Five-year Outcomes On Laparoscopic Roux-en-Y Gastric Bypass For T2D Treatment With Obesity

ObjectivesThis study retrospectively analyzed the 5-year follow-up outcomes after LRYGB in patients with T2D and obesity with the following objectives: a)To evaluate the comlications of LRYGB in 5 years;b)To assess the efficacy of LRYGB for T2D with obesity;c)To preliminarily explore the evaluation indexes for predicting the efficacy of LRYGB.MethodsIn this study,LRYGB was conducted to treat T2D patients with obesity accordance with the inclusion criteria and they were followed up at the prescribed time after operation.They were divided into two groups including BMI groups(Group A: BMI<28 kg/m2;Group B: BMI≥28kg/m2)and A1C groups(Group C: A1C<7%;Group D: A1C≥7%).Their medical records including basic information,biochemical indexes and medications were collected in 12,36,60 months.To evaluate the long-term-effect and predicted index after LRYGB.Results59 Chinese patients were collected,including 30 females and 29 males(50.8% vs.49.2%).The average age is 49.08±10.18 years.No one was lost to follow-up in five years.Postoperative complications included anastomotic fistula,intestinal obstruction: three patients had anastomotic fistula,two patients had intestinal obstruction.There were significant reductions in BMI,A1C and oral medication or insulin in all groups.Diabetes complete remission rates in 12,36 and 60 months postoperation were 77.97%,61.02%and 49.15%.T2D relapse and requirement for antihypertensive agents increased in 3rd and 5th years.Larger quantity of subcutaneous fat area(SFA)and shorter duration of T2D preoperation were more likely to achieve remission of T2D postoperation.Conclusions1.This study has confirmed that RYGB is an effective treatment for obese Chinese patients with T2D with less complicaitons.5-year follow-up outcomes showed that LRYGB resulted in diabetes remission,metabolic disorder control,and cardiovascular risk reduction.2.SFA and duration of T2D preoperation may predict the remission of T2D postoperation.3.There are also possibilities of postoperative fattening,relapse of type 2 diabetes and metabolic disorders.Long-term follow-up is very important for T2D patients with obesity.