Roux-En-Y Gastric Bypass Versus Vertical Partial Gastrectomy In The Control Of Type 2 Diabetes Mellitus Refractory To Medical Treatment

Romero C.B.; Cabrejo A.B.; Caballero-Alvarado J.; Zavaleta-Corvera C.; Peralta K.L.; Muente-Alva L.S. · Surgical Chronicles (2023)

Resumen

Objective: Determine the effectiveness of Roux-en-Y gastric bypass (RYGB or RYGB) versus vertical partial gastrectomy (VPG) in the control of patients with type 2 diabetes mellitus (T2DM) refractory to medical treatment. Methods: Analytical, observational, longitudinal retrospective cohorts during 2010 to 2017. 60 medical records of patients with type 2 diabetes mellitus refractory to medical treatment, operated on the General Surgery Department of the Santa Mónica Clinic, Lima, Peru, were reviewed. A convenience sample was divided into 30 patients with RYGB and 30 with GPV. Results: The average age was 43.3±8.09 years, range from 25 to 59; 60% were men; the body mass index (BMI) was 41.22±2.84. Fasting plasma glucose and glycosylated hemoglobin values were 110.1 mg/dL, 6.85% in RYGB and 110.9 mg/dL, 7.19% in VPG (p=0.000). The BMI in RYGB was 36.5 (p=0.000) and 38.4 in GPV (p=0.0009), respectively. Global control was achieved in 61.7%. RYGB achieved 51.4%, with a RR of 1.056 (95% CI=0.708-1.574; chi2=0.071, p=0.791). Likewise, of 12 controlled women, 66.7% corresponded to RYGB (RR=0.59, 95% CI=0.242-1.442) and of 25 controlled men, 56% to GPV (RR=1.139, 95% CI=0.732-1.772). Conclusions: Diabetes control occurred in 62%. RYGB was no more effective than PVG in controlling patients with refractory T2DM. The promotion of metabolic surgery and larger studies, with longer follow-up and multicenter, are suggested.

Instituciones: Universidad Privada Antenor Orrego