Norbert Runkel1, Rainer Brydniak1. 1. Department of General Surgery, Schwarzwald-Baar Hospital, Villingen-Schwenningen, Germany.
Abstract
BACKGROUND: Bariatric surgery is gastrointestinal surgery for weight control, and metabolic surgery refers to the use of surgery to primarily and purposely treat type 2 diabetes mellitus (T2DM)/metabolic syndrome mellitus. METHODS: The most recent literature was reviewed for surgery and T2DM in a non-systematic fashion. RESULTS: Roux-Y gastric bypass, biliopancreatic diversion with duodenal switch, and sleeve gastrectomy (SG) are the dominant procedures today. SG is emerging as the most popular operation worldwide. Laparoscopy has made metabolic surgery as safe as other common abdominal procedures. A BMI > 60 kg/m2, however, exposes a significantly higher perioperative risk. Most patients experience a sustained improvement of glycemic control with subsequent reduction of cardiovascular events. The remission rates depend on the severity and duration of diabetes. Prevention of long-term nutritional deficits and monitoring of metabolism require lifelong medical surveillance of the patients. CONCLUSIONS: The profound impact of weight reduction surgery on glucose metabolism explains the growing interest in treating T2DM by surgical means. Metabolic surgery is a safe option for carefully selected patients with metabolic syndrome.
BACKGROUND: Bariatric surgery is gastrointestinal surgery for weight control, and metabolic surgery refers to the use of surgery to primarily and purposely treat type 2 diabetes mellitus (T2DM)/metabolic syndrome mellitus. METHODS: The most recent literature was reviewed for surgery and T2DM in a non-systematic fashion. RESULTS: Roux-Y gastric bypass, biliopancreatic diversion with duodenal switch, and sleeve gastrectomy (SG) are the dominant procedures today. SG is emerging as the most popular operation worldwide. Laparoscopy has made metabolic surgery as safe as other common abdominal procedures. A BMI > 60 kg/m2, however, exposes a significantly higher perioperative risk. Most patients experience a sustained improvement of glycemic control with subsequent reduction of cardiovascular events. The remission rates depend on the severity and duration of diabetes. Prevention of long-term nutritional deficits and monitoring of metabolism require lifelong medical surveillance of the patients. CONCLUSIONS: The profound impact of weight reduction surgery on glucose metabolism explains the growing interest in treating T2DM by surgical means. Metabolic surgery is a safe option for carefully selected patients with metabolic syndrome.
Authors: Beat P Müller-Stich; Jonas D Senft; René Warschkow; Hannes G Kenngott; Adrian T Billeter; Gianmatteo Vit; Stefanie Helfert; Markus K Diener; Lars Fischer; Markus W Büchler; Peter P Nawroth Journal: Ann Surg Date: 2015-03 Impact factor: 12.969
Authors: Norbert Runkel; Mario Colombo-Benkmann; Thomas P Hüttl; Harald Tigges; Oliver Mann; Stephan Sauerland Journal: Dtsch Arztebl Int Date: 2011-05-20 Impact factor: 5.594
Authors: Philip R Schauer; Deepak L Bhatt; John P Kirwan; Kathy Wolski; Stacy A Brethauer; Sankar D Navaneethan; Ali Aminian; Claire E Pothier; Esther S H Kim; Steven E Nissen; Sangeeta R Kashyap Journal: N Engl J Med Date: 2014-03-31 Impact factor: 91.245
Authors: Anita P Courcoulas; Steven H Belle; Rebecca H Neiberg; Sheila K Pierson; Jessie K Eagleton; Melissa A Kalarchian; James P DeLany; Wei Lang; John M Jakicic Journal: JAMA Surg Date: 2015-10 Impact factor: 14.766
Authors: John B Buse; Sonia Caprio; William T Cefalu; Antonio Ceriello; Stefano Del Prato; Silvio E Inzucchi; Sue McLaughlin; Gordon L Phillips; R Paul Robertson; Francesco Rubino; Richard Kahn; M Sue Kirkman Journal: Diabetes Care Date: 2009-11 Impact factor: 19.112
Authors: Francesco Rubino; David M Nathan; Robert H Eckel; Philip R Schauer; K George M M Alberti; Paul Z Zimmet; Stefano Del Prato; Linong Ji; Shaukat M Sadikot; William H Herman; Stephanie A Amiel; Lee M Kaplan; Gaspar Taroncher-Oldenburg; David E Cummings Journal: Diabetes Care Date: 2016-06 Impact factor: 19.112
Authors: Thomas H Inge; Anita P Courcoulas; Todd M Jenkins; Marc P Michalsky; Michael A Helmrath; Mary L Brandt; Carroll M Harmon; Meg H Zeller; Mike K Chen; Stavra A Xanthakos; Mary Horlick; C Ralph Buncher Journal: N Engl J Med Date: 2015-11-06 Impact factor: 91.245
Authors: Lara L Roberson; Ehimen C Aneni; Wasim Maziak; Arthur Agatston; Theodore Feldman; Maribeth Rouseff; Thinh Tran; Michael J Blaha; Raul D Santos; Andrei Sposito; Mouaz H Al-Mallah; Ron Blankstein; Matthew J Budoff; Khurram Nasir Journal: BMC Public Health Date: 2014-01-08 Impact factor: 3.295