PMID- 30341657
OWN - NLM
STAT- MEDLINE
DCOM- 20200430
LR  - 20200430
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 33
IP  - 8
DP  - 2019 Aug
TI  - Effect of revisional bariatric surgery on type 2 diabetes mellitus.
PG  - 2642-2648
LID - 10.1007/s00464-018-6541-1 [doi]
AB  - INTRODUCTION: Bariatric and metabolic surgery significantly improves type 2 
      diabetes mellitus (T2DM). However, a small percentage of patients after bariatric 
      surgery either have persistent hyperglycemia or relapse of their T2DM. These 
      patients are usually medically managed. The aim of this study was to evaluate the 
      effect of revisional surgery on the glycemic status of patients with T2DM who 
      either failed to remit or relapsed after an initial remission following bariatric 
      surgery. METHODS: Metabolic parameters and clinical outcomes of 81 patients with 
      persistent or relapsed T2DM after revisional bariatric surgery at an academic 
      center between 2008 and 2017 were studied. RESULTS: The most common types of 
      revisional surgery were pouch and/or stoma revision of Roux-en-Y gastric bypass 
      (RYGB) (n = 22, 27.2%), conversion of vertical banded gastroplasty (VBG) to RYGB 
      (n = 20, 24.7%), conversion of adjustable gastric banding (AGB) to RYGB (n = 14, 
      17.3%), and conversion of sleeve gastrectomy (SG) to RYGB (n = 13, 16%). Revision 
      of pouch/stoma after RYGB yielded improvement of T2DM in 50% of patients and 
      remission in 22.7%. Conversion to RYGB yielded improvement of T2DM in 55%, 35.7%, 
      and 30.8% of patients who previously had VBG, AGB, or SG, respectively. 
      Furthermore, conversion of VBG, AGB, and SG to RYGB was associated with diabetes 
      remission rates of 35%, 35.7%, and 23.1%, respectively. CONCLUSION: Findings of 
      this study, which is the largest series to date, indicate that revisional surgery 
      in patients with persistent or relapsed T2DM after bariatric surgery can 
      significantly improve glucose control and use of diabetes medications. Further 
      clinical and mechanistic studies are needed to better demonstrate the role of 
      revisional bariatric surgery in patients with residual T2DM.
FAU - Aleassa, Essa M
AU  - Aleassa EM
AD  - Department of General Surgery, Bariatric and Metabolic Institute, Cleveland 
      Clinic, 9500 Euclid Ave, M61, Cleveland, OH, 44195, USA.
AD  - Department of Surgery, College of Medicine and Health Sciences, United Arab 
      Emirates University, Al Ain, United Arab Emirates.
FAU - Hassan, Monique
AU  - Hassan M
AD  - Department of General Surgery, Bariatric and Metabolic Institute, Cleveland 
      Clinic, 9500 Euclid Ave, M61, Cleveland, OH, 44195, USA.
FAU - Hayes, Kellen
AU  - Hayes K
AD  - Department of General Surgery, Bariatric and Metabolic Institute, Cleveland 
      Clinic, 9500 Euclid Ave, M61, Cleveland, OH, 44195, USA.
FAU - Brethauer, Stacy A
AU  - Brethauer SA
AD  - Department of General Surgery, Bariatric and Metabolic Institute, Cleveland 
      Clinic, 9500 Euclid Ave, M61, Cleveland, OH, 44195, USA.
FAU - Schauer, Philip R
AU  - Schauer PR
AD  - Department of General Surgery, Bariatric and Metabolic Institute, Cleveland 
      Clinic, 9500 Euclid Ave, M61, Cleveland, OH, 44195, USA.
FAU - Aminian, Ali
AU  - Aminian A
AD  - Department of General Surgery, Bariatric and Metabolic Institute, Cleveland 
      Clinic, 9500 Euclid Ave, M61, Cleveland, OH, 44195, USA. aminiaa@ccf.org.
LA  - eng
PT  - Journal Article
DEP - 20181019
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Adult
MH  - *Bariatric Surgery
MH  - Blood Glucose/metabolism
MH  - Diabetes Mellitus, Type 2/blood/*complications/*drug therapy
MH  - Female
MH  - Gastrectomy
MH  - Gastric Bypass
MH  - Gastroplasty
MH  - Humans
MH  - Hypoglycemic Agents/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Obesity, Morbid/*complications/*surgery
MH  - *Reoperation
MH  - Retrospective Studies
MH  - Surgical Stomas
MH  - Weight Loss
OTO - NOTNLM
OT  - Adjustable gastric banding
OT  - Diabetes
OT  - Revisional bariatric surgery
OT  - Roux-en-Y gastric bypass
OT  - Sleeve gastrectomy
OT  - Vertical band gastroplasty
EDAT- 2018/10/21 06:00
MHDA- 2020/05/01 06:00
CRDT- 2018/10/21 06:00
PHST- 2018/04/17 00:00 [received]
PHST- 2018/10/15 00:00 [accepted]
PHST- 2018/10/21 06:00 [pubmed]
PHST- 2020/05/01 06:00 [medline]
PHST- 2018/10/21 06:00 [entrez]
AID - 10.1007/s00464-018-6541-1 [pii]
AID - 10.1007/s00464-018-6541-1 [doi]
PST - ppublish
SO  - Surg Endosc. 2019 Aug;33(8):2642-2648. doi: 10.1007/s00464-018-6541-1. Epub 2018 
      Oct 19.