The comparative analysis of clinical efficacy of laparoscopic Roux-en-Y gastric bypass vs. laparoscopic sleeve gastrectomy in treatment of obesity combined with type 2 diabetes mellitus

Abstract

Objective To comparatively analyze the feasibility, safety and clinical efficacy of laparoscopic Roux-en-Y gastric bypass (LRYGB) vs. laparoscopic sleeve gastrectomy (LSG) in treatment of obesity combined with type 2 diabetes mellitus (T2DM). Methods The retrospetive cross-sectional study was conducted. The clinical data of 48 patients who underwent surgical treatment in our hospital between January 2014 and June 2017 were collected. Twenty patients were given LRYGB and 28 patients LSG. All the patients were followed up for 1 year. The surgical and postoperative recovery situations, the effect of weight reduction and hypoglycemic effect were compared between the two groups. Results The operations were performed successfully on 48 patients, without conversion to open surgery. There were no postoperative complications (anastomotic leak, bleeding and stenosis, etc) and perioperative deaths. As compared with LRYGB group, operation time, time of postoperative gastrointestinal function recovery, time of out of bed and duration of hospital stay were significantly shortened, and volume of intraoperative blood loss was significantly reduced in LSG group (P 0.05 for all). The remission rate of T2DM at 12th month postoperatively was 90% in LRYGB group and 92.86% in LSG group, with an effective rate of 100.0%. Moreover, there was no statistically significant difference between the two groups (P>0.05). Conclusion Both LRYGB and LSG are safe and effective in the treatment of obesity combined with T2DM, with a good short-term outcome and similar clinical effect. The LSG can be considered as a priority operation for its simple procedure and quick postoperative recovery. Key words: Obesity; Type 2 diabetes mellitus; Roux-en-Y gastric bypass; Sleeve gastrectomy; Clinical efficacy; Laparoscope