nach oben

Obesity Surgery

Erschienen in:

06.01.2021 | Original Contributions

The Short-Term Effects of Transit Bipartition with Sleeve Gastrectomy and Distal-Roux-en-Y Gastric Bypass on Glycemic Control, Weight Loss, and Nutritional Status in Morbidly Obese and Type 2 Diabetes Mellitus Patients

verfasst von: Ilhan Ece, Huseyin Yilmaz, Serdar Yormaz, Bayram Çolak, Akin Calisir, Mustafa Sahin

Erschienen in: Obesity Surgery | Ausgabe 5/2021

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The aim of this study was to compare the postoperative metabolic and nutritional outcomes after transit bipartition with sleeve gastrectomy (TB-SG) and distal-Roux-en-Y gastric bypass (D-RYGB).

Materials and Methods

A retrospective evaluation was made of 109 morbidly obese patients who underwent TB-SG or D-RYGB. Primary outcomes included metabolic variables such as glycemic control and serum lipid levels, and secondary outcomes consisted of nutritional deficiencies and weight loss after surgical procedures.

Results

During the study period, 83 and 26 patients underwent D-RYGB and TB-SG, respectively. The preoperative characteristics and nutritional status of the groups were similar. D-RYGB resulted in significantly higher weight loss rates in the first 3 months, but the percentage of excess weight loss (EWL %) was not different in the 12-month follow-up period. Although D-RYGB provided faster glycemic control due to early weight loss, there was no difference between the two groups. At the end of the follow-up period, the TB-SG was associated with significantly less deficiency of vitamin D, vitamin B12, iron, and folic acid. Anastomosis leakage was more common in the D-RYGB technique. The overall complication rates of the groups were similar.

Conclusion

TB-SG is a safe and effective alternative to D-RYGB for the treatment of obesity-related metabolic disorders with fewer nutritional deficiencies.

The National Institutes of Health Conference. Gastrointestinal surgery for severe obesity. Consensus development conference panel. Ann Intern Med. 1991; 115:956–61.

Members of the expert committee on the diagnosis and classification of diabetes mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003;26:5–20. https://doi.org/10.2337/diacare.26.2007.S5.CrossRef

Miller WC, Koceja DM, Hamilton EJ. A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. Int J Obes Relat Metab Disord. 1997;21:941–7. https://doi.org/10.1038/sj.ijo.0800499.CrossRefPubMed

Greenstein RJ, Rabner JG, Taler T. Bariatric surgery vs. conventional dieting in the morbidly obese. Obes Surg. 1994;4(1):16–23. https://doi.org/10.1381/096089294765558845.CrossRefPubMed

Sudan R, Jain-Spangler K. Tailoring bariatric surgery: sleeve gastrectomy, Roux-en-Y gastric bypass and biliopancreatic diversion with duodenal switch. J Laparoendosc Adv Surg Tech A. 2018;28(8):956–61. https://doi.org/10.1089/lap.2018.0397.CrossRefPubMed

Santoro S, Malzoni CE, Velhote MC, et al. Digestive adaptation with intestinal reserve: a neuroendocrine-based operation for morbid obesity. Obes Surg. 2006;16(10):1371–9. https://doi.org/10.1381/096089206778663841.CrossRefPubMed

Santoro S, Castro LC, Velhote MCP, et al. Sleeve gastrectomy with transit bipartition: a potent intervention for metabolic syndrome and obesity. Ann Surg. 2012;256(1):104–10. https://doi.org/10.1097/SLA.0b013e31825370c0.CrossRefPubMed

Food & Drug Association [Internet]. Silver Spring: The New Nutrition Facts Label; 2020 [cited 2020 Sep 17]. Daily value and percent daily value: changes on the new nutrition and supplement facts labels. Available from: https://www.fda.gov/food/new-nutrition-facts-label/daily-value-new-nutrition-and-supplement-facts-labels#referenceguide

Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13. https://doi.org/10.1097/01.sla.0000133083.54934.ae.CrossRefPubMedPubMedCentral

10.

Brethauer SA, Kim J, el Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis. 2015;11(3):489–506. https://doi.org/10.1016/j.soard.2015.02.003.CrossRefPubMed

11.

Benjamin EJ, Blaha MJ, Chiuve SE, et al. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics-2017 update: a report from the American Heart Association. Circulation. 2017;135(10):146–603. https://doi.org/10.1161/CIR.0000000000000485.CrossRef

12.

Goff DC Jr, Lloyd-Jones DM, Bennett G, Coady S, D’agostino RB, Gibbons R, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129:Suppl 2:49-73. [Erratum, Circulation 2014;129:Suppl 2:74-75.] https://doi.org/10.1161/01.cir.0000437741.48606.98

13.

Yormaz S, Yılmaz H, Ece I, et al. Laparoscopic Ileal interposition with diverted sleeve gastrectomy versus laparoscopic transit bipartition with sleeve gastrectomy for better glycemic outcomes in T2DM patients. Obes Surg. 2018;28(1):77–86. https://doi.org/10.1007/s11695-017-2803-6.CrossRefPubMed

14.

Ece I, Yılmaz H, Alptekin H, et al. Minimally invasive management of anastomotic leak after bariatric Roux-en-Y gastric bypass. J Minim Access Surg. 2015;11(2):160–2. https://doi.org/10.4103/0972-9941.144094.CrossRefPubMedPubMedCentral

15.

Mason EE, Ito C. Gastric bypass. Ann Surg. 1969;170(3):329–39.CrossRefPubMedPubMedCentral

16.

Scopinaro N, Gianetta E, Civalleri D, et al. The bilio-pancreatic bypass for functional surgical treatment of obesity. Minerva Med. 1979;70(52):3537–47.PubMed

17.

Marceau P, Biron S, Bourque RA, et al. Biliopancreatic diversion with a new type of gastrectomy. Obes Surg. 1993;3:29–35. https://doi.org/10.1381/096089295765557511.CrossRefPubMed

18.

Melissas J, Stavroulakis K, Tzikoulis V, et al. Sleeve Gastrectomy vs Roux-en-Y gastric bypass. Data from IFSO-European Chapter Center of Excellence Program. Obes Surg. 2017;27(4):847–55. https://doi.org/10.1007/s11695-016-2395-6.CrossRefPubMed

19.

Peterli R, Wölnerhanssen BK, Peters T, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss in patients with morbid obesity: the SM-BOSS randomized clinical trial. JAMA. 2018;319(3):255–65. https://doi.org/10.1001/jama.2017.20897.CrossRefPubMedPubMedCentral

20.

Borgeraas H, Hofsø D, Hertel JK, et al. Comparison of the effect of Roux-en-Y gastric bypass and sleeve gastrectomy on remission of type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Obes Rev. 2020;21(6):e13011. https://doi.org/10.1111/obr.13011.CrossRefPubMedPubMedCentral

21.

Guraya SY, Strate T. Surgical outcome of laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass for resolution of type 2 diabetes mellitus: a systematic review and meta-analysis. World J Gastroenterol. 2020;26(8):865–76. https://doi.org/10.3748/wjg.v26.i8.865.CrossRefPubMedPubMedCentral

22.

Albeladi B, Bourbao-Tournois C, Huten N. Short- and midterm results between laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy for the treatment of morbid obesity. J Obes. 2013;2013:934653–6. https://doi.org/10.1155/2013/934653.CrossRefPubMedPubMedCentral

23.

Gu L, Huang X, Li S, Mao D, Shen Z, Asutosh P, et al. A meta-analysis of the medium- and long-term effects of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. BMC Surg. 2020; 20(1):30. Published 2020 Feb 12. https://doi.org/10.1186/s12893-020-00695-x

24.

Arterburn D, Wellman R, Emiliano A, et al. Comparative effectiveness and safety of bariatric procedures for weight loss: a PCORnet cohort study. Ann Intern Med. 2018;169(11):741–50. https://doi.org/10.7326/M17-2786.CrossRefPubMedPubMedCentral

25.

Li JF, Lai DD, Ni B, et al. Comparison of laparoscopic Roux-en-Y gastric bypass with laparoscopic sleeve gastrectomy for morbid obesity or type 2 diabetes mellitus: a meta-analysis of randomized controlled trials. Can J Surg. 2013;56(6):E158–64. https://doi.org/10.1503/cjs.026912.CrossRefPubMedPubMedCentral

26.

McNickle AG, Bonomo SR. Predictability of first-year weight loss in laparoscopic sleeve gastrectomy. Surg Endosc. 2017;31(10):4145–9. https://doi.org/10.1007/s00464-017-5467-3.CrossRefPubMed

27.

Laferrere B, Heshka S, Wang K, et al. Incretin levels and effect are markedly enhanced 1 month after Roux-en-Y gastric bypass surgery in obese patients with type 2 diabetes. Diabetes Care. 2007;30(7):1709–16. https://doi.org/10.2337/dc06-1549.CrossRefPubMed

28.

Morinigo R, Lacy AM, Casamitjana R, et al. GLP-1 and changes in glucose tolerance following gastric bypass surgery in morbidly obese subjects. Obes Surg. 2006;16(12):1594–601. https://doi.org/10.1381/096089206779319338.CrossRefPubMed

29.

Rubino F, Forgione A, Cummings DE, et al. The mechanism of diabetes control after gastrointestinal bypass surgery reveals a role of the proximal small intestine in the pathophysiology of type 2 diabetes. Ann Surg. 2006;244:741–9. https://doi.org/10.1097/01.sla.0000224726.61448.1b.CrossRefPubMedPubMedCentral

30.

Drucker DJ. Glucagon-like peptide-1 and the islet beta-cell: augmentation of cell proliferation and inhibition of apoptosis. Endocrinology. 2003;144(12):5145–8. https://doi.org/10.1210/en.2003-1147.CrossRefPubMed

31.

Svane MS, Bojsen-Møller KN, Martinussen C, Dirksen C, Madsen JL, Reitelseder S, et al. Postprandial nutrient handling and gastrointestinal hormone secretion after Roux-en-Y gastric bypass vs sleeve gastrectomy. Gastroenterology. 2019; 156(6):1627–41.e1. https://doi.org/10.1053/j.gastro.2019.01.262

32.

Sundbom M, Holdstock C, Engström BE, et al. Early changes in ghrelin following Roux-en-Y gastric bypass: influence of vagal nerve functionality? Obes Surg. 2007;17(3):304–10. https://doi.org/10.1007/s11695-007-9056-8.CrossRefPubMed

33.

Anderson B, Switzer NJ, Almamar A, et al. The impact of laparoscopic sleeve gastrectomy on plasma ghrelin levels: a systematic review. Obes Surg. 2013;23(9):1476–80. https://doi.org/10.1007/s11695-013-0999-7.CrossRefPubMed

34.

Navarro García MI, González-Costea Martínez R, Torregrosa Pérez N, et al. Fasting ghrelin levels after gastric bypass and vertical sleeve gastrectomy: an analytic cohort study. Comportamiento de ghrelina en ayunas después de bypass gástrico y gastrectomía vertical: estudio de cohortes analítico. Endocrinol Diabetes Nutr. 2020;67(2):89–101. https://doi.org/10.1016/j.endinu.2019.07.004.CrossRef

35.

Meek CL, Lewis HB, Reimann F, et al. The effect of bariatric surgery on gastrointestinal and pancreatic peptide hormones. Peptides. 2016;77:28–37. https://doi.org/10.1016/j.peptides.2015.08.013.CrossRefPubMed

36.

Miyazaki T, Tanaka N, Hirai H, et al. Ghrelin level and body weight loss after esophagectomy for esophageal cancer. J Surg Res. 2012;176(1):74–8. https://doi.org/10.1016/j.jss.2011.09.016.CrossRefPubMed

37.

Coupaye M, Calabrese D, Sami O, et al. Evaluation of incidence of cholelithiasis after bariatric surgery in subjects treated or not treated with ursodeoxycholic acid. Surg Obes Relat Dis. 2017;13(4):681–5. https://doi.org/10.1016/j.soard.2016.11.022. Epub 2016 Dec 2CrossRefPubMed

38.

Sneineh MA, Harel L, Elnasasra A, et al. Increased incidence of symptomatic cholelithiasis after bariatric roux-en-Y gastric bypass and previous bariatric surgery: a single center experience. Obes Surg. 2020;30:846–50. https://doi.org/10.1007/s11695-019-04366-6.CrossRefPubMed

39.

Camaschella C. Iron deficiency: new insights into diagnosis and treatment. Hematology Am Soc Hematol Educ Program. 2015;2015:8–13. https://doi.org/10.1182/asheducation-2015.1.8.CrossRefPubMed

40.

Milman N. Intestinal absorption of folic acid - new physiologic & molecular aspects. Indian J Med Res. 2012 Nov;136(5):725–8.PubMedPubMedCentral

41.

Green R. Vitamin B12 deficiency from the perspective of a practicing hematologist. Blood. 2017 May 11;129(19):2603–11. https://doi.org/10.1182/blood-2016-10-569186.CrossRefPubMed

42.

Sala P, Belarmino G, Torrinhas RS, et al. Gastrointestinal transcriptomic response of metabolic vitamin B12 pathways in Roux-en-Y gastric bypass. Clin Transl Gastroenterol. 2017;8(1):e212. https://doi.org/10.1038/ctg.2016.67.CrossRefPubMedPubMedCentral

43.

Ettleson MD, Lager CJ, Kraftson AT, et al. Roux-en-Y gastric bypass versus sleeve gastrectomy: risks and benefits. Minerva Chir. 2017;72(6):505–19. https://doi.org/10.23736/S0026-4733.17.07441-7.CrossRefPubMed

44.

Arslan E, Sipahi M, Banli O. Early results of laparoscopic sleeve gastrectomy with loop bipartition. Surg Laparosc Endosc Percutan Tech. 2018;28(6):385–9. https://doi.org/10.1097/SLE.0000000000000541.CrossRefPubMed

45.

Karaca FC. Effects of sleeve gastrectomy with transit bipartition on glycemic variables, lipid profile, liver enzymes, and nutritional status in type 2 diabetes mellitus patients. Obes Surg. 2020;30(4):1437–45. https://doi.org/10.1007/s11695-019-04326-0.CrossRefPubMed

46.

Bilecik T. Metabolic effects of sleeve gastrectomy with transit bipartition in obese females with type 2 diabetes mellitus: results after 1-year follow-up. Obes Surg. 2019;29(3):805–10. https://doi.org/10.1007/s11695-018-3603-3.CrossRefPubMed

47.

Dogan K, Aarts EO, Koehestanie P, et al. Optimization of vitamin suppletion after Roux-en-Y gastric bypass surgery can lower postoperative deficiencies: a randomized controlled trial. Medicine (Baltimore). 2014;93(25):e169. https://doi.org/10.1097/MD.0000000000000169.CrossRefPubMedCentral

48.

Parrott J, Frank L, Rabena R, et al. American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient 2016 Update: Micronutrients. Surg Obes Relat Dis. 2017;13(5):727–41. https://doi.org/10.1016/j.soard.2016.12.018.CrossRefPubMed

49.

Kowalewski PK, Olszewski R, Kwiatkowski A, et al. Life with a gastric band. Long-term outcomes of laparoscopic adjustable gastric banding-a retrospective study. Obes Surg. 2017;27(5):1250–3. https://doi.org/10.1007/s11695-016-2435-2.CrossRefPubMed

50.

Verdi D, Prevedello L, Albanese A, et al. Laparoscopic gastric plication (LGCP) vs sleeve gastrectomy (LSG): a single institution experience. Obes Surg. 2015;25(9):1653–7. https://doi.org/10.1007/s11695-015-1600-3.CrossRefPubMed

51.

Felsenreich DM, Langer FB, Kefurt R, et al. Weight loss, weight regain, and conversions to Roux-en-Y gastric bypass: 10-year results of laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2016;12(9):1655–62. https://doi.org/10.1016/j.soard.2016.02.021.CrossRefPubMed

52.

Salminen P, Helmiö M, Ovaska J, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss at 5 years among patients with morbid obesity: the SLEEVEPASS randomized clinical trial. JAMA. 2018;319(3):241–54. https://doi.org/10.1001/jama.2017.20313.CrossRefPubMedPubMedCentral

Titel: The Short-Term Effects of Transit Bipartition with Sleeve Gastrectomy and Distal-Roux-en-Y Gastric Bypass on Glycemic Control, Weight Loss, and Nutritional Status in Morbidly Obese and Type 2 Diabetes Mellitus Patients
verfasst von: Ilhan Ece
Huseyin Yilmaz
Serdar Yormaz
Bayram Çolak
Akin Calisir
Mustafa Sahin
Publikationsdatum: 06.01.2021
Verlag: Springer US
Erschienen in: Obesity Surgery / Ausgabe 5/2021
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-020-05212-w

Neu im Fachgebiet Chirurgie

17.04.2024 | Postoperative nausea and vomiting | Nachrichten

Hochrisiko-Eingriffe für postoperative Übelkeit

16.04.2024 | HNO-Chirurgie | Nachrichten

HNO-Op. auch mit über 90?

16.04.2024 | Infektiologie | Nachrichten

Kein Abstrich bei chronischen Wunden ohne Entzündungszeichen!

10.04.2024 | Postoperative Schmerztherapie | Nachrichten

Chronische Schmerzen nach Op. oft mit neuropathischer Komponente

weitere anzeigen

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom CME-Kurs

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur CME-Kurs

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske

Dr. med. Benjamin Meyknecht

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis CME-Kurs

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

The Short-Term Effects of Transit Bipartition with Sleeve Gastrectomy and Distal-Roux-en-Y Gastric Bypass on Glycemic Control, Weight Loss, and Nutritional Status in Morbidly Obese and Type 2 Diabetes Mellitus Patients

Abstract

Purpose

Materials and Methods

Results

Conclusion

Neu im Fachgebiet Chirurgie

Hochrisiko-Eingriffe für postoperative Übelkeit

HNO-Op. auch mit über 90?

Kein Abstrich bei chronischen Wunden ohne Entzündungszeichen!

Chronische Schmerzen nach Op. oft mit neuropathischer Komponente

Update Chirurgie

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

S2e-Leitlinie „Distale Radiusfraktur“

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose

Materials and Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2021

Modified Nissen Fundoplication for Late Dumping Syndrome After Roux-en-Y Gastric Bypass

Impact of Bariatric Surgery in Reducing Macrovascular Complications in Severely Obese T2DM Patients

Obstructive Sleep Apnea in Obese Patients: a UK Population Analysis

Performance of Noninvasive Liver Fibrosis Tests in Morbidly Obese Patients with Nonalcoholic Fatty Liver Disease

Can Metabolite and Hormone Profiles Provide a Rationale for Choosing Between Bariatric Procedures?

Computed Tomography Assessment of Fat Distribution and Staple-Line Leak Risk After Sleeve Gastrectomy

Neu im Fachgebiet Chirurgie

Hochrisiko-Eingriffe für postoperative Übelkeit

HNO-Op. auch mit über 90?

Kein Abstrich bei chronischen Wunden ohne Entzündungszeichen!

Chronische Schmerzen nach Op. oft mit neuropathischer Komponente

Update Chirurgie

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

S2e-Leitlinie „Distale Radiusfraktur“

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“