| Objective:Through clinical observation and postoperative follow-up ways to assess the effects ofdifferent digestive tract reconstruction on type2diabetes mellitus (T2DM) forpostoperative gastric cancer，and a reference for type2diabetes was provided withsurgical treatment.Methods:Study population are46cases of gastric cancer patients complicated with type2diabeteswhich were diagnosed at the Affiliated Hospital of Yan’an University during theSeptember2011and October2013.The number of male cases is28,and the female is18.The age of the cases are between38and69,the Average age is52±8.2.By differentdigestive tract reconstruction,these patients were divided into3groups, BillrothⅠ group(n=11), Billroth Ⅱg roup (n=17) and Roux-en-Y group (n=18).The pre-and postoperativeclinical parameters associated with body mass index,Fasting blood glucose,glycatedhemoglobin levels,fasting C-peptide and oral glucose tolerance test were measuredduring a6-month follow-up period.Results:The effective rates are9.1%（1/11）,64.7%（11/17），94.4%（17/18）for BillrothⅠ group,BillrothⅡ group and Roux-en-Y group respectively after operation.Fasting blood glucoseand glycated hemoglobin levels were significantly decreased after surgery in both Billroth Ⅱ and Roux-en-Y groups (P<0.05). At3and6months, patients in bothBillrothⅡ and Roux-en-Y groups had significantly increased fasting C-peptide andsignificant improved oral glucose tolerance test (P<0.05). The changes of thoseparameters above in Roux-en-Y group were greater than those in BillrothⅡ group(P<0.05). However, the effects were not shown in BillrothⅠ group through theentire follow-up period（P>0.05）. T2DM control rate in Roux-en-Y group was higherthan that in BillrothⅠ and Billroth Ⅱgroup (P<0.05).Conclusion:As compared with BillrothⅠ,Billroth Ⅱ and Roux-en-Y group reconstruction aftergastrectomy,Roux-en-Y gastric bypass seems to be more effective to relieve thehyperglycemia after surgery,and the mechanism needs further study. |
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