PMID- 18347866
OWN - NLM
STAT- MEDLINE
DCOM- 20090219
LR  - 20211020
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 22
IP  - 12
DP  - 2008 Dec
TI  - Laparoscopic treatment of metabolic syndrome in patients with type 2 diabetes 
      mellitus.
PG  - 2670-8
LID - 10.1007/s00464-008-9808-0 [doi]
AB  - BACKGROUND: Metabolic syndrome refers to risk factors for cardiovascular disease. 
      Hyperglycemia is a critical component contributing to the predictive power of the 
      syndrome. This study aimed to evaluate the results from the laparoscopic 
      interposition of an ileum segment into the proximal jejunum for the treatment of 
      metabolic syndrome in patients with type 2 diabetes mellitus and a body mass 
      index (BMI) lower than 35. METHODS: Laparoscopic procedures were performed for 60 
      patients (24 women and 36 men) with a mean age of 51.7 +/- 6.4 years (range, 
      27-66 years) and a mean BMI of 30.1 +/- 2.7 (range, 23.6-34.4). All the patients 
      had a diagnosis of type 2 diabetes mellitus (T2DM) given at least 3 years 
      previously and evidence of stable treatment using oral hypoglycemic agents, 
      insulin, or both for at least 12 months. The mean duration of type 2 diabetes 
      mellitus was 9.6 +/- 4.6 years (range, 3-22 years). Metabolic syndrome was 
      diagnosed for all 60 patients. Arterial hypertension was diagnosed for 70% of the 
      patients (mean number of drugs, 1.6) and hypertriglyceridemia for 70%. 
      High-density lipoprotein was altered in 51.7% of the patients and the abdominal 
      circumference in 68.3%. Two techniques were performed: ileal interposition (II) 
      into the proximal jejunum and sleeve gastrectomy (II-SG) or ileal interposition 
      associated with a diverted sleeve gastrectomy (II-DSG). RESULTS: The II-SG 
      procedure was performed for 32 patients and the II-DSG procedure for 28 patients. 
      The mean postoperative follow-up period was 7.4 months (range, 3-19 months). The 
      mean BMI was 23.8 +/- 4.1 kg/m(2), and 52 patients (86.7%) achieved adequate 
      glycemic control. Hypertriglyceridemia was normalized for 81.7% of the patients. 
      An high-density lipoprotein level higher than 40 for the men and higher than 50 
      for the women was achieved by 90.3% of the patients. The abdominal circumference 
      reached was less than 102 cm for the men and 88 cm for the women. Arterial 
      hypertension was controlled in 90.5% of the patients. For the control of 
      metabolic syndrome, II-DSG was the more effective procedure. CONCLUSIONS: 
      Laparoscopic II-SG and II-DSG seem to be promising procedures for the control of 
      the metabolic syndrome and type 2 diabetes mellitus. A longer follow-up period is 
      needed.
FAU - DePaula, A L
AU  - DePaula AL
AD  - adepaula@uol.com.br
FAU - Macedo, A L V
AU  - Macedo AL
FAU - Rassi, N
AU  - Rassi N
FAU - Vencio, S
AU  - Vencio S
FAU - Machado, C A
AU  - Machado CA
FAU - Mota, B R
AU  - Mota BR
FAU - Silva, L Q
AU  - Silva LQ
FAU - Halpern, A
AU  - Halpern A
FAU - Schraibman, V
AU  - Schraibman V
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20080318
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
RN  - 0 (Blood Glucose)
RN  - 0 (Insulin)
RN  - 0 (Triglycerides)
RN  - 89750-14-1 (Glucagon-Like Peptide 1)
RN  - 97C5T2UQ7J (Cholesterol)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Blood Glucose/analysis
MH  - Blood Pressure
MH  - Body Mass Index
MH  - Cholesterol/blood
MH  - Diabetes Mellitus, Type 2/blood/physiopathology/*surgery
MH  - Female
MH  - Gastrectomy/methods/statistics & numerical data
MH  - Gastric Bypass/*methods/statistics & numerical data
MH  - Glucagon-Like Peptide 1/metabolism
MH  - Humans
MH  - Ileum/physiopathology/*surgery
MH  - Insulin/blood
MH  - Jejunum/*surgery
MH  - Laparoscopy/*methods/statistics & numerical data
MH  - Male
MH  - Metabolic Syndrome/blood/physiopathology/*surgery
MH  - Middle Aged
MH  - Triglycerides/blood
EDAT- 2008/03/19 09:00
MHDA- 2009/02/20 09:00
CRDT- 2008/03/19 09:00
PHST- 2007/06/12 00:00 [received]
PHST- 2008/01/24 00:00 [accepted]
PHST- 2008/01/11 00:00 [revised]
PHST- 2008/03/19 09:00 [pubmed]
PHST- 2009/02/20 09:00 [medline]
PHST- 2008/03/19 09:00 [entrez]
AID - 10.1007/s00464-008-9808-0 [doi]
PST - ppublish
SO  - Surg Endosc. 2008 Dec;22(12):2670-8. doi: 10.1007/s00464-008-9808-0. Epub 2008 
      Mar 18.