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Laparoskopic sleeve gastrektomi'nin kısa ve orta dönem sonuçları, tip 2 diyabet ve hipertansiyona etkileri

Yıl 2020, Cilt: 13 Sayı: 1, 19 - 26, 21.01.2020
https://doi.org/10.31362/patd.628093

Öz

Amaç: Laparoskopik
sleeve gastrektomi (LSG) son yıllarda yaygın olarak kullanılan primer bariatrik
cerrahi teknik haline gelmiştir. Bu çalışmada, LSG'nin kilo kaybındaki kısa ve orta
dönem etkinliğini, eşlik eden tip 2 diyabet ve hipertansiyona (HT) olan
etkilerini araştırmayı amaçladık.

Gereç
ve Yöntem:
Bu retrospektif çalışmaya Ocak 2009 - Aralık 2011
arasında LSG uygulanan ve postoperatif 6. ay, 1. yıl ve 3. yıl takip kayıtlarına
ulaşılabilen seksen iki hasta dahil edildi. Ameliyat öncesi boy/kilo değerleri,
komorbiditeler, HT ve/veya tip 2 diyabet için ilaç kullanımı ve postoperatif 6.
ay, 1. yıl, 3. yıllık ve 5. yıl verilerindeki değişiklikler kaydedildi.

Bulgular:
Ameliyat
öncesi verilerle karşılaştırıldığında, postoperatif 6. ay, 1. yıl ve 3. yıl
takiplerinde vücut kitle indeksindeki (VKİ) azalma istatistiksel olarak anlamlıydı
(p=0,0001, her biri için). Üçüncü
yılda 1. yıla göre VKİ artışı (p=0,0001),
operasyon öncesine göre 3. yılda diyabet ilacı ve antihipertansif ilaç kullanım
sıklığında azalma izlendi (p=0,0001,
herbiri için).







Sonuç: Morbid
obezitenin cerrahi tedavisinde primer tedavi olarak uygulanabilen LSG, düşük
mortalite ve morbidite oranları ile çok etkili ve güvenilir bir yöntemdir. Ek
olarak, tip 2 diyabet ve HT gibi komorbiditelerde önemli iyileşme sağlar. Orta dönemde
biraz kilo alımı olsa da, LSG'nin kısa ve orta dönem sonuçları etkili bir
cerrahi teknik olduğunu göstermektedir.

Kaynakça

  • Antipatis VJ, Gill TP. Obesity as a global problem. In: Björntorp P, ed. International textbook of obesity. Chichester: John Wiley & Sons Ltd, 2001;3-21.
  • Haslam DW, James WP. Obesity. Lancet. 2005;366:1197-1209.
  • Buchwald H, Williams SE. Bariatric surgery worldwide 2003. Obes Surg 2004;14:1157-1164.
  • Atila K. Morbid obezitenin cerrahi tedavisi. Archives of clinical toxicology. 2014;1:23-27. Turkey.
  • Sanchez SR, Masdevall C, Baltasar A, et al. Short and mid-term outcomes of sleeve gastrectomy for morbid obesity: the experience of the Spanish national registry. Obes Surg 2009;19:1203-1210.
  • Menenakos E, Stamou K, Albanopoulos K, Papailiou J, Theodorou D, Leandros E. Laparoscopic sleeve gastrectomy performed with intent to treat morbid obesity: a prospective single-center study of 261 patients with a median follow-up of 1 year. Obes Surg 2010;20:276-282.
  • Almogy G, Crookes PF, Anthone GJ. Longitudinal gastrectomy as atreatment for the high-risk super-obese patient. Obes Surg 2004;14:492-497.
  • Noah J, Smith A, Birch D, Karmali S. The metabolic effects of laparoscopic sleeve gastrectomy: a review. J Minim Invasive Surg Sci 2013;2:3-7.
  • Nocca D, Guillaume F, Noel P, et al. Impact of laparoscopic sleeve gastrectomy and laparoscopic gastric bypass on HbA1c blood level and pharmacological treatment of type 2 diabetes mellitus in severe or morbidly obese patients. Results of a multicenter prospective study at 1 year. Obes Surg 2011;21:738-743.
  • Zhou D, Jiang X, Ding W, et al. Impact of bariatric surgery on ghrelin and obestatin levels in obesity or type 2 diabetes mellitus rat model. J Diabetes Res 2014;2014:569435.
  • Tucker ON, Szomstein S, Rosenthal RJ. Indications for sleeve gastrectomy as a primary procedure for weight loss in the morbidly obese. J Gastrointest Surg 2008;12:662-667.
  • Park JY, Song D, Kim YJ. Clinical experience of weight loss surgery in morbidly obese Korean adolescents. Yonsei Med J 2014;55:1366-1372.
  • Alvarenga ES, Lo Menzo E, Szomstein S, Rosenthal RJ. Safety and efficacy of 1020 consecutive laparoscopic sleeve gasterctomies performed as a primary treatment modality for morbid obesity. A single-center experience from the metabolic and bariatric surgical accreditation quality and improvement program. Surg Endosc 2016;30:2673-2678.
  • Noel P, Nedelcu M, Eddbali I, Manos T, Gagner M. What are the long-term results 8 years after sleeve gastrectomy? Surg Obes Relat Dis 2017;13:1110-1115.
  • Dudric V, Constantea N, Crisan D, et al. Laparoscopic sleeve gastrectomy: short and mid-term outcome. HVM Bioflux 2016;8:171-175.
  • Greenspan SF, Gardner DG. Basic and clinical endocrinology. 7th ed. NewYork: McGraw-Hill, 2004.
  • Dunitz M, Kopelman PG. The management of obesity and related disorders. 1st ed. London, 2001.
  • The trials of hypertension prevention collaborative research group. Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with high-normal blood pressure. The trials of hypertension prevention, phase II. Arch Intern Med 1997;157:657-667.
  • Sarkhosh K, Birch DW, Shi X, Gill RS, Karmali S. The impact of sleeve gastrectomy on hypertension: a systematic review. Obes Surg 2012;22:832-837.
  • Leonetti F, Capoccia D, Coccia F, et al. Obesity, type 2 diabetes mellitus, and other comorbidities: a prospective cohort study of laparoscopic sleeve gastrectomy vs medical treatment. Arch Surg 2012;147:694-700.
  • Slater BJ, Bellatorre N, Eisenberg D. Early postoperative outcomes and medication cost savings after laparoscopic sleeve gastrectomy in morbidly obese patients with type 2 diabetes. J Obes 2011;2011:350523.
  • Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med 2012;26;366:1567-1576.
  • Shah PS, Todkar JS, Shah SS. Effectiveness of laparoscopic sleeve gastrectomy on glycemic control in obese Indians with type 2 diabetes mellitus. Surg Obes Relat Dis 2010;6:138-141.
  • Casella G, Abbatini F, Calì B, Capoccia D, Leonetti F, Basso N. Ten-year duration of type 2 diabetes as prognostic factor for remission after sleeve gastrectomy. Surg Obes Relat Dis 2011;7:697-702.
  • Hoogerboord M, Wiebe S, Klassen D, Ransom T, Lawlor D, Ellsmere J. Laparoscopic sleeve gastrectomy: perioperative outcomes, weight loss and impact on type 2 diabetes mellitus over 2 years. Can J Surg 2014;57:101-105.
  • Gill RS, Birch DW, Shi X, Sharma AM, Karmali S. Sleeve gastrectomy and type 2 diabetes mellitus: a systematic review. Surg Obes Relat Dis 2010;6:707-713.
  • Roslin MS, Dudiy Y, Weiskopf J, Damani T, Shah P. Comparison between RYGB, DS, and VSG effect on glucose homeostasis. Obes Surg 2012;22:1281-1286.
  • Juodeikis Ž, Brimas G. Long-term results after sleeve gastrectomy: a systematic review. Surg Obes Relat Dis 2017;13:693-699.
  • Makary MA, Clark JM, Shore AD, et al. Medication utilization and annual health care costs in patients with type 2 diabetes mellitus before and after bariatric surgery. Arch Surg 2010;145:726-731.

Short and midterm results of laparoscopic sleeve gastrectomy and its effects hypertension and type 2 diabetes

Yıl 2020, Cilt: 13 Sayı: 1, 19 - 26, 21.01.2020
https://doi.org/10.31362/patd.628093

Öz

Purpose:
Laparoscopic sleeve gastrectomy (LSG) has become a widely used primary
bariatric surgical technique in recent years. We aimed to investigate the short
and mid-term effectiveness of LSG in weight loss and its effects on comorbid
type 2 diabetes and hypertension (HT).

Materials
and Methods:
 
Eighty-two patients who underwent LSG between January 2009 and December
2011 and whose postoperative 6-month, 1-year, and 3-year follow-up records were
available were included in this retrospective study. Preoperative height/weight
values, comorbidities, using drugs for HT and/or type 2 diabetes, and changes
in postoperative 6-month, 1-year, 3-year, and 5-year data were noted.

Results:
When
we compared with the preoperative data, decrease in body mass index (BMI) at
the postoperative 6-month, 1-year, and 3-year follow-ups was statistically
significant (p=0.0001, for each). An
increase in BMI was observed at 3-year follow-up than at 1-year follow-up (p=0.0001). Decrease in using diabetes
medication and antihypertensive drug use was observed at postoperative 3 years compared
with the preoperative data (p=0.0001,
for each).







Conclusion:
LSG, which can be applied as a primary treatment in surgical treatment of
morbid obesity, is a very effective and reliable method with low mortality and
morbidity rates. In addition, it provides significant improvements in
comorbidities such as type 2 diabetes and HT. Although there is some weight
gain in the mid-term, the short and mid-term results of LSG showed that it is
an effective surgical technique.

Kaynakça

  • Antipatis VJ, Gill TP. Obesity as a global problem. In: Björntorp P, ed. International textbook of obesity. Chichester: John Wiley & Sons Ltd, 2001;3-21.
  • Haslam DW, James WP. Obesity. Lancet. 2005;366:1197-1209.
  • Buchwald H, Williams SE. Bariatric surgery worldwide 2003. Obes Surg 2004;14:1157-1164.
  • Atila K. Morbid obezitenin cerrahi tedavisi. Archives of clinical toxicology. 2014;1:23-27. Turkey.
  • Sanchez SR, Masdevall C, Baltasar A, et al. Short and mid-term outcomes of sleeve gastrectomy for morbid obesity: the experience of the Spanish national registry. Obes Surg 2009;19:1203-1210.
  • Menenakos E, Stamou K, Albanopoulos K, Papailiou J, Theodorou D, Leandros E. Laparoscopic sleeve gastrectomy performed with intent to treat morbid obesity: a prospective single-center study of 261 patients with a median follow-up of 1 year. Obes Surg 2010;20:276-282.
  • Almogy G, Crookes PF, Anthone GJ. Longitudinal gastrectomy as atreatment for the high-risk super-obese patient. Obes Surg 2004;14:492-497.
  • Noah J, Smith A, Birch D, Karmali S. The metabolic effects of laparoscopic sleeve gastrectomy: a review. J Minim Invasive Surg Sci 2013;2:3-7.
  • Nocca D, Guillaume F, Noel P, et al. Impact of laparoscopic sleeve gastrectomy and laparoscopic gastric bypass on HbA1c blood level and pharmacological treatment of type 2 diabetes mellitus in severe or morbidly obese patients. Results of a multicenter prospective study at 1 year. Obes Surg 2011;21:738-743.
  • Zhou D, Jiang X, Ding W, et al. Impact of bariatric surgery on ghrelin and obestatin levels in obesity or type 2 diabetes mellitus rat model. J Diabetes Res 2014;2014:569435.
  • Tucker ON, Szomstein S, Rosenthal RJ. Indications for sleeve gastrectomy as a primary procedure for weight loss in the morbidly obese. J Gastrointest Surg 2008;12:662-667.
  • Park JY, Song D, Kim YJ. Clinical experience of weight loss surgery in morbidly obese Korean adolescents. Yonsei Med J 2014;55:1366-1372.
  • Alvarenga ES, Lo Menzo E, Szomstein S, Rosenthal RJ. Safety and efficacy of 1020 consecutive laparoscopic sleeve gasterctomies performed as a primary treatment modality for morbid obesity. A single-center experience from the metabolic and bariatric surgical accreditation quality and improvement program. Surg Endosc 2016;30:2673-2678.
  • Noel P, Nedelcu M, Eddbali I, Manos T, Gagner M. What are the long-term results 8 years after sleeve gastrectomy? Surg Obes Relat Dis 2017;13:1110-1115.
  • Dudric V, Constantea N, Crisan D, et al. Laparoscopic sleeve gastrectomy: short and mid-term outcome. HVM Bioflux 2016;8:171-175.
  • Greenspan SF, Gardner DG. Basic and clinical endocrinology. 7th ed. NewYork: McGraw-Hill, 2004.
  • Dunitz M, Kopelman PG. The management of obesity and related disorders. 1st ed. London, 2001.
  • The trials of hypertension prevention collaborative research group. Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with high-normal blood pressure. The trials of hypertension prevention, phase II. Arch Intern Med 1997;157:657-667.
  • Sarkhosh K, Birch DW, Shi X, Gill RS, Karmali S. The impact of sleeve gastrectomy on hypertension: a systematic review. Obes Surg 2012;22:832-837.
  • Leonetti F, Capoccia D, Coccia F, et al. Obesity, type 2 diabetes mellitus, and other comorbidities: a prospective cohort study of laparoscopic sleeve gastrectomy vs medical treatment. Arch Surg 2012;147:694-700.
  • Slater BJ, Bellatorre N, Eisenberg D. Early postoperative outcomes and medication cost savings after laparoscopic sleeve gastrectomy in morbidly obese patients with type 2 diabetes. J Obes 2011;2011:350523.
  • Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med 2012;26;366:1567-1576.
  • Shah PS, Todkar JS, Shah SS. Effectiveness of laparoscopic sleeve gastrectomy on glycemic control in obese Indians with type 2 diabetes mellitus. Surg Obes Relat Dis 2010;6:138-141.
  • Casella G, Abbatini F, Calì B, Capoccia D, Leonetti F, Basso N. Ten-year duration of type 2 diabetes as prognostic factor for remission after sleeve gastrectomy. Surg Obes Relat Dis 2011;7:697-702.
  • Hoogerboord M, Wiebe S, Klassen D, Ransom T, Lawlor D, Ellsmere J. Laparoscopic sleeve gastrectomy: perioperative outcomes, weight loss and impact on type 2 diabetes mellitus over 2 years. Can J Surg 2014;57:101-105.
  • Gill RS, Birch DW, Shi X, Sharma AM, Karmali S. Sleeve gastrectomy and type 2 diabetes mellitus: a systematic review. Surg Obes Relat Dis 2010;6:707-713.
  • Roslin MS, Dudiy Y, Weiskopf J, Damani T, Shah P. Comparison between RYGB, DS, and VSG effect on glucose homeostasis. Obes Surg 2012;22:1281-1286.
  • Juodeikis Ž, Brimas G. Long-term results after sleeve gastrectomy: a systematic review. Surg Obes Relat Dis 2017;13:693-699.
  • Makary MA, Clark JM, Shore AD, et al. Medication utilization and annual health care costs in patients with type 2 diabetes mellitus before and after bariatric surgery. Arch Surg 2010;145:726-731.
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Cerrahi
Bölüm Araştırma Makalesi
Yazarlar

Seda Baştürk 0000-0002-0945-010X

Onur Birsen 0000-0001-6064-5693

Tuğberk Baştürk 0000-0002-6844-1916

Yayımlanma Tarihi 21 Ocak 2020
Gönderilme Tarihi 3 Ekim 2019
Kabul Tarihi 25 Aralık 2019
Yayımlandığı Sayı Yıl 2020 Cilt: 13 Sayı: 1

Kaynak Göster

AMA Baştürk S, Birsen O, Baştürk T. Short and midterm results of laparoscopic sleeve gastrectomy and its effects hypertension and type 2 diabetes. Pam Tıp Derg. Ocak 2020;13(1):19-26. doi:10.31362/patd.628093
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