"Obesity and type 2 diabetes are currently two common chronic, diseases in the countries of Western world, which are debilitating," the authors write as background in one of the articles. The surgery most commonly used to treat diabetes in the United States is the Roux-en-Y gastric bypass, more commonly called gastric bypass. In 2001, also known as the Tower-Banda, laparoscopic adjustable gastric band was introduced as a less invasive gastric bypass alternative. Gastric sleeve is another surgical intervention for weight loss, which implies a large part of the stomach surgical resection.
To assess the different results of Bariatric Surgery, Guilherme M. Campos, MD, now the University of Wisconsin School of medicine and public health, Madison, University of California, San Francisco and colleagues examined 100 (with a BMI greater than 40) morbid obese patients who underwent lap band surgery. These patients were accompanied by gender, race, age and the rate of initial weight (BMI) with 100 patients who underwent gastric bypass surgery.
All weight loss results were significantly higher in patients who have undergone gastric bypass surgery. Average weight for this excessive loss of Group was 64%, compared to 36% for lap band patients. In addition, 86 patients in the gastric bypass group correctly lost more than 40% of their excess weight by report at 29 (31%) of the lap band patients.
Each group had 34 patients with diabetes type 2. Resolution or improvement of type 2 diabetes was significantly better after gastric bypass surgery (26 patients or 76 per cent) to the lap band (17 patients or 50 per cent). Followed by one year, six of the eight patients of gastric bypass (75%) with insulin had suspended its use, while only a patient in six (17%) in the vuelta-malo Group had done so.
The rate of complications was similar in both groups, with 11 patients (12%) in the group the Tour-Banda and 14 patients (15%) of the Group of gastric bypass dealing with complications. Early complications (within 30 first postoperative days) were higher in the Group of gastric bypass (11 patients or 11%) of group vuelta - banda (2 or 2 per cent), however the re-operation rate was higher in patients of vuelta - banda (12 patients or 13%) compared to gastric bypass patients (2 patients or) (2 percent). No there were no deaths in any of the groups.
"Our study shows that Roux-en-Y gastric bypass, when carried out by expert surgeons, high-volume centres have a similar overall complication rate and the lowest rate of reoperations that laparoscopic adjustable gastric band"., "conclude the authors." "" Because you have a greater loss of weight, the highest resolution of diabetes and the best improvement in the quality of life, we conclude that, in the configuration that we study, gastric bypass, Roux in a better profile of the risks and benefits than the laparoscopic adjustable gastric band. »
In a second report, Wei - ?jei Lee, MD, PhD, Min Sheng General Hospital, Taiwan, Republic of China and colleagues conducted a randomized controlled double-blind 60 patients moderately obese (BMI between 25 and 35) aged from 30 to 60 years poorly controlled diabetes after conventional treatment. Between September 2007 and June 2008, half of the patients were assigned randomly to undergo gastric bypass surgery excluding the duodenum (ignoring the first 12 inches of the intestine) and half were divided at random to have a gastric sleeve without exclusion of the duodenum.
Overall, 42 patients (70%) had the remission of diabetes type 2 after 12 months of surgery. However, this resolution was significantly higher in patients of gastric bypass surgery (28 patients or 93 per cent) than the sleeve gastrectomy patients (14 patients or 47 per cent). The two groups also had significant weight loss in the postoperative follow-up of one to three months, but gastric bypass patients had better results in loss of weight in the six and 12 months follow-up.
In addition to a greater loss of weight, patients who underwent gastric bypass surgery reached a low waist circumference and had less glucose HbA1c and lipids in the blood of the patients in the Group of gastrectomy manga. Final complications in two patients (3%), a patient in each group and hospitalization for treatment, but no major adverse event have been observed.
"But clinical studies needed more data, this study and other studies have recommended gastric bypass as metabolic surgery should be included in the arming of the treatment of diabetes mellitus among the less obese (BMI of 25-35) and in the town of morbidly obese (BMI greater than 35)" conclude the authors.
(Source: JAMA/Archives: archives of surgery)
