Short-Term Efficacy of Laparoscopic Sleeve Gastrectomy for Obesity with Type 2 Diabetes Mellitus in China: A Systematic Analysis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 YANGZhi-wei ¹ , SUNZhao-dan ² , ZHUDa-yong ¹ , MAOXiao-guang ¹

1. The Second Department of General Surgery, Xiangfang School District Hospital of Heilongjiang Province, Harbin 150036, Heilongjiang Province, China;
2. Department of Immunization Program, Heilongjiang Province Disease Prevention Control Center, Harbin 150030, Heilongjiang Province, China;

Corresponding author：

YANGZhi-wei, Email: 1403897658@qq.com

Keywords：

Laparoscopic sleeve gastrectomy; Obesity; Type 2 diabetes mellitus; Short-term efficacy; Meta analysis

DOI：

10.7507/1007-9424.20150246

Video：

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Objective To investigate the short-term efficacy of laparoscopic sleeve gastrectomy (LSG) for obesity with type 2 diabetes mellitus (T2MD) in China. Methods Clinical randomized controlled trial literatures about domestic LSG treatment of obesity with T2MD were obtained from Wanfang Data, China Knowledge Resource Integrated Database, PubMed and Web of Science English Data. The literatures were selected according to the inclusive and exclusive criteria, then evaluated. Methodological quality assessment and meta analysis were evaluated according to the data extracted from those literatures. The short-term efficacy (fasting blood glucose or glycosylated hemoglobin) was evaluated after operation. Results One hundred and seven patients performed LSG were retrieved from 7 literatures. The levels of fasting blood glucose and glycosylated hemoglobin on the postoperative 6 months were all obviously decreased as compared with the levels before operation (fasting blood glucose:MD=2.99, 95% CI 2.39-3.60, P < 0.000 01; glycosylated hemoglobin:MD=2.24, 95% CI 1.43-3.04, P < 0.000 01), which on the postoperative 12 months were all obviously decreased as compared with the levels on the postoperative 6 months (fasting blood glucose:MD=0.56, 95% CI 0.16-0.95, P=0.006; glycosylated hemoglobin:MD=0.52, 95% CI 0.22-0.81, P=0.000 6). The postoperative fasting blood glucose and glycosylated hemoglobin levels in patients accepted LSG showed a downward trend. Conclusions LSG on obesity with T2MD has an obvious short-term curative effect. But its long-term efficacy still needs to be supported by large samples randomized controlled clinical research data.

Citation： YANGZhi-wei, SUNZhao-dan, ZHUDa-yong, MAOXiao-guang. Short-Term Efficacy of Laparoscopic Sleeve Gastrectomy for Obesity with Type 2 Diabetes Mellitus in China: A Systematic Analysis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(8): 942-947. doi: 10.7507/1007-9424.20150246 Copy

1.	Yang W, Lu J, Weng J, Jia W, et al. China National Diabetes and Metabolic Disorders Study Group. Prevalence of diabetes among men and women in China. N Engl J Med, 2010, 362(12):1090-1101.
2.	Xu Y, Wang L, He J, et al. 2010 China Noncommunicable Disease Surveillance Group. Prevalence and control of diabetes in Chinese adults. JAMA, 2013, 310(9):948-958.
3.	中国医师协会外科医师分会肥胖和糖尿病外科医师委员会.中国肥胖和2型糖尿病外科治疗指南(2014).中国实用外科杂志, 2014, 34(11):1005-1010.
4.	Guariguata L, Whiting D, Weil C, et al. The International Diabetes Federation diabetes atlas methodology for estimating global and national prevalence of diabetes in adults. Diabetes Res Clin Pract, 2011, 94(3):322-332.
5.	王跃东, 叶再元, 竺杨文, 等.腹腔镜袖套式胃减容术治疗病态性肥胖症.浙江医学, 2007, 29(3):258-259.
6.	刘金钢, 田忠, 杨福全, 等.腹腔镜下袖状胃切除术治疗单纯性肥胖症(2例报告). 2007中国外科周暨第16届亚洲外科年会, 北京, 2007, PO-064:136.
7.	胡三元, Frezza EE, 李峰.腹腔镜胃袖套状切除减肥术.腹腔镜外科杂志, 2007, 12(5):370-373.
8.	Yang X, Yang G, Wang W, et al. A Meta-analysis:to compare the clinical results between gastric bypass and sleeve gastrectomy for the obese patients. Obes Surg, 2013, 23(7):1001-1010.
9.	赵文嫣, 周勇, 刘源, 等.腹腔镜袖状胃切除术治疗肥胖症合并2型糖尿病的近期疗效.中华消化外科杂志, 2011, 10(3):120-121.
10.	张伟, 王苟.微创减重手术治疗2型糖尿病疗效分析.健康必读(中旬刊), 2012, 11(12):233-234.
11.	谢静, 张伟, 单成祥, 等.腹腔镜袖状胃切除术治疗病态性肥胖合并2型糖尿病近期疗效分析.现代生物医学进展, 2014, 14(5):870-872.
12.	王羊, 李强.完全腹腔镜袖状胃切除治疗肥胖症合并2-型糖尿病临床分析.中国冶金工业医学杂志, 2014, 31(4):412-413.
13.	廉东波, 朱斌, 樊庆, 等.腹腔镜胃旁路术和胃袖状切除术治疗肥胖合并2型糖尿病疗效对比分析.中国实用外科杂志, 2014, 34(11):1056-1059.
14.	常绪生, 郑成竹, 王鑫, 等.腹腔镜袖状胃切除术治疗肥胖性2型糖尿病的疗效分析.中华胃肠外科杂志, 2014, 17(7):658-662.
15.	杨巍, 宋培立.腹腔镜袖状胃切除术治疗病态性肥胖合并2型糖尿病近期疗效观察.实用医技杂志, 2014, 21(12):1324-1325.
16.	Marceau P, Hould FS, Simard S, et al. Biliopanereatic diversion with duodenal Switch. World J Surg, 1998, 22(9):947-954.
17.	Woelnerhanssen B, Peterli R, Steinert RE, et al. Effects of postbaria-tric surgery weight loss on adipokines and metabolic parameters:comparison of laparoscopic Roux-en-Y gastric bypass and laparo-scopic sleeve gastrectomy-a prospective randomized trial. Surg Obes Relat Dis, 2011, 7(5):561-568.
18.	Iannelli A, Anty R, Schneck AS, et al. Inflammation, insulin resis-tance, lipid disturbances, anthropometrics, and Metabolic syndrome in morbidly obese patients:a case control study comparing laparos-copic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy. Surgery, 2011, 149(3):364-370.
19.	Benaiges D, Goday A, Ramon JM, et al. Obemar Group. Laparos-copic sleeve gastrectomy and laparoscopic gastric bypass are equally effective for reduction of cardiovascular risk in severely obese patients at one year of follow-up. Surg Obes Relat Dis, 2011, 7(5):575-580.
20.	Leyba JL, Aulestia SN, Llopis SN. Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for the treatment of morbid obesity. A prospective study of 117 patients. Obes Surg, 2011, 21(2):212-216.
21.	O'Brien PE, Dixon JB, Laurie C, et al. Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program:a randomized trial. Ann Intern Med, 2006, 144(9):625-633.
22.	Rosenthal RJ, International Sleeve Gastrectomy Expert Panel, Diaz AA, et al. International sleeve gastrectomy expert panel consensus statement:best practice guidelines based on experience of >12 000 cases. Surg Obes Relat Dis, 2012, 8(1):8-19.
23.	Wang Y, Yan L, Jin Z, et al. Effects of sleeve gastrectomy in neona-tally streptozotocin-induced diabetic rats. PLoS One, 2011, 6(1):e16383.
24.	Basso N, Capoccia D, Rizzello M, et al. First-phase insulin secretion, insulin sensitivity, ghrelin, GLP-1, and PYY changes 72 h after sleeve gastrectomy in obese diabetic patients:the gastric hypothesis. Surg Endosc, 2011, 25(11):3540-3550.
25.	Karamanakos SN, Vagenas K, Kalfarentzos F, et al. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy:a prospective, double blind study. Ann Surg, 2008, 247(3):401-407.

1. Yang W, Lu J, Weng J, Jia W, et al. China National Diabetes and Metabolic Disorders Study Group. Prevalence of diabetes among men and women in China. N Engl J Med, 2010, 362(12):1090-1101.
2. Xu Y, Wang L, He J, et al. 2010 China Noncommunicable Disease Surveillance Group. Prevalence and control of diabetes in Chinese adults. JAMA, 2013, 310(9):948-958.
3. 中国医师协会外科医师分会肥胖和糖尿病外科医师委员会.中国肥胖和2型糖尿病外科治疗指南(2014).中国实用外科杂志, 2014, 34(11):1005-1010.
4. Guariguata L, Whiting D, Weil C, et al. The International Diabetes Federation diabetes atlas methodology for estimating global and national prevalence of diabetes in adults. Diabetes Res Clin Pract, 2011, 94(3):322-332.
5. 王跃东, 叶再元, 竺杨文, 等.腹腔镜袖套式胃减容术治疗病态性肥胖症.浙江医学, 2007, 29(3):258-259.
6. 刘金钢, 田忠, 杨福全, 等.腹腔镜下袖状胃切除术治疗单纯性肥胖症(2例报告). 2007中国外科周暨第16届亚洲外科年会, 北京, 2007, PO-064:136.
7. 胡三元, Frezza EE, 李峰.腹腔镜胃袖套状切除减肥术.腹腔镜外科杂志, 2007, 12(5):370-373.
8. Yang X, Yang G, Wang W, et al. A Meta-analysis:to compare the clinical results between gastric bypass and sleeve gastrectomy for the obese patients. Obes Surg, 2013, 23(7):1001-1010.
9. 赵文嫣, 周勇, 刘源, 等.腹腔镜袖状胃切除术治疗肥胖症合并2型糖尿病的近期疗效.中华消化外科杂志, 2011, 10(3):120-121.
10. 张伟, 王苟.微创减重手术治疗2型糖尿病疗效分析.健康必读(中旬刊), 2012, 11(12):233-234.
11. 谢静, 张伟, 单成祥, 等.腹腔镜袖状胃切除术治疗病态性肥胖合并2型糖尿病近期疗效分析.现代生物医学进展, 2014, 14(5):870-872.
12. 王羊, 李强.完全腹腔镜袖状胃切除治疗肥胖症合并2-型糖尿病临床分析.中国冶金工业医学杂志, 2014, 31(4):412-413.
13. 廉东波, 朱斌, 樊庆, 等.腹腔镜胃旁路术和胃袖状切除术治疗肥胖合并2型糖尿病疗效对比分析.中国实用外科杂志, 2014, 34(11):1056-1059.
14. 常绪生, 郑成竹, 王鑫, 等.腹腔镜袖状胃切除术治疗肥胖性2型糖尿病的疗效分析.中华胃肠外科杂志, 2014, 17(7):658-662.
15. 杨巍, 宋培立.腹腔镜袖状胃切除术治疗病态性肥胖合并2型糖尿病近期疗效观察.实用医技杂志, 2014, 21(12):1324-1325.
16. Marceau P, Hould FS, Simard S, et al. Biliopanereatic diversion with duodenal Switch. World J Surg, 1998, 22(9):947-954.
17. Woelnerhanssen B, Peterli R, Steinert RE, et al. Effects of postbaria-tric surgery weight loss on adipokines and metabolic parameters:comparison of laparoscopic Roux-en-Y gastric bypass and laparo-scopic sleeve gastrectomy-a prospective randomized trial. Surg Obes Relat Dis, 2011, 7(5):561-568.
18. Iannelli A, Anty R, Schneck AS, et al. Inflammation, insulin resis-tance, lipid disturbances, anthropometrics, and Metabolic syndrome in morbidly obese patients:a case control study comparing laparos-copic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy. Surgery, 2011, 149(3):364-370.
19. Benaiges D, Goday A, Ramon JM, et al. Obemar Group. Laparos-copic sleeve gastrectomy and laparoscopic gastric bypass are equally effective for reduction of cardiovascular risk in severely obese patients at one year of follow-up. Surg Obes Relat Dis, 2011, 7(5):575-580.
20. Leyba JL, Aulestia SN, Llopis SN. Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for the treatment of morbid obesity. A prospective study of 117 patients. Obes Surg, 2011, 21(2):212-216.
21. O'Brien PE, Dixon JB, Laurie C, et al. Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program:a randomized trial. Ann Intern Med, 2006, 144(9):625-633.
22. Rosenthal RJ, International Sleeve Gastrectomy Expert Panel, Diaz AA, et al. International sleeve gastrectomy expert panel consensus statement:best practice guidelines based on experience of >12 000 cases. Surg Obes Relat Dis, 2012, 8(1):8-19.
23. Wang Y, Yan L, Jin Z, et al. Effects of sleeve gastrectomy in neona-tally streptozotocin-induced diabetic rats. PLoS One, 2011, 6(1):e16383.
24. Basso N, Capoccia D, Rizzello M, et al. First-phase insulin secretion, insulin sensitivity, ghrelin, GLP-1, and PYY changes 72 h after sleeve gastrectomy in obese diabetic patients:the gastric hypothesis. Surg Endosc, 2011, 25(11):3540-3550.
25. Karamanakos SN, Vagenas K, Kalfarentzos F, et al. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy:a prospective, double blind study. Ann Surg, 2008, 247(3):401-407.

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Short-Term Efficacy of Laparoscopic Sleeve Gastrectomy for Obesity with Type 2 Diabetes Mellitus in China: A Systematic Analysis

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