = 0.013，CI：1.074 - 1.843），但轻度并发症风险无差异。
我们的数据表明，LSG对T2DM患者相对安全。术前控制糖化血红蛋白水平是否会降低并发症发生率有待前瞻性研究。
