ABSTRACT
Introduction: Bariatric surgeries have shown efficacy in weight reduction, glycemic control and improvement of type-2 diabetes (T2DM) in patients with obesity. We aimed to assess the efficacy of one anastomosis gastric bypass surgery (OAGB) in T2DM patients with body mass index (BMI) < 35 kg/m2 within a year after surgery. Methods: In this multicenter retrospective cohort study, 14 T2DM patients with BMI <35 kg/m2 (females, %: 71.4% (10 of 14), and age, mean (standard deviation): 51.2 (12.3) years) who had underwent OAGB surgery by the same surgeon, were followed at intervals of one, three, six, and 12 months after surgery. The remission rates of T2DM were calculated and the metabolic indices were compared using paired t-test and Wilcoxon rank test. Results: No adverse outcomes were detected 12 months after surgery. Within six months, seven (50%) patients underwent remission (one (7.1%) within one, three (21.4%) within three, and three (21.4%) within six months). Post-operative weight (p < 0.001) and fasting blood glucose (p < 0.01) in all time periods were significantly lower compared to pre-operative values. Hemoglobin A1C (HbA1C) was significantly lower at three- and six-month intervals (p < 0.05) but not at twelve months (p = 0.2). Thyroid-stimulating hormone and triglyceride levels were lower at six months compared to pre-surgical levels (p < 0.05) but cholesterol levels were not different in any of time points (p > 0.05). Conclusion: OAGB surgery is associated with weight reduction, glycemic control and a 50% remission rate within six months in patients with diabetes and BMI <35 kg/m2.
ABSTRACT
Introduction: & Importance: Laparoscopic sleeve gastrectomy (LSG) is a widely accepted and effective bariatric surgery for achieving weight loss in patients with extreme obesity. Performing this surgical procedure in patients with congenital anatomical changes including situs inversus (SI) is a challenge for the surgical team. In this condition, the orientation of intra-abdominal organs is the mirror image of those in normal populations. Case presentation: Herein, we present a 29-year-old female with situs inversus totalis who successfully underwent an LSG surgery with proper weight loss post-operatively and no early and late complications. Clinical discussion: By reviewing the literature for patients with SI undergoing the same procedure, all patients achieved significant weight loss. Three out of nineteen cases experienced complications which were controlled without significant morbidity or mortality.Conclusion: we concluded that LSG will be a safe and effective surgery for the treatment of extreme obesity in SI patients, if the condition is diagnosed preoperatively.
