医学
外科
Roux-en-Y吻合术
单中心
袖状胃切除术
体质指数
2型糖尿病
胃切除术
随机对照试验
减肥
吻合
糖尿病
胃分流术
内科学
肥胖
癌症
内分泌学
作者
Shibo Lin,Cong Liu,JiaJia Shen,Wei Guan,Hui Liang
标识
DOI:10.1016/j.soard.2022.07.003
摘要
Duodenojejunal bypass with sleeve gastrectomy (DJB-SG) is a novel bariatric surgery composed of sleeve gastrectomy (SG) and duodenojejunal anastomosis. Both loop and Roux-en-Y DJB-SGs were reported to have acceptable hypoglycemic and weight loss outcomes, but it remains unclear which reconstruction method is better regarding therapeutic efficacy and safety for type 2 diabetes (T2D).This study was undertaken to prospectively compare the short-term therapeutic outcomes and surgical safety of loop versus Roux-en-Y DJB-SG.University hospital.A total of 96 patients with T2D with body mass index of 27.5-40 kg/m2 were randomized in a 1:1 ratio to undergo loop or Roux-en-Y DJB-SG from January 2020 to December 2020. The primary end point was to determine the 1-year T2D remission rate. Additionally, medical cost, operative outcomes, weight loss, metabolic improvement, nutritional status, and gastrointestinal disorders at 1-year follow-up also were determined.The preoperative data were comparable at baseline. The 1-year follow-up rate was 89.6% (43 of 48 patients) for loop DJB-SG and 93.8% (45 of 48 patients) for Roux-en-Y DJB-SG. The T2D remission rates were 93.02% (40 of 43) for loop DJB-SG and 88.89% (40 of 45) for Roux-en-Y DJB-SG at 1-year follow-up. Loop DJB-SG patients exhibited higher total weight loss (30.85% ± 7.24% versus 26.11% ± 7.12%), shorter operative times, and less medical cost than Roux-en-Y DJB-SG patients. However, there was no statistical difference regarding lipid profiles, major postoperative complications, nutritional status, and gastrointestinal disorders between the 2 groups.Despite similar hypoglycemic effects, loop DJB-SG was simpler and exhibited better weight loss and less medical cost than Roux-en-Y DJB-SG. Thus, loop DJB-SG was better than Roux-en-Y DJB-SG for T2D.
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