lunes, 29 de septiembre de 2014

Cirugía bariátrica/Bariatric surgery

STAMPEDE: La cirugía bariátrica gana más apoyo basada en evidencias


STAMPEDE: Bariatric surgery gains more evidence based support.
Al Suwaidi J.
Glob Cardiol Sci Pract. 2014 Jan 29;2014(1):45-8. doi: 10.5339/gcsp.2014.8. eCollection 2014.
Abstract
Diabetes mellitus (DM) and obesity are associated with significant morbidity and mortality. Recent large-scale trials of intensive medical management for obesity and diabetes have been disappointing. Observational studies and small-scale trials of bariatric surgery on DM patients have shown promising results. The effects of sleeve gastrectomy and gastric bypass in a larger cohort of patients with DM and obesity was tested in the STAMPEDE trial over a 3-year follow-up.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4104377/pdf/gcsp-2014-045.pdf





Comparación de la efectividad de cuatro cirugías bariátricas en obesos con DM tipo 2. Estudio retrospectivo


Comparison of the effectiveness of four bariatric surgery procedures in obese patients with type 2 diabetes: a retrospective study.
Pham S, Gancel A, Scotte M, Houivet E, Huet E, Lefebvre H, Kuhn JM, Prevost G.

J Obes. 2014;2014:638203. doi: 10.1155/2014/638203. Epub 2014 May 22.

Abstract

AIM:The aim of the present retrospective study was to evaluate the efficacy of four bariatric surgical procedures to induce diabetes remission and lower cardiovascular risk factors in diabetic obese patients. Moreover, the influence of surgery on weight evolution in the diabetic population was compared with that observed in a nondiabetic matched population. METHODS:Among 970 patients who were operated on in our center since 2001, 81 patients were identified as type 2 diabetes. Laparoscopic adjustable gastric banding (GB), intervention type Mason (MA), gastric bypass (RYGB), and sleeve gastrectomy (SG) were performed, respectively, in 25%, 17%, 28%, and 30% of this diabetic population. RESULTS:The resolution rate of diabetes one year after surgery was significantly higher after SG than GB (62.5% versus 20%, P < 0.01), but not significantly different between SG and RYGB. In terms of LDL-cholesterol reduction, RYGB was equivalent to SG and superior to CGMA or GB. Considering the other cardiovascular risk factors, there was no significant difference according to surgical procedures. The weight loss was not statistically different between diabetic and nondiabetic matched patients regardless of the surgical procedures used. CONCLUSION:Our data confirm that the efficacy of surgery to treat diabetes is variable among the diverse procedures and SG might be an interesting option in this context.

http://www.hindawi.com/journals/jobe/2014/638203/



Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org

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