Khalil Omar, Dargham Soha, Jayyousi Amin, Al Suwaidi Jassim, Abi Khalil Charbel
Research Department, Weill Cornell Medicine-Qatar, Doha P.O. Box 24144, Qatar.
Department of Medicine, Virginia Commonwealth University Health, Richmond, VA 23298, USA.
J Clin Med. 2024 May 28;13(11):3174. doi: 10.3390/jcm13113174.
: Bariatric surgery is a central cornerstone in obesity treatment. We aimed to assess the impact of diabetes on the postoperative outcomes of bariatric surgery and compare three techniques: sleeve gastrectomy, Roux-en-Y, and gastric banding. : We extracted data from the National Inpatient Sample (2015-2019) using ICD codes. The primary outcome was postoperative mortality. Secondary outcomes were major bleeding, atrial fibrillation, and acute renal failure. : Among patients who underwent sleeve gastrectomy, diabetes was associated with a higher adjusted risk of mortality (aOR 2.07 [1.36-3.16]), atrial fibrillation, and acute renal failure, but a similar risk of bleeding. Among patients who underwent Roux-en-Y, diabetes did not increase mortality and bleeding risk. Still, it was associated with a higher risk of atrial fibrillation and acute renal failure. Among patients who underwent gastric banding, diabetes was only associated with a higher risk of bleeding. When comparing the three techniques in diabetes patients, Roux-en-Y was significantly associated with higher mortality and acute renal failure risk when compared to the other procedures. Bleeding was more common in Roux-en-Y than in Sleeve. : In total, diabetes is associated with worse postoperative outcomes in bariatric surgery, regardless of the technique. Among diabetes patients, Roux-en-Y was associated with the highest mortality and morbidity.
减重手术是肥胖症治疗的核心基石。我们旨在评估糖尿病对减重手术术后结局的影响，并比较三种手术技术：袖状胃切除术、Roux-en-Y胃旁路术和胃束带术。
我们使用国际疾病分类代码从国家住院患者样本（2015 - 2019年）中提取数据。主要结局是术后死亡率。次要结局是大出血、心房颤动和急性肾衰竭。
在接受袖状胃切除术的患者中，糖尿病与调整后的更高死亡率风险（调整后比值比2.07 [1.36 - 3.16]）、心房颤动和急性肾衰竭相关，但出血风险相似。在接受Roux-en-Y胃旁路术的患者中，糖尿病并未增加死亡率和出血风险。不过，它与更高的心房颤动和急性肾衰竭风险相关。在接受胃束带术的患者中，糖尿病仅与更高的出血风险相关。在糖尿病患者中比较这三种手术技术时，与其他手术相比，Roux-en-Y胃旁路术与更高的死亡率和急性肾衰竭风险显著相关。Roux-en-Y胃旁路术的出血比袖状胃切除术更常见。
总体而言，无论采用何种技术，糖尿病都与减重手术更差的术后结局相关。在糖尿病患者中，Roux-en-Y胃旁路术与最高的死亡率和发病率相关。
