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Beyond Oncologic Benefit: Diabetes Remission Following Long-Limb Roux-en-Y Reconstruction in Laparoscopic Gastric
Serdar Çulcu1, Selim Tamam2, Gökhan Gökten3
1Surgical Oncology Department, Ankara University School of Medicine, Ankara, Turkey.
Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|October 20, 2025
Summary
Oncometabolic Roux-en-Y surgery significantly improves type 2 diabetes remission and glycemic control in gastric cancer patients compared to conventional methods. This advanced technique offers substantial metabolic benefits alongside oncological advantages.
Area of Science:
- Surgical Oncology
- Metabolic Surgery
- Gastroenterology
Background:
- Gastric cancer patients often have type 2 diabetes, complicating treatment.
- Conventional Roux-en-Y reconstruction's metabolic impact is less understood.
- Oncometabolic surgical techniques offer potential for improved glycemic control.
Purpose of the Study:
- To compare oncometabolic Roux-en-Y reconstruction with conventional methods.
- To evaluate the impact on type 2 diabetes remission and glycemic control.
- To assess outcomes in patients undergoing laparoscopic radical gastrectomy.
Main Methods:
- Prospective comparative study of 44 gastric cancer patients with type 2 diabetes.
- 19 patients received oncometabolic Roux-en-Y reconstruction.
- 25 patients received conventional Roux-en-Y reconstruction; outcomes assessed over one year.
Main Results:
- Diabetes remission rates were 52.6% with oncometabolic vs. 20% with conventional surgery (P=.024).
- Oncometabolic surgery increased remission likelihood 5.75-fold (OR=5.75; P=.03).
- Antidiabetic medication use decreased by 78.9% and insulin needs by 31.5% in the oncometabolic group.
Conclusions:
- Oncometabolic surgery offers significant metabolic advantages for gastric cancer patients.
- This technique improves type 2 diabetes remission and glycemic control.
- Oncometabolic surgery benefits both oncological and metabolic outcomes.
