Published online Feb 28, 2020. doi: 10.3748/wjg.v26.i8.865
Peer-review started: September 24, 2019
First decision: November 27, 2019
Revised: December 23, 2019
Accepted: January 19, 2020
Article in press: January 19, 2020
Published online: February 28, 2020
Processing time: 156 Days and 18.9 Hours
Bariatric procedures are considered superior to medical therapies in managing type 2 diabetes mellitus (T2DM). Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are the most commonly used procedures for weight loss and comorbidity resolution worldwide. However, it is not yet known whether the degree of T2DM is influenced by the choice of bariatric procedure.
To quantitatively compare T2DM resolution over 1-5 years follow-up by LRYGB and LSG in morbidly obese patients.
We searched the selected databases for full-text English language clinical studies that compared the effectiveness of LRYGB and LSG for T2DM resolution. Review manager 5.3 was used for data analysis, and the overall effect summary was represented in a forest plot.
From 1,650 titles retrieved by an initial search, we selected nine studies for this research. We found insignificant differences for T2DM resolution by LRYGB and LSG, with an odds ratio of 0.93 (95%CI: 0.64-1.35, Z statistics = 0.38, P = 0.71). Additionally, subset analyses for T2DM resolution showed insignificant differences after 24 mo (χ2 = 1.24, df = 4, P = 0.87, overall Z effect = 0.23), 36 mo (χ2 = 0.41, df = 2, P = 0.81, overall Z effect = 0.51), and 60 mo (χ2 = 4.75, df = 3, P = 0.19, overall Z effect = 1.20) by LRYGB and LSG. This study reports a T2DM remission rate of 82.3% by LRYGB and 80.7% by LSG.
This study reports similar T2DM resolution rates by both LRYGB and LSG during 1-5 years of follow-up. However, long-term follow-up of 10 years is needed to further substantiate these findings.
Core tip: Based on our research findings, both laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy can be used for type 2 diabetes mellitus resolution in morbidly obese patients.