Department of Surgery, Faculty of Medicine, Near East University, Nicosia, Cyprus.
Department of Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
Obes Facts. 2022;15(5):717-729. doi: 10.1159/000526718. Epub 2022 Sep 7.
This study examined whether 355 obese patients with type 2 diabetes (T2D) of varying duration and severity experienced equivalent weight loss and T2D remission following a newer sleeve gastrectomy (SG) procedure - SG with transit bipartition (SG-TB).
Primary outcomes were changes in body mass index (BMI), total weight loss (TWL), excess BMI loss (EBMIL), A1C, and diabetes medication use through 24 months.
Between December 2015 and December 2019, 399 patients who underwent SG-TB reached the 2-year time point. Follow-up was possible in 355 patients (89.0%): 206 females (58.0%), mean age 51.5 years (24.0-73.0), BMI 34.0 kg/m2 (28.0-50.5), and T2D duration 12.0 years (4.0-37.0). At 2 years, total sample respective mean TWL and EBMIL were 20.2 ± 6.1% (95% CI: 19.5, 20.8) and 87.7 ± 35.2% (84.1, 91.4) corresponding to mean BMI change of 7.0 ± 2.7 kg/m2 (6.7, 7.3) (p < 0.001). T2D duration and severity subgroups experienced comparable BMI and A1C change from baseline (p < 0.001); 281 (79.2%) maintained complete remission. ANOVA showed significant mean increases in vitamin D, calcium, and albumin: overall complication rate, 10.2%; no mortality.
DISCUSSION/CONCLUSION: In 355 patients with obesity who underwent SG-TB, excellent weight loss, T2D, and nutritional outcomes were seen at 2-year follow-up regardless of preoperative T2D duration and severity.
本研究旨在探讨 355 例不同病程和严重程度的 2 型糖尿病（T2D）肥胖患者在接受新型袖状胃切除术（SG）-SG 中转位分区术（SG-TB）后是否能获得同等的减重效果和 T2D 缓解。
主要结局指标为 24 个月时体重指数（BMI）、总减重（TWL）、超重 BMI 损失（EBMIL）、糖化血红蛋白（A1C）和糖尿病药物使用的变化。
2015 年 12 月至 2019 年 12 月，399 例患者接受了 SG-TB，达到了 2 年时间点。355 例患者（89.0%）可进行随访：206 例女性（58.0%），平均年龄 51.5 岁（24.0-73.0），BMI 34.0kg/m2（28.0-50.5），T2D 病程 12.0 年（4.0-37.0）。2 年时，总样本相应的平均 TWL 和 EBMIL 分别为 20.2±6.1%（95%CI：19.5，20.8）和 87.7±35.2%（84.1，91.4），对应的 BMI 变化均值为 7.0±2.7kg/m2（6.7，7.3）（p<0.001）。T2D 病程和严重程度亚组从基线开始 BMI 和 A1C 变化相当（p<0.001）；281 例（79.2%）患者维持完全缓解。方差分析显示，维生素 D、钙和白蛋白的均值显著增加：总体并发症发生率为 10.2%；无死亡病例。
讨论/结论：355 例肥胖患者接受 SG-TB 治疗，2 年随访时体重减轻、T2D 及营养状况良好，与术前 T2D 病程和严重程度无关。
