Resolution of type 2 diabetes after gastrectomy for gastric cancer with long limb Roux-en Y reconstruction: a prospective pilot study / 대한외과학회지
Journal of the Korean Surgical Society
;
: 88-93, 2013.
Article
in English
| WPRIM
| ID: wpr-18697
ABSTRACT
PURPOSE:
It is unclear whether metabolic surgery is effective in non obese type 2 diabetes mellitus (T2DM) and the result after gastrectomy and conventional reconstruction for gastric cancer with non obese T2DM are not satisfactory for improvement of T2DM. Prospective single-arm pilot study with long limb Roux-en Y reconstruction after gastrectomy was evaluated on its safety and efficacy as a potential cure for T2DM in patients with non obese gastric cancer.METHODS:
Fifteen patients with non obese T2DM and gastric cancer were enrolled. After gastrectomy, the gastrointestinal tract was reconstructed by Roux-en Y gastrojejunostomy or esophagojejunostomy. The biliopancreatic and Roux limb were 100 to 120 cm long each.RESULTS:
There was no surgery-related mortality, but four cases experienced complications (26.7%). Before surgery, the mean body mass index was 25.2 +/- 3.4 kg/m2 and mean glycated hemoglobin (HbA1c) was 7.7 +/- 1.4% with antidiabetic medications. The mean BMI decreased to 21.7 +/- 3.1 kg/m2 (P < 0.05) and the mean HbA1c decreased to 6.3 +/- 0.8% (P < 0.05) 6 months after surgery. At the end of the study (follow-up duration, 12.5 +/- 5.5 months), HbA1c decreased to <6% in 11 patients (78.6%) without any antidiabetic medications. There were no patients who had anemia, and/or malnutrition after surgery except one patient who died due to recurrence four months after surgery.CONCLUSION:
Long limb Roux-en Y reconstruction after gastrectomy is feasible and has the potential to cure T2DM in non obese gastric cancer patients. A randomized controlled trial is needed to confirm this result.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Recurrence
/
Stomach Neoplasms
/
Hemoglobins
/
Anastomosis, Roux-en-Y
/
Gastric Bypass
/
Body Mass Index
/
Pilot Projects
/
Prospective Studies
/
Gastrointestinal Tract
/
Malnutrition
Type of study:
Controlled clinical trial
/
Observational study
Limits:
Humans
Language:
English
Journal:
Journal of the Korean Surgical Society
Year:
2013
Type:
Article
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