精准腹腔镜胃袖状切除术治疗肥胖症的疗效

目的探讨精准腹腔镜胃袖状切除术（LSG）治疗肥胖症的疗效。方法回顾性分析2011年8月至2013年7月暨南大学附属第一医院收治的50例施行精准LSG治疗肥胖症患者的临床资料。记录术前、术后患者BMI、并发症情况以及相关代谢性疾病缓解情况。结果50例患者均顺利完成LSG,手术时间为（59±10）min,出血量为（10±4）ml,术后住院时间为（5．2±1．1）d。术后患者未发生严重并发症。术后随访时间〉1年的23例患者多余体质量减少率（EWL）为80％±18％,BMI下降（10．1±3．4）kg／m2;术后随访6～12个月的13例患者EWL为71％±15％,BMI下降（8．6±2．3）kg／m2;随访1～6个月（不含6个月）的14例患者EWL为28％±12％,BMI下降（4．2±1．6）kg／m。。6例合并胰岛素抵抗患者恢复正常;6例合并脂肪肝患者,5例血脂水平下降,1例变化不明显;4例合并2型糖尿病患者中,3例无需药物控制血糖,1例口服降糖药物控制良好;3例合并高血压患者停用降压药物血压控制良好。结论施行精准LSG治疗肥胖症,术中采取精细、准确的操作,减少术中、术后并发症,可取得满意疗效,使患者获益。     

腹腔镜袖状胃切除术对肥胖相关疾病的治疗分析

目的探讨腹腔镜袖状胃切除术（LSG）治疗肥胖症及肥胖相关疾病的安全性和有效性。方法回顾性分析2006年12月至2011年7月间在浙江省人民医院接受LSG术的67例肥胖症患者的临床资料。观察术后1年患者体质量指数（BMI）、多余体质量减少率（EWL）以及2型糖尿病、高血压等肥胖相关疾病的改善情况。结果67例患者均顺利完成LSG术。手术时间（78±17）min．术后住院时间（5．0±1．7）d。术后恢复均顺利,无围手术期死亡及术后严重并发症发生。64例（95．5％）患者获得术后1年的随访,BMI由术前的（37．7±4．1）kg／m2下降了（10．4±3．7）kg／m2,EWL为（80．2±27．7）％。2型糖尿病和高血压的治愈率分别为53．8％（7／13）和45．5％（5／11）,缓解率均达100％。高三酰甘油血症（51例）、高尿酸血症（42例）、睡眠呼吸暂停综合征（2例）、骨关节疾病（9例）和棘皮病（8例）等其他肥胖相关疾病也得到治愈或不同程度的改善。结论LSG治疗肥胖症是安全可行的。在明显减轻体质量的同时还能治愈或改善2型糖尿病和高血压等肥胖相关疾病。     

腹腔镜袖状胃切除术在治疗超级肥胖的近期疗效观察

目的 探讨治疗超级肥胖的近期疗效研究。方法 选取医院2020年3月至2023年1月收治的超级肥胖患者68例,均实施腹腔镜袖状胃切除术治疗,对其临床资料进行分析。术后3个月、6个月、12个月分别对患者进行随访,对其体重、BMI、糖代谢指标[空腹血糖（FBG）、糖化血红蛋白（HbA1）]、脂代谢指标（胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C））、尿酸代谢指标（血清尿酸（UA））及手术安全性进行观察统计,评价其临床疗效。结果 68例患者均顺利完成LSG手术,术中无中转开腹或死亡,无严重围术期并发症发生。LSG术后,患者体重、BMI与术前比较均显著降低（P<0.05）;随访结束时所有患者EBMIL%均高于30%,LSG效果显著。与术前比较,LSG术后随访至12个月时,患者FBG、HbA1、TG及UA水平显著降低,HDL-C水平均显著提高,均出现显著改善（P<0.05）;术后至随访12个月时,患者2型糖尿病、高血压等肥胖合并症均取得有效缓解与改善。结论 对超级肥胖患者实施LSG治疗能够取得显著的治疗效果,术后减重效果显著,可显...     

腹腔镜下管状胃切除术和可调节胃绑带术对肥胖患者的影响

目的 比较腹腔镜下管状胃切除术（LSG）和腹腔镜下可调节胃绑带术（LAGB）两种手术方式对于肥胖患者的减肥效果以及对于伴随肥胖而产生的2型糖尿病（T2DM）患者的改善情况,探讨何种方式具有优势.方法 检索PubMed、Embase、万方、知网数据库从2000年1月1日-2012年8月17日公开发表的关于LSG和LAGB的文献,采用RevMan 5.0统计软件进行分析,比较通过这两种手术方式后6个月和12个月患者体重的减轻程度以及对T2DM的改善情况,通过选择计算相对危险度（95％ CI）作为效应尺度指标来评估这两种方式的有效性.结果 11篇关于腹腔镜下管状胃切除术和腹腔镜下可调节胃绑带术的比较的研究符合要求,共计1 004例患者.Meta分析显示,对于LAGB,6个月的平均的促进体重减轻（EWL）（年）百分比是33.9％,12个月的EWL（年）百分比是37.8％.对于LSG,6个月的平均EWL为50.6％,而12个月的EWL则达到了51.8％.68例T2DM患者中有42例（61.8％）在经过LAGB手术后病情得到改善或治愈,80例行LSG的T2DM患者中有66例（82.5％）得到改善或治愈.结论 相对于LAGB,LSG是一个更加有效的方式,在改善病态肥胖和T2DM上具有更加良好的效果.     

腹腔镜Roux-en-Y胃分流术治疗病态性肥胖合并2型糖尿病

目的 评价腹腔镜Roux-en-Y胃分流术(LRYGB)对病态性肥胖合并2型糖尿病患者的治疗效果,探讨该术式治疗糖尿病的可能机制.方法 前瞻性分析2007年1月至7月美国克利夫兰医院30例体质量指数(BMI)≥35.00合并2型糖尿病的病态性肥胖患者的临床资料,采用t检验分析患者接受LRYGB后的疗效.结果 与术前比较,术后第6个月的BMI、空腹血糖、糖化血红蛋白明显降低(t=27.399,23.025,15.593,P＜0.05).第2个月治愈率为70%(21/30),第6个月治愈率为90%(27/30),3例糖尿病症状得到改善.进一步分析术后第2个月和第6个月体质量下降程度,改善患者分别为27.89%±5.51%、45.73%±2.82%,治愈患者分别为35.65%±1.97%、58.00%±1.05%,糖尿病治愈患者比改善患者下降幅度大(t=5.755,7.081,P＜0.05).结论 LRYGB对病态性肥胖合并2型糖尿病患者有着良好治疗效果,体质量下降幅度越大,糖尿病治愈可能性就越大.     

胃转流术对非肥胖型2型糖尿病的治疗作用

目的:观察胃转流术对非肥胖型2型糖尿病的治疗作用。 方法:回顾性分析5年余行胃转流术治疗的胃癌伴非肥胖型2型糖尿病患者103例的临床资料，包括手术前后体重指数（BMI）、空腹血糖水平、胰岛素抵抗指数、糖化血红蛋白的变化情况及术后6个月糖尿病转归情况。结果:全组患者术后BMI较术前无明显变化（P＞0.05）; 而从术后1周开始空腹血糖水平即出现持续而稳定下降的趋势（P＜0.05）; 伴随着术后血糖水平的改善，胰岛素抵抗指数、糖化血红蛋白亦出现明显下降（P＜0.05）。术后6个月，糖尿病总治愈率为79.6%; 而不同的胃转流术式(食管-空肠Roux-en-Y术和莫氏法胃空肠吻合术)对糖尿病的控制无统计学差异(P＞0.05)。 结论:胃转流术对非肥胖型2型糖尿病具有较好的治疗作用; 其对2型糖尿病的控制不依赖于体重的降低。     

袖状胃切除间置回肠的十二指肠空肠旁路手术对非肥胖性2型糖尿病患者脂质代谢的影响

目的评价袖状胃切除间置回肠的十二指肠空肠旁路手术对非肥胖性2型糖尿病患者脂质代谢的影响。方法回顾性分析2009年3月至2010年8月间在四川省攀枝花市中心医院接受袖状胃切除间置回肠的十二指肠空肠旁路手术的29例非肥胖型2型糖尿病患者的临床资料。术后12个月检测总胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白、胰岛素抵抗指数及糖化血红蛋白（HbAlc）的变化。结果术后12个月时,28例（96．5％）患者血糖得到控制,无需服降糖药,HbAlc从术前的（8．4±1．3）％降至术后的（6．2±0．8）％,另1例血糖亦获改善。25例（86．2％）患者脂质代谢紊乱得到纠正,其中19例术前高胆固醇血症患者中16例（84．2％）术后恢复正常,17例高三酰甘油血症患者中14例（82.3％）恢复正常,12例高密度脂蛋白异常患者中8例（66．6％）恢复正常,16例低密度脂蛋白异常的患者中5例（31．2％）恢复正常;总胆固醇／高密度脂蛋白从术前的5．6±1．2降至术后的2．8±1．0,三酰甘油／高密度脂蛋白从术前的3．2±1.3降至术后的1．5±0．8（均P〈0．01）。结论袖状胃切除间置回肠的十二指肠空肠旁路手术能有效地改善非肥胖型2型糖尿病患者的脂质代谢紊乱。     

国内腹腔镜袖状胃切除术对肥胖合并2型糖尿病的近期疗效的Meta分析

目的探讨国内腹腔镜袖状胃切除术(LSG)对肥胖合并2型糖尿病(T2MD)的近期疗效。方法检索万方、知网中文数据库、Pub Med和Web of Science英文数据库,按照纳入和排除标准筛选文献,提取纳入文献中的相关数据,并对其进行方法学质量评价,对LSG治疗肥胖合并T2DM的近期疗效(术后空腹血糖和糖化血红蛋白水平)进行Meta分析。结果本研究共纳入7篇文献共计107例符合纳入条件的患者。Meta分析结果显示:1空腹血糖水平:术后6个月与术前比较以及术后12个月与术后6个月比较均明显下降(术后6个月与术前比较:MD=2.99,95%CI为2.39~3.60,P0.000 01;术后12个月与术后6个月比较:MD=0.56,95%CI为0.16~0.95,P=0.006)。2糖化血红蛋白水平:术后6个月与术前比较以及术后12个月与术后6个月比较均明显下降(术后6个月与术前比较:MD=2.24,95%CI为1.43~3.04,P0.000 01;术后12个月与术后6个月比较:MD=0.52,95%CI为0.22~0.81,P=0.000 6)。LSG术后患者空腹血糖和糖化血红蛋白呈下降趋势。结论 LSG治疗肥胖合并T2MD的近期疗效明显,其长期疗效还需要大样本临床随机对照研究数据支持。     

腹腔镜袖状胃切除术治疗病态性肥胖症合并2型糖尿病的疗效及相关因素分析

目的:探讨腹腔镜袖状胃切除术(LSG)治疗病态性肥胖症合并2型糖尿病的临床疗效,并分析影响疗效的相关因素.方法:回顾分析2013年7月至2018年7月为45例病态性肥胖症合并2型糖尿病患者行LSG的临床资料及随访情况,分析手术对患者体重及血糖的控制情况,并应用单因素与多因素Logistic回归分析影响体重及血糖控制效果...     

胃癌BillrothⅡ式胃切除术对合并2型糖尿病患者的治疗价值

目的探讨胃癌BillrothⅡ式胃切除术对合并2型糖尿病患者糖代谢的影响。方法回顾性观察7例体重指数（BMl）〈35kg／m^2合并2型糖尿病的病人因胃癌接受Billroth Ⅱ式胃切除手术前后血糖控制情况以及糖尿病治疗的变化。结果7例均成功完成了根治性BillrothⅡ式胃切除术，4例行腹腔镜手术，3例行开腹手术。术后未发生严重并发症。术前空腹血糖（FPG）6．6～9．0mmol／L，平均8．1mmol／L；糖化血红蛋白（HbAlc）6．8％～9．5％，平均7．8％。术后1～8个月复查FPG4．8～7．9mmol／L，平均6．4mmol／L；HbAlc5．5％～7．2％，平均6．3％。据美国糖尿病协会（ADA）糖尿病疗效判断标准，4例治愈，3例改善。结论胃癌BillrothⅡ式胃切除术可治疗胃癌患者合并的2型糖尿病。     

Long-term remission of type 2 diabetes in morbidly obese patients after sleeve gastrectomy

BackgroundThe aim of this study was to evaluate the long-term effects of laparoscopic sleeve gastrectomy (LSG) on type 2 diabetes mellitus (T2DM) and other related co-morbidities in severely obese patients.MethodsFrom May 2003 to July 2008, 33 morbidly obese diabetic patients (20 with body mass index [BMI]>50 kg/m²) underwent LSG. A total of 23 females and 10 males participated, with a mean age of 49.3±8 years, mean preoperative BMI of 52.1±8.5 kg/m², mean fasting plasma glucose (FPG) of 143.2±47.9 mg/dL, mean glycosylated hemoglobin (HbA_1c) of 7.3%±1.4%, and a mean T2DM duration of 7 years. All patients had a 36-month follow-up, and 13 had a 60-month follow-up.ResultsTwenty-nine patients (87.8%) discontinued antidiabetic medications 3 months after LSG, (mean BMI of 42.8±7.8 kg/m²; FPG of 104.5±22.1 mg/dL; HbA_1c of 5.3%±.4%). At 36 months, 22 of 26 LSG patients (84.6%) had normal FPG and HbA_1c values without antidiabetic therapy. At the 60-month follow-up, 10 of 13 patients (76.9%) had normal FPG and HbA_1c values without antidiabetic therapy. The Framingham risk score decreased significantly from 9.7% preoperatively to 4.7% postoperatively. No new diabetic retinopathy occurred during the whole period of observation.ConclusionsThis study confirms the efficacy of LSG in the treatment of T2DM and indicates that, at both 36- and 60-month follow-ups, LSG can provide a significant percentage of treated patients with a prolonged remission of T2DM, with diminished cardiac risk factors and no development of diabetic retinopathy. These results compare favorably with those reported after standard medical therapy.     

Metabolic Surgery for the Treatment of Type 2 Diabetes in Patients with BMI <35 kg/m<Superscript>2</Superscript>: An Integrative Review of Early Studies

Type 2 diabetes mellitus (T2DM) resolution in morbidly obese patients following metabolic surgery suggests the efficacy of T2DM surgery in non-morbidly obese patients (body mass index [BMI] <35 kg/m²). This literature review examined research articles in English over the last 30 years (1979–2009) that addressed surgical resolution of T2DM in patients with a mean BMI <35. Weighted and simple means (95% CI) were calculated to analyze study outcomes. Sixteen studies met inclusion criteria; 343 patients underwent one of eight procedures with 6–216 months follow-up. Patients lost a clinically meaningful, not excessive, amount of weight (from BMI 29.4 to 24.2; −5.1), moving from the overweight into the normal weight category. There were 85.3% patients who were off T2DM medications with fasting plasma glucose approaching normal (105.2 mg/dL, −93.3), and normal glycated hemoglobin, 6% (−2.7). In subgroup comparison, BMI reduction and T2DM resolution were greatest following malabsorptive/restrictive procedures, and in the preoperatively mildly obese (30.0–35.0) vs overweight (25.0–25.9) BMI ranges. Complications were few with low operative mortality (0.29%). Novel and/or known mechanisms of T2DM resolution may be engaged by surgery at a BMI threshold ≤30. The majority of low-BMI patients experienced resolution of laboratory and clinical manifestations of T2DM without inappropriate weight loss.     

Clinical Efficacy of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Gastric Bypass in Obese Type 2 Diabetic Patients: a Retrospective Comparison

Background

Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are performed in patients with obesity and type 2 diabetes mellitus (T2DM). The aim of this study is to evaluate retrospectively the clinical efficacy of RYGB and SG in two groups of obese T2DM patients.

Methods

From the hospital database, we extracted the clinical records of 31 obese T2DM patients, of whom 15 (7 F/8 M) had undergone laparoscopic SG (LSG) and 16 (7 F/9 M) laparoscopic RYGB (LRYGB) in the period 2005?C2008. The groups were comparable for age (range 33?C59?years) and BMI (range 38?C57?kg/m²). LRYGB alimentary limb was 150?cm, and biliopancreatic limb was 150?cm from the Treitz ligament. LSG vertical transection was calibrated on a 40-Fr orogastric bougie. Data were analysed at 6, 12 and 18?C24?months with reference to weight loss and remission of comorbidities.

Results

The reduction in body weight was comparable in the two groups. At 18?C24?months the percent BMI reduction was 29?±?8 and 33?±?11?% in LSG and LRYGB, respectively. Percent excess weight loss was 53?±?16 and 52?±?19?% in LSG and LRYGB, respectively. Thirteen patients in LSG and 14 patients in LRYGB discontinued their hypoglycaemic medications. Five (55?%) patients in LSG and eight (89?%) in LRYGB discontinued antihypertensive drugs. Three out of five patients in LSG and one out of two patients in LRYGB withdrew lipid-lowering agents.

Conclusions

LSG and LRYGB are equally effective in terms of weight loss and remission of obesity-related comorbidities. Controlled long-term comparisons are needed to establish the optimal procedure in relation to patients?? characteristics.     

Type 2 diabetes in obese patients with body mass index of 30-35 kg/m2: sleeve gastrectomy versus medical treatment

BackgroundType 2 diabetes mellitus (T2DM) and obesity are diseases of epidemic proportions. Long-term realistic weight loss by nonsurgical methods has a variable effect on glycemic control, and only a proportion of patients with T2DM have a worthwhile response. Laparoscopic sleeve gastrectomy (LSG) has been proposed as an advantageous bariatric procedure for patients with a lower body mass index (BMI). Our objective was to compare the effects of LSG and medical therapy on patients with T2DM and a BMI of <35 kg/m².MethodsA total of 18 nonmorbidly obese patients with T2DM, diagnosed according to the American Diabetes Association guidelines, were consecutively enrolled. Of these patients, 9 underwent LSG (group A) and 9 underwent conventional medical therapy (group B). The 2 groups were matched for BMI, glycated hemoglobin (HbA1c) and C-peptide levels, pretrial therapy type, and number of patients with a T2DM duration of >10 years.ResultsIn group A, T2DM resolution was achieved in 8 (88.8%) of the 9 patients (T2DM duration 5.2 yr). Hypertension was controlled in all 8 of 9 patients. Dyslipidemia was corrected. In 1 patient, obstructive sleep apnea syndrome improved. In group B, all 9 patients continued to have T2DM and required hypertensive and hypolipemic therapies throughout the observation period. At baseline, 3 patients were affected by obstructive sleep apnea syndrome and remained affected 1 year later.ConclusionThe results of the present study have confirmed the efficacy of LSG in the treatment of nonmorbidly obese T2DM patients, with a remission rate of 88.8% without undesirable excessive weight loss. The results in this group of patients add to those obtained by us in patients with a BMI >35 kg/m².     

腹腔镜下袖状胃切除术治疗高体重指数2型糖尿病的效果分析

目的探讨腹腔镜袖状胃切除术(LSG)治疗高体重指数2型糖尿病(T2DM)患者的可行性及疗效的稳定性。 方法回顾性分析2010年至2016年间两个医院24例实施LSG的T2DM患者的临床资料,所有数据建立完整的excel表格,采用SPSS 17.0分析。术前术后体重和糖化血红蛋白(HBALc)水平以( ±s)表示,采用t检验;分类数据以频率和百分比表示,采用卡方检验。P<0.05认为差异有统计学意义。 结果24例患者平均基线体重为(117.2±30.2) kg,在术后3个月、6个月、12个月和24个月时显著下降至(100.3±22.1) kg、(91.6±22.4) kg、(81.3±16.5) kg和(80.3±14.3) kg, P<0.001。术前平均基线HbA1c为(8.5±2.2)%,分别在3个月、6个月、12个月和24个月显著降低至(6.4±1.6)%,(5.8±1.1)%, (5.7±0.7)%和(5.3±0.6)% P<0.001。19例接受袖状胃切除术的T2DM患者停止使用胰岛素和口服降糖药,根据血糖控制标准,24例患者24个月缓解率达79.2%。除1例继续使用2种降压药外,其余高血压患者(17例)停止降压药治疗。 结论LSG治疗高体重T2DM患者,方法简单,手术安全,治疗效果确切,值得在临床中普遍推广应用。     

不同类型减重代谢手术治疗重度肥胖合并2型糖尿病的近期疗效分析

背景与目的：减重代谢手术是肥胖合并2型糖尿病（T2DM）的有效治疗方式,但不同的减重代谢手术在治疗肥胖症和控制血糖等方面效果不同。因此,本研究探讨不同减重代谢手术方式治疗重度肥胖合并T2DM的短期疗效,以及它们在减重、降糖、降脂等方面的特点,以期为临床治疗选择提供参考。 方法：回顾分析63例行减重代谢手术重度肥胖合并T2DM患者的临床资料。其中25例行腹腔镜胃袖状切除（LSG）,18例行LSG+空肠旁路术（LSG+JJB）,20例行腹腔镜胃旁路术（LRYGB）,比较三组患者术前及术后6、12个月的临床数据。 结果：三组术前各项资料具有可比性。所有患者均顺利完成手术,三组手术时间比较差异有统计学意义（P<0.05）,其余手术相关指标差异均无统计学意义（均P>0.05）。三组术后体质量、腰围、臀围、BMI、多余体质量减少百分比（%EWL）等减重指标均较术前明显改善（均P>0.05）,除臀围在同组术后6个月与12个月以及三组间术后相同时间点差异均无统计学意义外（均P>0.05）,其余4项指标均为同组术后12个月明显优于术后6个月、同时间点LSG+JJB组与LRYGB组优于LSG组（均P<0.05）,而LSG+JJB组与LRYGB组间差异无统计学意义（均P>0.05）。三组患者术后空腹血糖、空腹胰岛素、糖化血红蛋白、胰岛素抵抗指数等糖代谢指标均较术前明显改善（均P<0.05）,但以上指标在同组术后6个月与12个月间以及三组同时间点差异均无统计学意义（均P>0.05）;三组术后6、12个月糖尿病缓解率比较,差异均无统计学意义（均P>0.05）。三组患者术后血胆固醇、甘油三脂、低密度脂蛋白、高密度脂蛋白、尿酸等脂代谢指标均较术前明显改善（均P<0.05）,三组间甘油三脂、高密度脂蛋白、低密度脂蛋白改善效果差异无统计学意义（均P>0.05）,LRYGB组、LSG+JJB组血尿酸及胆固醇降低程度均优于LSG组（均P<0.05）。 结论：LSG、LSG+JJB、LRYGB均有良好的减重及改善糖脂代谢作用,短期效果显著;三者均能有效降低血糖、血脂指标。LSG+JJB和LRYGB的减重、降尿酸、降胆固醇的效果优于LSG。LSG+JJB手术操作简单,效果明显,值得在临床中进一步推广运用。     

Impact of Laparoscopic Sleeve Gastrectomy and Laparoscopic Gastric Bypass on HbA1c Blood Level and Pharmacological Treatment of Type 2 Diabetes Mellitus in Severe or Morbidly Obese Patients. Results of a Multicenter Prospective Study at 1 Year

Gastric bypass (GBP) has proved its efficacy 30 years ago in the management of diabetes mellitus (T2DM) for severe obese patients. More recently, interesting results have been published after sleeve gastrectomy (SG) in the same indication. Between 2005 and 2008, three bariatric centers have prospectively collected the data of T2DM patients treated by laparoscopic gastric bypass (LGBP) or laparoscopic sleeve gastrectomy (LSG). Effects on hemoglobin A1c (HbA1c), pharmacological treatment and excess weight loss after 1 year of surgery have been analyzed. All patients (35 LGBP and 33 LSG) were treated with oral anti-diabetics (OAD) or insulin before surgery (32 OAD and three insulin in LGBP group and 27 OAD and six insulin in LSG group). The average body mass index (BMI) in the LGBP group was 47.9 and 50.6 kg/m2 in the LSG group. At 1 year after surgery, the average HbA1c lost was 2,537 in the GBP group and 2,175 in the SG group. T2DM had resolved (withdrawal of pharmacological treatment) in 60% of the LGBP group and 75.8% of the LSG group. Reduced use of pharmacological therapy was noted in 31.42% of the LGBP group and 15.15% of the LSG group. Percentage excess weight loss and BMI lost were 56.35% and 29.75% in the LGBP group and 60.11% and 29.80% in the LSG group, respectively. During short-term follow-up, the impact on regulation of HbA1c blood level of LGBP or LSG is important. At 1 year after surgery, LSG seems to be as effective as LGBP for the management of T2DM in severely obese patients.     

Diabetes Remission and Insulin Secretion After Gastric Bypass in Patients with Body Mass Index <35 kg/m<Superscript>2</Superscript>

Background  

Most morbidly obese patients who undergo gastric bypass experience rapid remission of type 2 diabetes mellitus (T2DM) but the response in non-morbidly obese patients is not clear. This trial prospectively assessed the effect of diabetes remission, glucose metabolism, and the serial changes of insulin secretion after gastric bypass in inadequately controlled T2DM patients with a BMI of 23–35 kg/m².     

腹腔镜手术治疗219例肥胖症疗效分析

目的探讨腹腔镜下胃肠外科手术治疗单纯性肥胖症及其合并2型糖尿病（T2DM）患者的效果及安全性。方法上海第二军医大学附属长海医院微创外科2003年6月至2010年6月间对219例肥胖症患者进行了腹腔镜下胃肠外科手术,其中201例行腹腔镜下可调节胃绑带术（LAGB组）,13例行腹腔镜下改良简易型胃肠短路术（LMGB组）,5例行腹腔镜下管状胃胃切除术（LSG组）。总结分析该组患者的临床和随访资料。结果LAGB组患者体质量指数（BMI）平均37．9kg／m2,术后6个月及12个月BMI分别为平均32．4kg／mz和29．7kg／m2;43例术前合并T2DM者．11例（25．6％）术后临床部分缓解,16例（37．2％）完全缓解;有26例（12．9％）术后出现并发症。LMGB组患者BMI平均34．7kg／m2,术后6个月及12个月BMl分别为平均31．6kg／m2和26．9kg／m2：10例术前合并T2DM者,2例（20．0％）术后临床部分缓解,7例（70．0％）完全缓解;有2例（15．4％）术后出现并发症。LSG组患者BMI平均43．8kg／m2．术后6个月及12个月BMl分别为平均38．1kg／m2和34．3kg／m2;3例术前合并T2DM者,术后1例达到临床部分缓解,1例完全缓解：有1例术后出现并发症。所有术式组均无围手术期死亡。结论腹腔镜下胃肠外科手术对单纯性肥胖症有效．并能使合并的T2DM得到缓解．同时手术并发症较少。     

Laparoscopic Roux-en-Y Gastric Bypass for the Treatment of Type II Diabetes Mellitus in Chinese Patients with Body Mass Index of 25–35

Background  

Laparoscopic Roux-en-Y gastric bypass (LRYGB) can dramatically ameliorate type 2 diabetes mellitus (T2DM) in morbidly obese patients. However, there is little evidence supporting the effectiveness of LRYGB in low body mass index (BMI) patients. The study was designed to evaluate the safety and results of LRYGB for achieving T2DM remission in patients with BMI in the range of 25–35 kg/m².