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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Techniques of Sleeve Gastrectomy and Modified Roux-en-Y Gastric Bypass in Mice
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Metabolic Surgery in Korea.

Yeon-Ju Huh1,2, Hyuk-Joon Lee1,3

  • 1Department of Surgery, Seoul National University Hospital, Seoul, Korea.

Journal of Metabolic and Bariatric Surgery
|January 10, 2024
PubMed
Summary

Metabolic surgery (MS) effectively treats type 2 diabetes in obese patients, with sleeve gastrectomy being the most common procedure in Korea. Further research is needed for optimal patient selection and surgical approach.

Keywords:
Diabetes mellitusGastrectomyGastric bypassMetabolic surgeryObesity, morbid

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Area of Science:

  • Metabolic and bariatric surgery
  • Endocrinology
  • Surgical innovation

Background:

  • Metabolic surgery (MS) addresses obesity-related comorbidities, particularly type 2 diabetes, distinguishing it from bariatric surgery (BS) focused on weight loss.
  • In Korea, metabolic and bariatric surgery (MBS) has been covered by national health insurance since 2019, with specific BMI criteria for eligibility.
  • The two primary MS procedures are Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG).

Purpose of the Study:

  • To analyze the trends and patient demographics of metabolic surgery in Korea.
  • To compare the utilization of different MS procedures (SG, RYGB, duodenal switch) based on patient BMI and comorbidities.
  • To assess the role of MS in managing type 2 diabetes in an obese population.

Main Methods:

  • Retrospective analysis of data from the Korean Society of Metabolic and Bariatric Surgery registry.
  • Categorization of patients based on Body Mass Index (BMI) and diabetes status.
  • Comparison of surgical procedure types (SG, RYGB, duodenal switch) performed between 2019 and 2021.

Main Results:

  • A total of 1,560 metabolic surgeries were performed for obese patients with diabetes in Korea between 2019 and 2021, representing 35.6% of all bariatric surgeries.
  • Sleeve gastrectomy (SG) was the most frequently performed procedure, followed by RYGB and duodenal switch surgery.
  • While SG dominated both BMI groups (<35 and ≥35), RYGB and duodenal switch were proportionally more common in patients with BMI <35.

Conclusions:

  • Metabolic surgery is a significant and growing treatment option for obese patients with type 2 diabetes in Korea.
  • Sleeve gastrectomy is the predominant surgical approach, but procedure choice may vary with patient BMI.
  • Additional research is essential to refine patient selection criteria and optimize surgical technique for managing diabetes through MS.