Efficacies of sleeve gastrectomy and Roux-en-Y gastric bypass for the treatment of type 2 diabetes mellitus: a Meta-analysis / 中华消化外科杂志

ABSTRACT

Objective To review the efficacies of sleeve gastrectomy and Roux-en-Y gastric bypass for the treatment of type 2 diabetes mellitus.Methods The Cochrane library,PubMed,China Journal Full Text Database,Chinese Scientific Journal Full Text Database,Chinese Biomedical Literature Database and Wanfang Database were searched with key words including“减重手术”,“胃切除术”,“胃绕道术”,“胃旁路手术”,“胃转流术”,“胃袖状切除术”,“糖尿病”,“bariatric surgery”,“gastric bypass”,“sleeve gastrectomy”,“diabetes,T2DM and et al.Literatures published between the time of database establishment and December 2012 were searched.Literatures focused on the comparison of the efficacies of sleeve gastrectomy and Roux-en-Y gastric bypass for the treatment of type 2 diabetes mellitus were retrieved.Data extraction and quality evaluation of the literatures were done by 2 researchers independently.Meta analysis was performed by RevMan 5.1.2 software.The count data were presented by risk ratio (RR) or odds ratio (OR),and the measurement data were presented by mean difference (MD) or standard mean difference (SMD).The heterogeneity of the literatures was analyzed by I2.Results Five literatures were retrieved,including 164 patients in the sleeve gastrectomy group and 184 patients in the Roux-en-Y gastric bypass group.The results of Meta analysis showed that Roux-en-Y gastric bypass could significantly increase the remission rate of type 2 diabetes (OR =0.48,95 ％ confidence interval0.26-0.91,P ＜ 0.05),increase the percentage of patients without drugs during follow up (OR =0.37,95 ％ confidence interval0.16-0.84,P ＜0.05),decrease the levels of HbA1c and body weight (MD =0.28,-0.44,95％ confidence interval0.14-0.43,-0.76--0.13,P ＜ 0.05) when compared with sleeve gastrectomy.There was no significant difference in the incidence of complications between the 2 groups (OR =1.81,95％ confidence interval0.20-16.73,P ＞ 0.05).Conclusion Roux-en-Y gastric bypass is superior to sleeve gastrectomy for patients with type 2 diabetes.