Laparoscopic treatment of type 2 diabetes mellitus for patients with a body mass index less than 35

DePaula, Aureo L.; Macedo, António; Rassi, Nelson; Machado, Carlos A.; Schraibman, Vladimir; Silva, L Q; Halpern, Alfredo

doi:10.1007/s00464-007-9472-9

Cited by 136 publications

(125 citation statements)

References 50 publications

(36 reference statements)

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“…In studies in type 2 diabetic patients with a BMI Ͻ35 kg/m 2 , DePaula et al (86) reported that ileal interposition with a sleeve gastrectomy (with or without diversion) resulted in weight loss and a drastic fall in A1C, fasting glucose, and HOMA-IR 7 months later. A "hindgut hypothesis" thus proposes that contact with undigested nutrients triggers an ileal brake, i.e., a combination of effects influencing eating behavior and digestion.…”

Section: Mechanismsmentioning

confidence: 99%

Impact of Different Bariatric Surgical Procedures on Insulin Action and β-Cell Function in Type 2 Diabetes

2009

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Section: Mechanismsmentioning

confidence: 99%

Impact of Different Bariatric Surgical Procedures on Insulin Action and β-Cell Function in Type 2 Diabetes

2009

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“…61,112 Conclusions Metabolic operations are increasingly performed worldwide as the obesity epidemic advances. In view of their profound metabolic effects, they are no longer considered as purely weight loss interventions, 116 and are increasingly applied to patients of lower body mass indices 117 and have been considered as ''bionic'' therapies. 118 These procedures demonstrate a significant reduction of mortality and incidence of cancer.…”

Section: Cellular Energeticsmentioning

confidence: 99%

Metabolic surgery and cancer

Ashrafian

Ahmed

Rowland

et al. 2010

Cancer

133

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The worldwide epidemic of obesity and the global incidence of cancer are both increasing. There is now epidemiological evidence to support a correlation between obesity, weight gain, and some cancers. Metabolic or bariatric surgery can provide sustained weight loss and reduced obesity-related mortality. These procedures can also improve the metabolic profile to decrease cardiovascular risk and resolve diabetes in morbidly obese patients. The operations offer several physiological steps, the so-called BRAVE effects: 1) bile flow alteration, 2) reduction of gastric size, 3) anatomical gut rearrangement and altered flow of nutrients, 4) vagal manipulation and 5) enteric gut hormone modulation. Metabolic operations are also associated with a significant reduction of cancer incidence and mortality. The cancer-protective role of metabolic surgery is strongest for female obesity-related tumors; however, the underlying mechanisms may involve both weight-dependent and weight-independent effects. These include the improvement of insulin resistance with attenuation of the metabolic syndrome as well as decreased oxidative stress and inflammation in addition to the beneficial modulation of sex steroids, gut hormones, cellular energetics, immune system, and adipokines. Elucidating the precise metabolic mechanisms of cancer prevention by metabolic surgery can increase our understanding of how obesity, diabetes, and metabolic syndrome are associated with cancer. It may also offer novel treatment strategies in the management of tumor generation and growth. Cancer 2011;117:1788-99. V C 2010 American Cancer Society.KEYWORDS: metabolic surgery, bariatric surgery, cancer, oncology.The worldwide epidemic of obesity and the global incidence of cancer are both increasing. According to the World Health Organization (WHO), obesity is rising by 30 million cases per year, 1 whereas the overall number of new cancer cases will increase by 300,000 cases per year.2 Both obesity and cancer contribute to increased worldwide mortality and healthcare costs. They are now both recognized as global healthcare concerns and have been the subject of worldwide calls to action. 3,4Several treatment strategies have been developed to decrease obesity; these include prevention, lifestyle, behavioral modification, and pharmacotherapy. The weight-loss effects of these strategies have only been marginally successful, 5 and, therefore, a surgical solution has been developed to provide consistent weight loss in severely obese patients. The operations initially titled ''bariatric procedures'' have demonstrated long-term weight loss at more than 15 years after surgery 6,7 ; however in addition, they achieve pronounced metabolic effects including diabetes resolution in the majority of morbidly obese patients. [8][9][10] As a result, these procedures are now considered as ''metabolic'' operations. 10-14The epidemiological association between obesity rates and cancer rates has come under increased scrutiny as there is now evidence to establish obesity as a significant...

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“…In this case, II-SG is also called the neuroendocrine brake. 50 The sleeve gastrectomy is performed and then the jejunum is divided with a linear stapler 50 cm distal to the ligament of Treitz. The distal ileum is divided 30 cm proximal to the ileocecal valve.…”

Section: Ileal Interposition With Sleeve Gastrectomymentioning

confidence: 99%

Surgical Procedures to Achieve Weight Loss

Grinberg¹,

Afthinos²,

Gibbs³

2012

Advanced Bariatric and Metabolic Surgery

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Laparoscopic treatment of type 2 diabetes mellitus for patients with a body mass index less than 35

Abstract: The laparoscopic ileal interposition via either a sleeve gastrectomy or diverted sleeve gastrectomy seems to be a promising procedure for the control of T2DM and the metabolic syndrome. A longer follow-up period is needed.

Cited by 136 publications

References 50 publications

Impact of Different Bariatric Surgical Procedures on Insulin Action and β-Cell Function in Type 2 Diabetes

Impact of Different Bariatric Surgical Procedures on Insulin Action and β-Cell Function in Type 2 Diabetes

Metabolic surgery and cancer

Surgical Procedures to Achieve Weight Loss

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