dc.contributor.author |
Murphy, Rinki |
en |
dc.contributor.author |
Clarke, Michael G |
en |
dc.contributor.author |
Evennett, Nicholas J |
en |
dc.contributor.author |
John Robinson, S |
en |
dc.contributor.author |
Lee Humphreys, M |
en |
dc.contributor.author |
Hammodat, Hisham |
en |
dc.contributor.author |
Jones, Bronwen |
en |
dc.contributor.author |
Kim, David D |
en |
dc.contributor.author |
Cutfield, Richard |
en |
dc.contributor.author |
Johnson, Malcolm |
en |
dc.contributor.author |
Plank, Lindsay |
en |
dc.contributor.author |
Booth, Michael WC |
en |
dc.date.accessioned |
2018-11-07T21:45:32Z |
en |
dc.date.issued |
2018-02 |
en |
dc.identifier.issn |
0960-8923 |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/44086 |
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dc.description.abstract |
BACKGROUND:There are very few randomised, blinded trials comparing laparoscopic sleeve gastrectomy (LSG) versus laparoscopic Roux-en-Y gastric bypass (LRYGB) in achieving remission of type 2 diabetes (T2D), particularly silastic ring (SR)-LRYGB. We compared the effectiveness of (LSG) versus SR-LRYGB among patients with T2D and morbid obesity. METHODS:Prospective, randomised, parallel, 2-arm, blinded clinical trial conducted in a single Auckland (New Zealand) centre. Eligible patients aged 20-55 years, T2D of at least 6 months duration and BMI 35-65 kg/m2 were randomised 1:1 to LSG (n = 58) or SR-LRYGB (n = 56) using random number codes disclosed after anaesthesia induction. Primary outcome was T2D remission defined by different HbA1c thresholds at 1 year. Secondary outcomes included weight loss, quality of life, anxiety and depressive symptoms, post-operative complications and mortality. RESULTS:Mean ± standard deviation (SD) pre-operative BMI was 42.5 ± 6.2 kg/m2, HbA1c 63 ± 16 mmol/mol (30% insulin-treated, 28% had diabetes duration over 10 years). Proportions achieving HbA1c ≤ 38 mmol/mol, < 42 mmol/mol, < 48 mmol/mol and < 53 mmol/mol without diabetes medication at 1 year in SR-LRYGB vs LSG were 38 vs 43% (p = 0.56), 52 vs 49% (p = 0.85), 75 vs 72% (p = 0.83) and 80 vs 77% (p = 0.82), respectively. Mean ± SD % total weight loss at 1 year was greater after SR-LRYGB than LSG: 32.2 ± 7.7 vs 27.1 ± 7.5%, respectively (p < 0.001). Gastrointestinal complications were more frequent after SR-LRYGB (including 3 ulcers, 1 anastomotic leak, 1 abdominal bleeding). Quality of life and depression symptoms improved significantly in both groups. CONCLUSION:Despite significantly greater weight loss after SR-LRYGB, there was similar T2D remission and psychosocial improvement after LSG and SR-LRYGB at 1 year. TRIAL REGISTRATION:Prospectively registered at Australia and New Zealand Clinical Trials Register (ACTRN 12611000751976) and retrospectively registered at Clinical Trials (NCT1486680). |
en |
dc.format.medium |
Print |
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dc.language |
eng |
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dc.relation.ispartofseries |
Obesity surgery |
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dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
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dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
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dc.subject |
Humans |
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dc.subject |
Diabetes Mellitus, Type 2 |
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dc.subject |
Obesity, Morbid |
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dc.subject |
Postoperative Complications |
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dc.subject |
Weight Loss |
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dc.subject |
Laparoscopy |
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dc.subject |
Treatment Outcome |
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dc.subject |
Gastric Bypass |
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dc.subject |
Gastrectomy |
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dc.subject |
Double-Blind Method |
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dc.subject |
Quality of Life |
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dc.subject |
Adult |
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dc.subject |
Middle Aged |
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dc.subject |
New Zealand |
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dc.subject |
Female |
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dc.subject |
Male |
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dc.subject |
Young Adult |
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dc.subject |
Anastomotic Leak |
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dc.title |
Laparoscopic Sleeve Gastrectomy Versus Banded Roux-en-Y Gastric Bypass for Diabetes and Obesity: a Prospective Randomised Double-Blind Trial. |
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dc.type |
Journal Article |
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dc.identifier.doi |
10.1007/s11695-017-2872-6 |
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pubs.issue |
2 |
en |
pubs.begin-page |
293 |
en |
pubs.volume |
28 |
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dc.rights.holder |
Copyright: The author |
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dc.identifier.pmid |
28840525 |
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pubs.end-page |
302 |
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pubs.publication-status |
Published |
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dc.rights.accessrights |
http://purl.org/eprint/accessRights/RestrictedAccess |
en |
pubs.subtype |
Research Support, Non-U.S. Gov't |
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pubs.subtype |
Randomized Controlled Trial |
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pubs.subtype |
Journal Article |
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pubs.elements-id |
656778 |
en |
pubs.org-id |
Medical and Health Sciences |
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pubs.org-id |
School of Medicine |
en |
pubs.org-id |
Medicine Department |
en |
pubs.org-id |
Surgery Department |
en |
pubs.org-id |
Science |
en |
pubs.org-id |
Science Research |
en |
pubs.org-id |
Maurice Wilkins Centre (2010-2014) |
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dc.identifier.eissn |
1708-0428 |
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pubs.record-created-at-source-date |
2017-08-26 |
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pubs.dimensions-id |
28840525 |
en |