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Outcomes After Metabolic Surgery in Asians-a Meta-analysis
Danson Yeo1, Charleen Yeo2, Tze Yi Low2
1Upper Gastrointestinal Surgery Unit, Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore. danson_xw_yeo@ttsh.com.sg.
Obesity Surgery
|September 10, 2018
Summary
Roux-en-Y gastric bypass (RYGB) offers greater excess weight loss than sleeve gastrectomy (SG) in Asian patients. However, both procedures show similar improvements in type 2 diabetes mellitus (T2DM) and hypertension, suggesting SG may be preferable for T2DM management without reflux symptoms.
Area of Science:
- Metabolic surgery outcomes in Asian populations.
- Comparative analysis of bariatric procedures for obesity and T2DM.
Background:
- Obesity and type 2 diabetes mellitus (T2DM) present unique challenges in Asian populations.
- Disease patterns and surgical outcomes may differ between Asian and Western individuals.
- Need for evidence-based data on metabolic surgery efficacy in Asians.
Purpose of the Study:
- To systematically review and analyze existing evidence on metabolic surgery outcomes in Asian patients.
- To compare the effectiveness of Roux-en-Y gastric bypass (RYGB) versus sleeve gastrectomy (SG).
Main Methods:
- Meta-analysis of 13 publications (9 RCTs, 4 case-matched studies) with a minimum 1-year follow-up.
- Evaluated outcomes included % excess weight loss (EWL), BMI, T2DM resolution/improvement, and hypertension resolution.
- Data synthesis using standardized mean differences (SMD) and pooled odds ratios (OR).
Main Results:
- Roux-en-Y gastric bypass (RYGB) demonstrated significantly higher % excess weight loss (SMD 0.53) compared to sleeve gastrectomy (SG).
- T2DM resolution/improvement (OR 1.39) and hypertension resolution (OR 0.96) showed no statistically significant difference between RYGB and SG.
- Analysis included 1052 patients, with data pooled from randomized controlled trials and case-matched studies.
Conclusions:
- RYGB leads to superior weight loss in Asian patients compared to SG.
- Both RYGB and SG offer comparable rates of T2DM and hypertension improvement.
- Sleeve gastrectomy (SG) may be a preferred surgical option for Asian patients with T2DM and metabolic syndrome, particularly those without GERD symptoms.
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