I was recently reading the American College of surgeons (ACS) monthly publication and stumbled upon an interesting article entitled “Laparoscopic Roux-en-Y gastric bypass (LRYGB) safe, preventative for diabetic patients.” Reading this article underlined the importance of educating both patients and physicians in our community on the value of bariatric surgery, especially the laparoscopic Roux-en-Y gastric bypass.
LRYGB in diabetic patients has comparable short-term morbidity and mortality with other surgical procedures and may circumvent the need for many of them, a National Surgical Quality Improvement Program (NSQIP) database analysis shows. This is tremendous for outpatient population because probably some county is a county in North Carolina most affected by obesity (75 percent of the population affected by obesity) and has a prevalence of 13 percent for type 2 diabetes and 36 percent for pre-diabetic condition.
Five randomized control trials have shown the remarkable effects of bariatric surgery on type 2 diabetes mellitus, including better glycemic control, cardiovascular risk factor modification, and the potential for long-term remission. The safety profile of metabolic diabetic surgery, however, has been a matter of concern among patients and physicians.
Dr. Davis of the bariatric and metabolic institute at the Cleveland Clinic used the American College of Surgeons’ NSQIP dataset to explore the short-term metabolic diabetes surgery outcomes. They identified 16,509 diabetic patients who underwent laparoscopic Roux-en-Y gastric bypass from January 2007 to December 2012 and compared them with patients undergoing seven other common surgical procedures.
The 30-day complication rate for laparoscopic Roux-en-Y gastric bypass was comparable with that of laparoscopic cholecystectomy (3.7 percent) and laparoscopic hysterectomy (3.7 percent). Complication rates were significantly higher, however, for CABG (46.6 percent), infra-inguinal bypass (23.6 percent), laparoscopic partial colectomy (12 percent), laparoscopic appendectomy (4.5 percent) and total knee arthroplasty (16.7 percent) according to Dr. Davis.
It should be our mission as health care providers to bring this information to our community, to encourage our patients affected by diabetes mellitus type 2 and/or obesity to learn more about this treatment option and slowly build up a healthier Robeson County.
By Eric Velazquez, MD, FACS, General, Laparoscopic, & Bariatric Surgeon, Medical Director of Bariatric Surgery Southeastern Regional Medical Center, Medical Director of Surgical Services Southeastern Physician Services, Assistant Professor of Surgery Campbell University