Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates.
Department of Surgery, Reinbek Hospital, Academic Teaching Hospital of the University of Hamburg, Reinbek D-21465, Germany.
World J Gastroenterol. 2020 Feb 28;26(8):865-876. doi: 10.3748/wjg.v26.i8.865.
Bariatric procedures are considered superior to medical therapies in managing type 2 diabetes mellitus (T2DM). Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are the most commonly used procedures for weight loss and comorbidity resolution worldwide. However, it is not yet known whether the degree of T2DM is influenced by the choice of bariatric procedure.
To quantitatively compare T2DM resolution over 1-5 years follow-up by LRYGB and LSG in morbidly obese patients.
We searched the selected databases for full-text English language clinical studies that compared the effectiveness of LRYGB and LSG for T2DM resolution. Review manager 5.3 was used for data analysis, and the overall effect summary was represented in a forest plot.
From 1,650 titles retrieved by an initial search, we selected nine studies for this research. We found insignificant differences for T2DM resolution by LRYGB and LSG, with an odds ratio of 0.93 (95%CI: 0.64-1.35, statistics = 0.38, = 0.71). Additionally, subset analyses for T2DM resolution showed insignificant differences after 24 mo ( = 1.24, = 4, = 0.87, overall effect = 0.23), 36 mo ( = 0.41, = 2, = 0.81, overall Z effect = 0.51), and 60 mo ( = 4.75, = 3, = 0.19, overall Z effect = 1.20) by LRYGB and LSG. This study reports a T2DM remission rate of 82.3% by LRYGB and 80.7% by LSG.
This study reports similar T2DM resolution rates by both LRYGB and LSG during 1-5 years of follow-up. However, long-term follow-up of 10 years is needed to further substantiate these findings.
减重手术被认为在治疗 2 型糖尿病（T2DM）方面优于药物治疗。腹腔镜 Roux-en-Y 胃旁路术（LRYGB）和腹腔镜袖状胃切除术（LSG）是目前全球范围内用于减肥和解决合并症的最常用手术方法。然而，目前尚不清楚 T2DM 的严重程度是否受到减重手术方式的影响。
定量比较 LRYGB 和 LSG 治疗肥胖患者 T2DM 的缓解效果，随访时间为 1-5 年。
我们在选定的数据库中检索了比较 LRYGB 和 LSG 治疗 T2DM 缓解效果的英文全文临床研究。使用 Review Manager 5.3 进行数据分析，并用森林图表示总效应总结。
从最初搜索的 1650 个标题中，我们选择了 9 项研究进行此项研究。我们发现 LRYGB 和 LSG 治疗 T2DM 的缓解效果无显著差异，优势比为 0.93（95%CI：0.64-1.35， 统计量=0.38，=0.71）。此外，对于 T2DM 缓解的亚组分析显示，24 个月（ = 1.24， = 4， = 0.87，总效应=0.23）、36 个月（ = 0.41， = 2， = 0.81，总 Z 效应=0.51）和 60 个月（ = 4.75， = 3， = 0.19，总 Z 效应=1.20）时 LRYGB 和 LSG 之间也无显著差异。本研究报告 LRYGB 和 LSG 的 T2DM 缓解率分别为 82.3%和 80.7%。
本研究报告 LRYGB 和 LSG 在 1-5 年随访期间 T2DM 缓解率相似。然而，需要 10 年的长期随访来进一步证实这些发现。
