Long-term Follow-up for Type 2 Diabetes Mellitus after Gastrectomy in Non-morbidly Obese Patients with Gastric Cancer: the Legitimacy of Onco-metabolic Surgery

이태훈; 이창민; 박성수; 정도현; 장유진; 김종한; 박성흠; 목영재

doi:https://doi.org/10.5230/jgc.2017.17.e34

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자료유형: 학술저널

저자정보: 이태훈 (고려대학교) 이창민 (고려대학교) 박성수 (고려대학교) 정도현 (고려대학교) 장유진 (고려대학교) 김종한 (고려대학교) 박성흠 (고려대학교) 목영재 (고려대학교)

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제17권 제4호

발행연도: 2017.12

수록면: 283 - 294 (12page)

DOI: https://doi.org/10.5230/jgc.2017.17.e34

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연구배경

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연구방법

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Purpose: This study primarily aimed to investigate the short- and long-term remission rates of type 2 diabetes (T2D) in patients who underwent surgical treatment for gastric cancer, especially patients who were non-obese, and secondarily to determine the potential factors associated with remission. Materials and Methods: We retrospectively reviewed the clinical records of patients with T2D who underwent radical gastrectomy for gastric cancer, from January 2008 to December 2012. Results: T2D improved in 39 out of 70 (55.7%) patients at the postoperative 2-year follow-up and 21 of 42 (50.0%) at the 5-year follow-up. In the 2-year data analysis, preoperative body mass index (BMI) (P=0.043), glycated hemoglobin (A1C) level (P=0.039), number of anti-diabetic medications at baseline (P=0.040), reconstruction method (statistical difference was noted between Roux-en-Y reconstruction and Billroth I; P=0.035) were significantly related to the improvement in glycemic control. Unlike the results at 2 years, the 5-year data analysis revealed that only preoperative BMI (P=0.043) and A1C level (P=0.039) were statistically significant for the improvement in glycemic control; however, the reconstruction method was not. Conclusions: All types of gastric cancer surgery can be effective in short- and long-term T2D control in non-obese patients. In addition, unless long-limb bypass is considered in gastric cancer surgery, the long-term glycemic control is not expected to be different between the reconstruction methods.

#Type 2 diabetes mellitus #Stomach neoplasms #Surgery #Reconstruction method #Glycemic index #Control

참고문헌 (8)

참고문헌 신청

Fong DS / 2004 / Retinopathy in diabetes / Diabetes Care 27(Suppl 1):S84~S87

이창민 / 2017 / 고도 비만의 외과적 치료 / Korean Journal of Helicobacter Upper Gastrointestinal Research 17(2):72~78

Chang Min Lee / 2016 / A comparison between two methods for tumor localization during totally laparoscopic distal gastrectomy in patients with gastric cancer / 대한외과학회지 91(3):112~117

조영민 / 2014 / A Gut Feeling to Cure Diabetes: Potential Mechanisms of Diabetes Remission after Bariatric Surgery / Diabetes and Metabolism Journal 38(6):406~415

김지원 / 2015 / The effect of long Roux-en-Y gastrojejunostomy in gastric cancer patients with type 2 diabetes and body mass index < 35 kg/m2: preliminary results / 대한외과학회지 88(4):215~221

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