Glucose Homeostasis and Weight Loss in Morbidly Obese Patients Undergoing Banded Sleeve Gastrectomy: A Prospective Clinical Study

Abstract

OBJECTIVETo assess glucose homeostasis and weight loss in morbidly obese patients undergoing Silastic® ring sleeve gas-trectomy.METHODSThis was a prospective clinical study. Thirty-three female patients with a mean body mass index (BMI) of 42.33 ± 1.50 kg/m2 (range: 40–45 kg/m2), a mean age of 36.7 ± 9.4 years and a mean waist circumference of 118.7 ± 5.98 cm were included in this study. Type 2 diabetes mellitus was observed in 11 patients (33.3%), and glucose intolerance was observed in 4 patients (12.1%). Mean plasma fasting glucose levels were 109.77 ± 44.19 mg/dl (75–320) in the preoperative period. All Silastic® ring sleeve gastrectomy procedures were performed by the same surgical team using the same anesthetic technique. The patients were monitored for at least 12 months after surgery.RESULTSThe mean weight of the patients decreased from 107.69 ± 6.57 kg to 70.52 ± 9.36 kg (p < 0.001), the mean BMI decreased to 27.4 ± 2.42 kg/m2 (p < 0.001), and the mean waist circumference decreased to 89.87 cm ± 6.66 (p < 0.001) in the postoperative period. Excess BMI loss was 86.5 ± 14.2%. Fasting glucose levels were reduced to 80.94 ± 6.3 mg/dl (p < 0.001). Remission of diabetes and glucose intolerance was observed in all patients.CONCLUSIONSilastic® ring sleeve gastrectomy was effective in promoting weight loss, waist circumference reduction and control of glucose homeostasis in morbidly obese patients.

The influence of laparoscopic adjustable gastric banding and laparoscopic sleeve gastrectomy on weight loss, plasma ghrelin, insulin, glucose and lipids

“…One of the first publications discussing glucose homeostasis and weight loss in patients undergoing the sleeve + banding technique [74] was recently released. The developments it describes are promising, but due to the small number of patients and the short follow-up, they require further observation.…”

Can Bariatric or Metabolic Surgery Cure Type 2 Diabetes?

“…We obtained a small, functional stomach, like that obtained with traditional vertical gastroplasty, and removed the principal site of ghrelin production, which gave the SRSG the characteristics of both bariatric and endocrine surgery. 19 The removal of the principal site of ghrelin production led to a decrease in ghrelin levels, adding a hormonal element to SRSG, which other restrictive procedures such as adjustable gastric banding lack. 31 Some authors have reported the use of added restriction in SG in order to increase the intensity and duration of weight loss 19,37,38 .…”

“…19 The removal of the principal site of ghrelin production led to a decrease in ghrelin levels, adding a hormonal element to SRSG, which other restrictive procedures such as adjustable gastric banding lack. 31 Some authors have reported the use of added restriction in SG in order to increase the intensity and duration of weight loss 19,37,38 . In addition, by placing a Silastic® ring around the stomach in all patients of our sample, both procedures became identical at the portion located above the ring.…”

“…12,15 Both SG and RYGB can be performed with or without the placement of a Silastic® ring. 18,19 The metabolic control achieved with bariatric procedures has been demonstrated and reproduced in various medical centers worldwide. 6 Metabolic control can be achieved with gastric restrictive procedures such as vertical banded gastroplasty, 5 adjustable gastric banding 20 and, more recently, SG.…”

Organic consequences of ileal transposition in rats with diet-induced obesity

“…92,93 Recent studies have shown that vertical gastrectomy as an isolated and definite bariatric surgery is as effective as the Fobi-Capella procedure for the control of comorbidities; in addition, it provides the potential to avoid some of the associated complications. [94][95][96][97] Although the surgical procedure is simpler, research investigating humans who were undergoing vertical gastrectomy alone demonstrated the presence of limitations 98 and complications. 99,100 Studies continue to be developed with the objective of developing simpler and effective surgical therapies for metabolic diseases that are associated with overweight and obese individuals, especially DM2.…”