Almekhlafi Tofik A, Awn Fares S, Al-Sumat Ameera H, Ebrahim Ebrahim M, Jowah Haitham M
Department of Surgery, Faculty of Medicine and Health Science, Sana'a University, Sana'a, YEM.
Department of Surgery, University of Science and Technology Hospital, Sana'a, YEM.
Cureus. 2024 Nov 27;16(11):e74603. doi: 10.7759/cureus.74603. eCollection 2024 Nov.
Background The incidence of obesity and related comorbidities, such as diabetes, gastroesophageal reflux disease (GERD), and osteoarthritis, is increasing. Many patients with obesity do not respond to conservative treatments. For these patients, bariatric surgery, also known as metabolic bariatric surgery (MBS), has emerged as an effective option. This study aimed to evaluate the impact of laparoscopic bariatric surgery on weight loss, diabetes remission, and improvement in other comorbidities among patients in Sana'a, Yemen, in 2019. Methods This prospective study included 50 patients who underwent laparoscopic MBS between January and December 2019 at three tertiary hospitals in Sana'a, Yemen. The procedures included sleeve gastrectomy (SG), single anastomosis sleeve ileal bypass (SASI), and single anastomosis duodenal ileal bypass with sleeve (SADI-S). Patients were followed for six months postoperatively. Data on demographics, baseline comorbidities, and preoperative anthropometrics were collected. Weight loss was measured using multiple metrics, including percentage excess weight loss (EWL), percentage excess body mass index lost (EBMIL), and percentage total body weight loss (TBWL). Diabetes remission was defined as achieving glycated hemoglobin (HbA1c) < 6% without the use of medications. Results The study included 50 patients, with a mean age of 37.45 ± 10.25 years, and 28 (56%) were female. The mean preoperative weight was 121.5 ± 25.3 kg, and the mean height was 162.8 ± 8.5 cm, resulting in a mean body mass index (BMI) of 45.43 ± 7.3 kg/m². Among the patients, 15 (30%) had diabetes, 38 (76%) had GERD, and 45 (90%) had joint pain. At the six-month follow-up, the mean BMI significantly decreased to 32.46 ± 4.03 kg/m² (p < 0.001). The mean percentage of EBMIL was 63.5%, and the mean percentage of TBWL was 28.5%. Among the 15 patients with diabetes, 12 (80%) achieved diabetes remission, with HbA1c improving from 8.1 ± 2.3% to 5.3 ± 1.2% (p < 0.001). GERD improved in 30 (78.9%) of 38 patients, with complete resolution in 8 (21.1%). Joint pain improved in 39 (86.6%) of 45 patients, with complete resolution in six (13.4%). Conclusion Laparoscopic bariatric surgery is an effective intervention for achieving substantial weight loss, diabetes remission, and improvements in comorbidities among Yemeni patients. These findings are consistent with global literature and underscore the importance of bariatric surgery in addressing the increasing rates of obesity and metabolic disorders in Yemen. Further studies are needed to evaluate the long-term outcomes in this population.
肥胖及相关合并症，如糖尿病、胃食管反流病（GERD）和骨关节炎的发病率正在上升。许多肥胖患者对保守治疗无反应。对于这些患者，减肥手术，也称为代谢性减肥手术（MBS），已成为一种有效的选择。本研究旨在评估2019年也门萨那患者接受腹腔镜减肥手术对体重减轻、糖尿病缓解及其他合并症改善的影响。
这项前瞻性研究纳入了2019年1月至12月在也门萨那的三家三级医院接受腹腔镜MBS的50例患者。手术包括袖状胃切除术（SG）、单吻合口袖状回肠旁路术（SASI）和带袖状胃的单吻合口十二指肠回肠旁路术（SADI-S）。患者术后随访6个月。收集人口统计学、基线合并症和术前人体测量学数据。使用多种指标测量体重减轻情况，包括超重减轻百分比（EWL）、体重指数降低百分比（EBMIL）和总体重减轻百分比（TBWL）。糖尿病缓解定义为在不使用药物的情况下糖化血红蛋白（HbA1c）<6%。
该研究纳入50例患者，平均年龄37.45±10.25岁，28例（56%）为女性。术前平均体重为121.5±25.3kg，平均身高为162.8±8.5cm，平均体重指数（BMI）为45.43±7.3kg/m²。患者中，15例（30%）患有糖尿病，38例（76%）患有GERD，45例（90%）有关节疼痛。在6个月的随访中，平均BMI显著降至32.46±4.03kg/m²（p<0.001）。EBMIL的平均百分比为63.5%，TBWL的平均百分比为28.5%。在15例糖尿病患者中，12例（80%）实现糖尿病缓解，HbA1c从8.1±2.3%改善至5.3±1.2%（p<0.001）。38例患者中的30例（78.9%）GERD有所改善，8例（21.1%）完全缓解。45例患者中的39例（86.6%）关节疼痛有所改善，6例（13.4%）完全缓解。
腹腔镜减肥手术是也门患者实现显著体重减轻、糖尿病缓解及合并症改善的有效干预措施。这些发现与全球文献一致，并强调了减肥手术在应对也门肥胖率和代谢紊乱率上升方面的重要性。需要进一步研究评估该人群的长期结局。
