Abstract
Bariatric surgeries such as sleeve gastrectomy; mini-gastric bypass surgery are successful weight reduction surgeries which significantly impact metabolic syndrome. The purpose of this research was to assess the impact of laparoscopy gastrectomy and mini-gastric bypasses on weight decrease and diabetes remission of diabetic mellitus type 2 through two years of monitoring. Furthermore, this study looked at the difference between the two procedures regarding their efficacy and identify which one is proper for patients according to their comorbidities. A prospective study was held in Al Sadder Medical City and Al-Gadeer private hospitals in Al-Najaf city, Iraq, from January 2016 to February 2018. The study included 35 obese and morbidly obese patients with a known history of diabetes mellitus type 2, diagnosed from at least two years before surgery. 15 patients undergo uneventful laparoscopic sleeve gastrectomy (6 females and 9 males). 20 patients underwent uneventful laparoscopic gastric mini bypass surgery (6 females and 14 males). In addition, the patients were followed in the short-term postoperatively (3, 6, 12, 24 months) by monitoring their BMI, weight loss, and HbA1c. There was a decrease in BMI of about 45% from the baseline BMI in sleeve gastrectomy surgery and a decrease in HbA1c of about 45%, less than 6%. In gastric mini-bypass surgery, there was a decrease in BMI of about 47% from the baseline BMI and a decrease in HbA1c of about 45% from the baseline less than 6%, during a 24-month monitoring. Both surgeries were fruitful and had efficient results on patients, but the gastric mini bypass was more efficient than sleeve gastrectomy in controlling and remission of DM type 2 without the need for medications. A long-term study should be performed to reveal their effect and benefits to the patients.
Highlights
Morbid obesity causes serious public health problems worldwide, and the prevalence has risen repeatedly in Asian countries in recent decades [1]
Twenty patients in the MGB group and 15 in the Laparoscopic gastrectomy (LSG) group enrolled in this study, and no statistically meaningful differences were observed between the two groups in terms of the basic characteristics, P value>0.05 as (Table 1 and 2)
We found a significant difference in body mass index (BMI) within studied groups from baseline levels; in the MGB group, BMI mean 46.04 kg/m2 reduced to 41.83 kg/m2 after three months to 38.28 kg/m2 at six months, 30.93 kg/m2 at 12 months and reached 25.20 kg/m2 at 24th month (Table 3)
Summary
Morbid obesity causes serious public health problems worldwide, and the prevalence has risen repeatedly in Asian countries in recent decades [1]. The main purpose of obesity surgery (BS) is to decrease weight of the body or body mass index (BMI). There is increasing recognition that surgery can affect many health comorbidities accompanying obesity, like diabetes mellitus type 2 (DMT2), uncontrolled lipidemia, and sleep apnea. Laparoscopic gastrectomy (LSG) is a common weight reduction procedure globally, with a growing prevalence over the last ten years [3]. In 2013, LSG was the second most common weight reduction surgery globally (37%), followed by gastric bypass Roux-en-Y (RYGB), with a significant increase from 2003 to 2013. OAGB/MGB seems very efficient in decreasing obesity-concerning comorbidities. Gain parameters should consider weight and BMI but mainly the HbA1c, C peptide, fasting glycemic, levels of insulin, lipid profile, and comparable indexes [4,5,6]
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