METABOLIC EFFECTS OF THREE DIFFERENT BARIATRIC PROCEDURES-A RETROSPECTIVE STUDY
Keywords:
Bariatric metabolic surgery, Glycosylated hemoglobin, Obesity, Type 2DM Laparoscopic Roux-en-Y gastric bypass, Laparoscopic mini gastric bypass, Laparoscopic sleeve gastrectomy, Essential weight loss (EWL)Abstract
Objective: In this study it is proposed to compare the effect of three different bariatric metabolic procedures such as Laparoscopic Roux-en-Y gastric bypass (RYGB) Laparoscopic Mini gastric bypass (MGB) and Laparoscopic sleeve gastrectomy (SG) on diabetes remission and reduction in co-morbidities.
Methods: A retrospective analysis of prospectively collected data base of three bariatric metabolic surgery groups were screened from the year 2010-2014 at the study centre for patients satisfying the inclusion criteria. Three follow up data at an interval of three months and a base line value for all the three groups were collected. Outcome measure the percentage of patients achieved diabetes remission according to American Diabetes Association Criteria (ADA)/International Diabetic Federation (IDF) criteria i.e. Glycosylated haemoglobin (HbA1c)<6 % or<6.5 % without active pharmacological therapy at least I year post surgically and percentage patients lost>60% excess body weight. Secondary outcome includes the percentage reduction in cardiovascular risk factors, changes in medication associated with diabetes and cardiovascular diseases and immediate and later complications of the three different procedures of surgery. All calculations were performed using SPSS Version 18 statistical software. Descriptive statistics included are calculation of mean and standard deviation. Chi–square test and two factor ANOVA for comparison of means between groups under study.
Results: All the three surgical groups were comparable in reducing the excess body weight, HbA1c and cardiovascular complications. Highest response to weight reduction at 9 to 12 mo was reported from MGB group which was statistically significant between groups. Percentage of patients achieved diabetes remission according to ADA/IDF criteria was not statistically significant between groups but within group it was highly significant. Hypercholestremia reduction between MGB and GB was highly significant P value is **0.002. The lowest percentage of complications after surgery was reported by MGB group followed by SG.
Conclusion: MGB relatively a new surgical procedure seems to be a better option for treating, obesity, uncontrolled diabetes and related co-morbidities.
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References
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