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Resolution of type 2 diabetes after gastrectomy for gastric cancer with long limb Roux-en Y reconstruction: a prospective pilot study

Authors
 Whan Sik Kim  ;  Jong Won Kim  ;  Chul Woo Ahn  ;  Seung Ho Choi 
Citation
 JOURNAL OF THE KOREAN SURGICAL SOCIETY , Vol.84(2) : 88-93, 2013 
Journal Title
JOURNAL OF THE KOREAN SURGICAL SOCIETY
ISSN
 2233-7903 
Issue Date
2013
Keywords
Gastrectomy ; Roux-en-Y anastomosis ; Stomach neoplasms ; Type 2 diabetes mellitus
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/m(2) and mean glycated hemoglobin (HbA1c) was 7.7 ± 1.4% with antidiabetic medications. The mean BMI decreased to 21.7 ± 3.1 kg/m(2) (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.
Files in This Item:
T201205617.pdf Download
DOI
10.4174/jkss.2013.84.2.88
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jong Won(김종원)
Ahn, Chul Woo(안철우) ORCID logo https://orcid.org/0000-0003-3733-7486
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0002-9872-3594
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91163
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