Effect of Roux-en-Y Gastric Bypass with Different Pouch Size in Chinese T2DM Patients with BMI 30–35 kg/m2

Ren, Yixing; Yang, Wah; Yang, Jingge; Wang, Cunchuan

doi:10.1007/s11695-014-1411-y

Cited by 21 publications

(4 citation statements)

References 19 publications

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“…We believe that the main reason for not lowering the cut-off for surgery was the economic and national regularity conditions rather than the safety of the procedure, as already the action BMI cut points are reduced by 2.5 kg/ m 2 to BMI 27.5, 32.5, and 37.5 kg/m 2 for Asian populations due to ethnic liability for obesity-associated medical problems [15]. In addition, many studies in the literature have proved the safety and effectiveness of metabolic surgery in patients with mild obesity especially in patients with T2DM [16][17][18][19][20][21][22][23][24]. A recent meta-analysis by Ji et al showed the safety of BMS in general in Asian patients with type 2 diabetes and BMI < 30 kg/m 2 [25], while Wang L concluded the same effect with laparoscopic sleeve gastrectomy on type 2 diabetes mellitus in patients with a body mass index (BMI) less than 30 kg/m 2 [26].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and Safety of Laparoscopic Sleeve Gastrectomy for Weight Loss in Mild Obesity: Prospective Cohort Study with 3-Year Follow-up

et al. 2022

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Purpose Patients with mild obesity especially in absence of associated medical problems (OAMP) are commonly managed by non-surgical approaches. Laparoscopic sleeve gastrectomy (LSG) has proved itself to be effective and it is now the most performed weight loss procedure. We aimed to study the effectiveness and safety of LSG for weight loss in mild obesity. Methods A prospective cohort study. Group A; BMI (30–34.9 kg/m2), and group B; BMI ≥ 40 or BMI ≥ 35 with OAMP. Demographic data, perioperative complications, % excess weight loss (EWL), % total weight loss (TWL), nutritional profile, and evolution of OAMP were recorded and statistically analyzed. Results A total of 250 patients, with 80 patients (32%) in group A, and 170 (68%) in group B. The majority were female. The mean preoperative weight, BMI, and excess weight were 90.1 ± 9.52, 32.7 ± 1.4, and 21.5 ± 4.9 in group A, and 129.88 ± 26.12, 47.8 ± 8.2, and 62.3 ± 23.6 kg in group B respectively. The low BMI group had significantly lower OAMP, with higher pre-LSG non-surgical procedures rate. Overall post-operative morbidity rate was significantly higher in group B. %TWL was significantly lower in low BMI group. Nutritional profile was within the normal range in both groups at 3-year follow-up. Conclusion Laparoscopic sleeve gastrectomy is a safe and effective weight loss solution for mild obesity with better outcome than for higher BMI. Further studies are warranted to reconsider NIH’s statement for medicolegal aspects, and for matching the current changes in bariatric surgery practice, safety evidence, and patients’ demand. Graphical abstract

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Section: Discussionmentioning

confidence: 99%

Effectiveness and Safety of Laparoscopic Sleeve Gastrectomy for Weight Loss in Mild Obesity: Prospective Cohort Study with 3-Year Follow-up

et al. 2022

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“…A systematic review in 2020 gathered studies that evaluated the gastric pouch or gastrojejunostomy size on weight outcomes following Roux-en-Y gastric bypass; of fourteen studies found, five reported poorer results for larger pouches [ 8 , 9 , [24] , [25] , [26] ], while other studies did not find any associations between weight outcome and pouch size [ [11] , [12] , [13] , 15 , 23 , [27] , [28] , [29] , [30] ]. The mentioned review article concluded that larger pouches were associated with poorer outcomes.…”

Section: Discussionmentioning

confidence: 99%

The impact of gastric pouch size, based on the number of staplers, on the short-term weight outcomes of Roux-en-Y gastric bypass

Haghighat

Kamran²,

Moaddeli³

et al. 2022

Annals of Medicine &Amp; Surgery

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“…Controversy regarding the size of the gastric pouch has persisted over the past 30 years. Scholars have performed many studies on the postoperative efficacy of different gastric pouch sizes (9)(10)(11). Much of the recent literature focuses on the short-term impact of gastric pouch size on the weight loss of patients with BMI > 35 kg/m2 after RYGB, and the results are controversial (12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

Large Versus Small Gastric Pouch for Roux-en-Y Gastric Bypass in Individuals With Type 2 Diabetes and a Body Mass Index < 35 kg/m2: Six-Year Outcomes

et al. 2022

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BackgroundRoux-en-Y gastric bypass (RYGB) results in extraordinary weight loss and glycemic control outcomes for patients with obesity; however, the effect of gastric pouch size is still unclear, and the reported results are contradictory. Additionally, long-term data on type 2 diabetes (T2D) patients with low body mass index (BMI) are sparse. This study was to assess the effect of 6-year outcomes in Chinese patients with T2D and a BMI < 35 kg/m2 who underwent RYGB with gastric pouches of different sizes.MethodsA retrospective cohort study was performed. There were 42 patients in the large gastric pouch group (L) and 53 patients in the small gastric pouch group (S). Baseline demographic history, pre- and postoperative BMI, waist circumference, and glucose- and lipid metabolism-related indicators were compared.ResultsAssessments were completed in 100%, 100%, 93.6%, and 89.4% of patients at baseline, 1 year, 3 years, and 6 years, respectively. At 6 years, the changes in BMI and fasting plasma glucose were greater in the S group (-4.25 ± 0.51 kg/m2 and -4.58 ± 0.73 mmol/l) than in the L group (-2.06 ± 0.48 kg/m2 and -2.64 ± 0.61 mmol/l). The independent predictors of complete remission of T2D were preoperative BMI and the size of the gastric pouch. A large gastric pouch was associated with a higher risk for marginal ulcers.ConclusionsA small gastric pouch results in better weight loss and glycemic control. High preoperative BMI and a small gastric pouch are associated with better T2D remission rates. A large gastric pouch leads to a higher incidence of marginal ulcers.

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Effect of Roux-en-Y Gastric Bypass with Different Pouch Size in Chinese T2DM Patients with BMI 30–35 kg/m2

Cited by 21 publications

References 19 publications

Effectiveness and Safety of Laparoscopic Sleeve Gastrectomy for Weight Loss in Mild Obesity: Prospective Cohort Study with 3-Year Follow-up

Effectiveness and Safety of Laparoscopic Sleeve Gastrectomy for Weight Loss in Mild Obesity: Prospective Cohort Study with 3-Year Follow-up

The impact of gastric pouch size, based on the number of staplers, on the short-term weight outcomes of Roux-en-Y gastric bypass

Large Versus Small Gastric Pouch for Roux-en-Y Gastric Bypass in Individuals With Type 2 Diabetes and a Body Mass Index < 35 kg/m2: Six-Year Outcomes

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