Page 4 - World Journal of Laparoscopic Surgery

Mohamed Abdelmohsen, Hazem Badr
almost eliminates the chance of anemia, osteoporosis Pearson correlation coefficient (r) was calculated
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protein deficiency, and vitamin deficiency. The aim of to test the association between quantitative variables;
this study is to assess the short- and long-term effects of p-values ≤0.05 were considered significant.
LSG on body weight and glucose homeostasis in morbidly
obese diabetic patients. RESULTS

The study was conducted on 40 patients of morbid obesity
MATERIALS AND METHODS
that had T2DM.
This is a prospective study which was conducted on Patient age: The mean age of the studied group was 38.8
40 diabetic patients randomly selected suffering from ± 7.0 years (25–50) as shown in Table 1.
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morbid obesity (BMI more than 35 kg/m ). Patients were From the table, 45% of patients’ age ranged from 41 to
managed by LSG in Al-Zahraa Hospital, Faculty of Medi- 50, 40% ranged from 31 to 40, and 15% ranged 20 to 30.
cine for girls, Al-Azhar University, from January 2012 to Patient gender: 77.5% of patients were women and 22.5%
December 2015, to assess the short- and long-term effects were men as in Table 2.
of the procedure on glucose homeostasis. Patient BMI: The BMI of patients were (35.0–39.9) 2.5%,
(40.0–44.9) 22.5%, (45.0–49.9) 32.5%, (50.0–54.9) 40%, and
Operative Technique (55.0–59.9) 2.5% as in Table 3.

All operative procedures were performed laparoscopi- Preoperatively, the mean fasting blood glucose (FBG)
cally. The first step consists in opening the gastrocolic level was (209.3 ± 36.6) (156–299) mg/dL and postopera-
ligament attached to the stomach, usually starting 10 to tively was (172.5 ± 29) (130–250) mg/dL, (125.6 ± 16.7)
12 cm from the pylorus toward the lower pole of the (99–169) mg/dL, (111.7 ± 20.9) (77–167) mg/dL, (105 ± 18.3)
spleen. Then the gastric greater curvature is freed up to (73–137) mg/dL, and (102.9 ± 21) (70–145) mg/dL at 1 day
the cardioesophageal junction close to stomach. Meticu- and 3, 6, 9, and 12 months respectively as in Table 4.
lous dissection is performed at the angle of His with full The mean percentage of FBG changes postopera-
mobilization of the gastric fundus. The mobilization of tively were (-16.8 ± 10.3)%, (-38.1 ± 14.1)%, (-45 ± 14.4)%,
the stomach continues dissecting the greater gastric curve (–48.6 ± 12)%, and (-49.4 ± 13.8)% at 1 day and 3, 6, 9, and
toward the antrum up to 5 to 7 cm from the pylorus. At this 12 months respectively, as in Table 5.
time a 36-Fr orogastric tube is inserted direct toward the Postoperatively, the FBG levels were improved with
pylorus, proximal to the lesser curvature of the stomach. significant declining at one day (p < 0.001), 3 months
Then, the stomach is resected with linear staplers paral- Table 1: Age (range and mean) and age groups
lel to orogastric tube along the lesser curve starting 5 to
7 cm far from pylorus. The orogastric bougie is replaced Range Mean ± SD
by a nasogastric tube, i.e., positioned in the distal stomach Age (years) 25–50 38.8 ± 7.0
42.7 ± 6.3
Males
31–50
to perform a methylene blue test. The transection line is Females 25–49 37.6 ± 6.9
inspected to search blue positively. In case of negative test, Age groups n %
the resected stomach is removed by left midabdominal 20–30 years 6 15.0
trocar usually without prolonging incision. The gastric 31–40 years 16 40.0
residual volume ranged from 60 to 80 mL. 41–50 years 18 45.0
SD: Standard deviation
Statistical Analysis

Data were summarized using mean and standard devia- Table 2: Sex distribution
tion or median and percentile for quantitative variables Description
and frequency and percentage for qualitative variables. Sex n %
Relative % change was calculated to get the actual Male 9 22.5
change in each time measure. Female 31 77.5
Relative % change = [(postmeasure – premeasure)/
premeasure] × 100 Table 3: The body mass index
Comparison between groups was done using inde- BMI pre Frequency Percentage
pendent sample t-test for quantitative variables. 35.0–39.9 1 2.5
Repeated measures analysis of variance test was 40.0–44.9 9 22.5
conducted to compare different measures at different 45.0–49.9 13 32.5
time situation with post hoc Bonferroni test for pairwise 50.0–54.9 16 40.0
comparisons. 55.0–59.9 1 2.5
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