Outcomes of Duodenal Switch with a Moderate Common Channel Length and Roux-en-y Gastric Bypass: Does One Pose More Risk?

Autor: Sada A; Department of Surgery, Mayo Clinic, 200 1st ST SW, Rochester, MN, 55905, USA.; Mayo Clinic Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Rochester, MN, USA., Calderon-Rojas RD; Department of Surgery, Mayo Clinic, 200 1st ST SW, Rochester, MN, 55905, USA., Yamashita TS; Department of Surgery, Mayo Clinic, 200 1st ST SW, Rochester, MN, 55905, USA., Reidt WS; Department of Health Services Research, Mayo Clinic, Rochester, MN, USA., Glasgow AE; Mayo Clinic Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Rochester, MN, USA., Kendrick ML; Department of Surgery, Mayo Clinic, 200 1st ST SW, Rochester, MN, 55905, USA., Collazo-Clavell ML; Division of Endocrinology, Mayo Clinic, Rochester, MN, USA., Habermann EB; Mayo Clinic Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Rochester, MN, USA.; Department of Health Services Research, Mayo Clinic, Rochester, MN, USA., McKenzie TJ; Department of Surgery, Mayo Clinic, 200 1st ST SW, Rochester, MN, 55905, USA., Kellogg TA; Department of Surgery, Mayo Clinic, 200 1st ST SW, Rochester, MN, 55905, USA. Kellogg.Todd@mayo.edu.
Jazyk: angličtina
Zdroj: Obesity surgery [Obes Surg] 2020 Aug; Vol. 30 (8), pp. 2870-2876.
DOI: 10.1007/s11695-020-04619-9
Abstrakt: Background: Traditional duodenal switch (DS) typically leaves a short common channel and is infrequently performed in part due to increased risk of malnutrition. We compared nutritional deficiencies between DS with a moderate channel length and standard proximal Roux-en-Y gastric bypass (RYGB).
Methods: We conducted a retrospective review of 61 matched pairs who underwent DS or RYGB using our institutional database; patients were matched on sex, age, race, and BMI. DS was performed with a common channel length between 120 and 150 cm. Thirty-day complications, total body weight loss (TBWL) %, and nutritional labs up to 24 months were compared using paired t test and Wilcoxon rank sum tests.
Results: Weight loss was similar at each time point (all p > 0.1). DS patients had lower vitamin D levels at 6 months, lower calcium levels at 6 and 12 months, and lower hemoglobin at 12 months and otherwise equivalent (all p < 0.05). Revision was rare (1 DS; 0 RYGB). There were no differences in short-term complications (p = 0.28).
Conclusion: DS with a moderate common channel length is safe with a low revision rate. Weight loss and nutritional outcomes appear to be comparable to RYGB, and it may be considered an effective RYGB alternative.
Databáze: MEDLINE
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