1
|
Teke E, Güneş Y, Çoruhlu B, Esen Bulut N, Fersahoglu MM, Ergin A, Sancak S. Effects of laparoscopic sleeve gastrectomy on thyroid hormones and relationship between metabolic parameters and long-term total weight loss. Surg Endosc 2024; 38:1807-1812. [PMID: 38291160 DOI: 10.1007/s00464-024-10693-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Bariatric surgery has significant effects on metabolic parameters and hormone levels. However, the specific impact of laparoscopic sleeve gastrectomy (LSG) on thyroid hormones and other metabolic parameters remains unclear. This study aimed to investigate the short and long-term effects of LSG on thyroid hormone levels, HbA1c, and other metabolic parameters. METHODS A total of 619 euthyroid patients without a history of thyroid disease or thyroid hormone replacement therapy were included in the study. Patients with diabetes were excluded from the study. Preoperative, 1-year postoperative, and 5-year postoperative levels of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), HbA1c, and other metabolic parameters were recorded and analyzed. RESULTS LSG resulted in significant weight loss and improvements in metabolic parameters. At 1 year postoperatively, there were significant reductions in BMI, HbA1c, TSH, fT3, and triglyceride levels, while fT4 levels increased. A statistically significant negative correlation was found between preoperative HbA1c level and percentage of total weight loss (%TWL) value at the fifth postoperative year. Additionally, a statistically significant negative correlation was found between the 5-year change in TSH and %TWL. CONCLUSION Being the first study to predict long-term total weight loss based on preoperative HbA1c, it is significant. This finding has important implications for personalized patient management and could aid clinicians in identifying individuals who may benefit most from sleeve gastrectomy as a treatment modality. This is valuable in that it emphasizes multidisciplinary work, including the endocrinologist and dietician.
Collapse
Affiliation(s)
- Emre Teke
- General Surgery Department, Haydarpaşa Numune Training and Research Hospital, Tıbbiyecaddesi No:23, Üsküdar, 34668, Istanbul, Turkey.
| | - Yasin Güneş
- General Surgery Department, Fatih Sultan Mehmet Training and Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8, Ataşehir, 34752, Istanbul, Turkey
| | - Bedirhan Çoruhlu
- General Surgery Department, Fatih Sultan Mehmet Training and Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8, Ataşehir, 34752, Istanbul, Turkey
| | - Nuriye Esen Bulut
- General Surgery Department, Fatih Sultan Mehmet Training and Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8, Ataşehir, 34752, Istanbul, Turkey
| | - Mehmet Mahir Fersahoglu
- General Surgery Department, Fatih Sultan Mehmet Training and Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8, Ataşehir, 34752, Istanbul, Turkey
| | - Anıl Ergin
- General Surgery Department, Fatih Sultan Mehmet Training and Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8, Ataşehir, 34752, Istanbul, Turkey
| | - Seda Sancak
- Department of Endocrinology and Metabolic Diseases, Fatih Sultan Mehmet Training and Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8, Ataşehir, 34752, Istanbul, Turkey
| |
Collapse
|
2
|
Kirkil C, Aydin I, Yur M, Ag O, Bozcan MY. Comparison of the ABCD Score's Accuracy in Predicting Remission of Type 2 Diabetes Mellitus One Year After Sleeve Gastrectomy, One Anastomosis Gastric Bypass, and Sleeve Gastrectomy with Transit Bipartition. Obes Surg 2024; 34:133-140. [PMID: 37985569 DOI: 10.1007/s11695-023-06950-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/05/2023] [Accepted: 11/13/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE ABCD score is one of the scoring systems that predicts the probability of T2DM remission after bariatric surgery. Its success in determining T2DM remission after sleeve gastrectomy with transit bipartition (TB) has not yet been validated. The aim of this study was to evaluate the predictive value of ABCD score in TB. MATERIALS AND METHODS Of 438 patients with T2DM, 191 underwent sleeve gastrectomy (SG), 136 underwent one anastomosis gastric bypass (OAGB), and 111 underwent TB. Retrospective analysis of ABCD scores, 1-year postoperative remission rates, and the predictive accuracy of ABCD scores for these were conducted. RESULTS In the SG, OAGB, and TB groups, respectively, median ABCD scores were 7, 6, and 4, while complete remission rates were 95.3%, 84.6%, and 76.6% (p < 0.001). The area under curves (AUCs) for SG, OAGB, and TB were 0.829 (95% CI = 0.768 to 0.879, p < 0.0001), 0.801 (95% CI = 0.724 to 0.865, p < 0.0001), and 0.840 (95% CI = 0.758 to 0.902, p < 0.0001), respectively. There was no statistically significant difference between AUCs. CONCLUSION ABCD score predicts the probability of remission at 1-year follow-up in T2DM patients undergoing TB as accurately as in patients receiving SG or OAGB.
Collapse
Affiliation(s)
- Cuneyt Kirkil
- School of Medicine, Department of General Surgery, University of Firat, 23119, Elazig, Turkey.
| | - Ilayda Aydin
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Ataturk University, 25240, Erzurum, Turkey
| | - Mesut Yur
- School of Medicine, Department of General Surgery, University of Firat, 23119, Elazig, Turkey
| | - Onur Ag
- School of Medicine, Department of General Surgery, University of Firat, 23119, Elazig, Turkey
| | - Muhammed Yusuf Bozcan
- School of Medicine, Department of General Surgery, University of Firat, 23119, Elazig, Turkey
| |
Collapse
|
3
|
Qin X, Mao Z, Lee WJ, Zhang M, Chen SC, Chen JC, Wu G, Zhou X, Wei T, Huang Y. Sleeve gastrectomy with one anastomosis bipartition versus one anastomosis gastric bypass: A pilot study. Asian J Endosc Surg 2024; 17:e13258. [PMID: 37952933 DOI: 10.1111/ases.13258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/21/2023] [Accepted: 10/26/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND One anastomosis gastric bypass (OAGB) is a new recognized metabolic surgery, but the problem that we cannot screen the excluded stomach is a troubling issue in China. The emergence of sleeve gastrectomy plus one anastomosis bipartition (SG + OAB) makes us see a hope to solve this problem. OBJECTIVES By comparing the efficacy of the two surgical methods, to evaluate whether SG + OAB surgery can solve the dilemma faced by OAGB that the excluded stomach cannot be screened. METHODS A retrospective study to compare the patients who underwent OAGB and SG + OAB was conducted. The main outcome measures were (1) operation risk, (2) weight loss, and (3) diabetes remission at 6 months. RESULTS This study was conducted in the bariatric/metabolic surgical center. From November 2021 to February 2022, a total of 30 patients with obesity who received SG + OAB surgery were recruited. Another matched 60 patients undergoing OAGB were recruited as control group. There was no difference in preoperative age (32.15 ± 9.02 vs. 34.47 ± 7.22; p = .224), female ratio (83% vs. 85%; p = .837), and BMI (36.18 ± 5.30 vs. 34.68 ± 5.58; p = .217) between the two groups. OAGB had a shorter mean operation time (121.67 ± 20.41 vs. 143.50 ± 25.07 min; p < .001) and a lower intraoperative blood loss (21.92 ± 12.35 vs. 32.43 ± 22.01 mL; p = .005), but a longer postoperative flatus passage (2.13 ± 0.43 vs. 1.87 ± 0.43 days; p = .007) compared with the SG + OAB group. Two patients (6.7%) developed major surgical complication in SG + OAB group but no major complication developed in OAGB group. At 6 months after surgery, SG + OAB had a higher %total weight loss than OAGB (31.05 ± 3.12 vs. 28.14 ± 5.43%; p = .015), but diabetes remission rate was similarly high in both groups. CONCLUSIONS SG + OAB operation had a non-inferior or even better weight loss than OAGB, with a similar glycemic control efficacy. However, the high complication rate of SG + OAB is the major drawback that needs attention.
Collapse
Affiliation(s)
- Xiaoguang Qin
- Department of Metabolic/Bariatric Medical Center, Suzhou BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Suzhou, Jiangsu Province, China
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhongqi Mao
- Department of Metabolic/Bariatric Medical Center, Suzhou BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Suzhou, Jiangsu Province, China
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Wei-Jei Lee
- Department of Metabolic/Bariatric Medical Center, Suzhou BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Suzhou, Jiangsu Province, China
- Medical Weight Loss Center, Department of General Surgery, China Medical University Hsinchu Hospital, Taiwan, China
| | - Min Zhang
- Department of Metabolic/Bariatric Medical Center, Suzhou BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Suzhou, Jiangsu Province, China
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shu-Chun Chen
- Medical Weight Loss Center, Department of General Surgery, China Medical University Hsinchu Hospital, Taiwan, China
| | - Jung-Chien Chen
- Medical Weight Loss Center, Department of General Surgery, China Medical University Hsinchu Hospital, Taiwan, China
| | - Guoqiang Wu
- Department of Metabolic/Bariatric Medical Center, Suzhou BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Suzhou, Jiangsu Province, China
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaoqing Zhou
- Department of Metabolic/Bariatric Medical Center, Suzhou BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Suzhou, Jiangsu Province, China
| | - Tiantian Wei
- Department of Metabolic/Bariatric Medical Center, Suzhou BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Suzhou, Jiangsu Province, China
| | - Yan Huang
- Department of Metabolic/Bariatric Medical Center, Suzhou BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Suzhou, Jiangsu Province, China
| |
Collapse
|
4
|
Valezi AC, Campos ACL, Bahten LCV. BRAZILIAN MULTI-SOCIETY POSITION STATEMENT ON EMERGING BARIATRIC AND METABOLIC SURGICAL PROCEDURES. ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2023; 36:e1759. [PMID: 37729276 PMCID: PMC10510373 DOI: 10.1590/0102-672020230041e1759] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 07/13/2023] [Indexed: 09/22/2023]
Abstract
This Brazilian multi-society position statement on emerging bariatric and metabolic surgical procedures was issued by the Brazilian Society of Bariatric and Metabolic Surgery (SBCBM), the Brazilian College of Digestive Surgery (CBCD), and the Brazilian College of Surgeons (CBC). This document is the result of a Brazilian Emerging Surgeries Forum aimed at evaluating the results of surgeries that are not yet listed in the Federal Council of Medicine (CFM), the regulatory agency that oversees and regulates medical practice in Brazil. The Forum integrated more than 400 specialists and academics with extensive knowledge about bariatric and metabolic surgery, representing the three surgical societies: SBCBM, CBC, and CBCD. International speakers participated online and presented their experiences with the techniques under discussion, emphasizing the regulatory policies in their countries. The indications for surgery and the subsequent procedures were carefully reviewed, including one anastomosis gastric bypass (OAGB), single anastomosis duodeno-ileal with sleeve gastrectomy (SADI-S or OADS), sleeve gastrectomy with transit bipartition (SGTB), and sleeve gastrectomy with ileal interposition (SGII). The recommendations of this document are based on an extensive literature review and discussions among bariatric surgery specialists from the three surgical societies. We concluded that patients with a body mass index over 30 kg/m2 may be candidates for metabolic surgery in the presence of comorbidities (arterial hypertension and type 2 diabetes) with no response to clinical treatment of obesity or in the control of other associated diseases. Regarding the surgical procedures, we concluded that OAGB, OADS, and SGTB are associated with low morbidity rates, satisfactory weight loss, and resolution of obesity-related comorbidities such as diabetes and arterial hypertension. SGII was considered a good and viable promising surgical alternative technique. The recommendations of this statement aim to synchronize our societies with the sentiments and understandings of most of our members and also serve as a guide for future decisions regarding bariatric surgical procedures in our country and worldwide.
Collapse
|
5
|
Demir C, Arslan E, Sariyildiz G, Anil C, Banli O. Laparoscopic Sleeve Gastrectomy With Transit Loop Bipartition and Transit Bipartition in Type 2 Diabetic Patients With Obesity: A Retrospective Analysis. Surg Laparosc Endosc Percutan Tech 2023; 33:357-364. [PMID: 37343192 DOI: 10.1097/sle.0000000000001189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/04/2023] [Indexed: 06/23/2023]
Abstract
AIM We aimed to compare 1-year postoperative results of patients with obesity and type 2 diabetes mellitus (T2DM) who underwent laparoscopic sleeve gastrectomy with transit bipartition (LSG-TB) and transit loop bipartition (LSG-TLB) and mini gastric bypass (MGB). PATIENTS AND METHODS This is a retrospective comparison of 2 novel bariatric surgery techniques with MGB. Primary outcome measure of the study was a rate of T2DM remission. Secondary outcomes included excess body mass index (BMI) loss, improvement in hepatosteatosis, and duration of operation. Revision surgery needs were also assessed. RESULTS Overall, 32 patients underwent the LSG-TLB, 15 underwent LSG-TB, and 50 underwent MGB. Mean age and sex distribution were comparable for all groups. Presurgical BMI was similar in MGB and LSG + TB groups, whereas LSG + TLB group had significantly lower BMI values compared with the MGB group. In both groups, BMI values reduced significantly compared with respective baseline values. Excess BMI loss was significantly higher in patients who underwent LSG-TLB compared with patients treated with LSG-TB and MGB. Bariatric surgery procedures lasted shorter in LSG-TLB than in LSG-TB. However, the shortest of all was MGB. The remission of T2DM rates were 71% and 73.3% in LSG-TLB and LSG-TB groups, respectively ( P > 9.999). The rate of revision surgeries was comparable in both groups. CONCLUSION In conclusion, LSG-TLB took less time and provided significantly higher excess BMI loss compared with LSG-TB. T2DM remission and improvement rates were similar in both groups. LSG-TLB seemed like a promising bariatric surgery technique in patients with obesity and T2DM.
Collapse
Affiliation(s)
- Canan Demir
- Department of Endocrinology and Metabolism, Atilim University School of Medicine
| | - Ergin Arslan
- Department of General Surgery, Ankara Obesity Surgery Clinic
| | - Gülçin Sariyildiz
- Department of General Surgery, Atilim University, Vocational School of Health Services
| | - Cüneyd Anil
- Department of Endocrinology and Metabolism, Güven Hospital, Ankara, Turkey
| | - Oktay Banli
- Department of General Surgery, Ankara Obesity Surgery Clinic
| |
Collapse
|
6
|
Robert M, Pasquer A, Saber T. Robotic Transit Bipartition with Sleeve Gastrectomy: Technical Points. Obes Surg 2022; 32:2100-2101. [PMID: 35437674 DOI: 10.1007/s11695-022-06070-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/13/2022] [Accepted: 04/13/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Maud Robert
- Department of Digestive and Bariatric Surgery, University Hospital of Edouard Herriot, Lyon 1 University, 69437, Lyon, Cedex 03, France.,Claude Bernard Lyon 1 University, Lyon, France
| | - Arnaud Pasquer
- Department of Digestive and Bariatric Surgery, University Hospital of Edouard Herriot, Lyon 1 University, 69437, Lyon, Cedex 03, France. .,Claude Bernard Lyon 1 University, Lyon, France.
| | - Toufic Saber
- Department of Digestive and Bariatric Surgery, University Hospital of Edouard Herriot, Lyon 1 University, 69437, Lyon, Cedex 03, France
| |
Collapse
|
7
|
Comparison of the Outcomes of Single Anastomosis Duodeno-Ileostomy with Sleeve Gastrectomy (SADI-S), Single Anastomosis Sleeve Ileal (SASI) Bypass with Sleeve Gastrectomy, and Sleeve Gastrectomy Using a Rodent Model with Diabetes. Obes Surg 2022; 32:1209-1215. [PMID: 35050482 DOI: 10.1007/s11695-022-05920-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Single anastomosis duodeno-ileostomy with sleeve gastrectomy (SADI-S) is a powerful form of bariatric surgery; however, it has a high risk of malnutrition. Single anastomosis sleeve ileal (SASI) bypass with sleeve gastrectomy may be used as an alternative procedure to avoid malnutrition associated with SADI-S; however, no comparison between the two procedures has been performed. METHODS Sprague-Dawley rats with diabetes (n = 32) were divided into four groups: SADI-S (n = 8), SASI (n = 8), SG (n = 8), and SHAM (n = 8). Body weight, food intake, and fasting blood glucose were measured, and the oral glucose tolerance test (OGTT) and insulin tolerance test (ITT) were performed before and after surgery. Blood samples were collected before and after the surgery to assess the levels of glucagon-like peptide-1 (GLP-1), hemoglobin, albumin, vitamin B12, calcium, and iron. RESULTS The SADI-S and SASI groups showed significantly greater weight loss and better glucose control than the SG group postoperatively. The SADI-S and SASI groups showed similar improvements in glucose control throughout the study. The SADI-S and SASI groups had significantly higher GLP-1 levels than the SG group at 6 months. The SADI-S and SASI groups presented with various degrees of deficiencies, with the SADI-S group showing a higher risk for hypoalbuminemia and iron deficiency than the SASI group. CONCLUSIONS The SASI procedure may be a better alternative as it has excellent bariatric and metabolic results with lower risk for hypoalbuminemia and can be easily converted into either SADI-S or SG procedures. Nevertheless, further clinical results are needed.
Collapse
|