Comparison of single-anastomosis gastric bypass and sleeve gastrectomy on type 2 diabetes mellitus remission for obese patients: A meta-analysis of randomized controlled trials

医学 减肥 随机对照试验 袖状胃切除术 吻合 内科学 胃切除术 糖尿病 体质指数 荟萃分析 外科 胃肠病学 2型糖尿病 临床试验 肥胖 胃分流术 内分泌学 癌症
作者
Zhiyong Ding,Jin Liu,Shuang Yu,Chenglei Feng,Pengfei Shen,Hang Li
出处
期刊:Asian Journal of Surgery [Elsevier]
卷期号:46 (10): 4152-4160 被引量:2
标识
DOI:10.1016/j.asjsur.2023.03.062
摘要

Currently, the increasing numbers of one anastomosis gastric bypass (OAGB) brought this technique in the third position in order of frequency, behind sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). However, OAGB is still considered lack of evidence in reducing obesity- related comorbidities. Our study aimed to compare the efficacy for SG and OAGB improving type 2 diabetes mellitus (T2DM) remission and weight loss in obese patients. PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched for randomized controlled trials (RCTs) comparing OAGB and SG. Review Manager 5.4.1 was used to analyze the data, and the right effect model was chosen based on heterogeneity. Five randomized controlled trials were included in the study. The remission of T2DM in the OAGB group was more efficient at 1 year and 5 years. Meanwhile, the OAGB group has a greater improvement than the SG group in terms of hypertension (HTN) and fasting plasma glucose (FPG). Although the percentage of excess BMI loss (%EBMIL) between the OAGB and SG groups was not significant at 6 months, the OAGB group had a conspicuous %EBMIL at 1 year. And 5 years after surgery, a higher percentage of excess weight loss (%EWL) was found in the OAGB group. Besides, the OAGB group showed a lower body mass index (BMI) at 5 years than the SG group, but the BMI at 6 months and 1 year were not significant. Finally, at 6 months, the OAGB group exhibited a more remarkable percentage of total weight loss (%TWL) than the SG group. In general, OAGB exhibited a better therapeutic effect in T2DM, HTN, and weight loss than SG in the medium-term follow-up period. To assess the long-term efficacy, clinics should be encouraged to continue longer-term follow-up studies and possibly RCTs.
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