Surgical Treatment of Obesity Diabetes: A Much Safer Option To Go For!

According to a new research from the Cleveland Clinic Bariatric and Metabolic Institute, Laparoscopic gastric bypass surgery for the Type 2 diabetes patients, once considered a high-risk procedure, carries a complication and mortality rate similar to some of the safest and most commonly performed surgeries in America, including gallbladder surgery, appendectomy, and total knee replacement.

The recent study named, “How Safe is Metabolic/Diabetes Surgery?” was presented at the 31st ASMBS (Annual Meeting of the American Society for Metabolic and Bariatric Surgery) during ObesityWeek 2014, the largest international event focused on the basic science, clinical application and prevention and treatment of obesity. ObesityWeek 2014 is hosted by the ASMBS and TOS (The Obesity Society).

The metabolic surgery, particularly gastric bypass involves 30-day complication rate, was 3.4% about the same rate as gallbladder surgery (Laparoscopic Holecystectomy) and hysterectomy. Hospital stays and readmission rates were similar to laparoscopic appendectomy. The month-long mortality rate for metabolic or diabetes surgery was 0.30%, about that of total knee replacement, and about 1/10^th the risk of death after cardiovascular surgery. As compared to laparoscopic colon resections, gastric bypass patients had considerably better short-term outcomes in all examined variables.

Ali Aminian, MD, Clinical Scholar of Advanced Metabolic and Diabetes Surgery at Cleveland Clinic and co-author of the study said, “The perception regarding gastric bypass that it’s a very risky operation, but the reality is, it is as safe, if not safer, than many of the most commonly performed surgeries in America. The risk-to-benefit ratio of gastric bypass for diabetes and obesity is very favorable. There’s a significant weight loss, diabetes improvement or remission, and a relatively low complication and mortality rate. Moreover, earlier intervention with metabolic surgery may eliminate the need for some later higher-risk procedures to treat cardiovascular complications of diabetes.”

During the study, the researchers reviewed a national database of 66,678 patients with diabetes who had various surgical procedures including laparoscopic gallbladder surgery, appendectomy, partial colon resections, hysterectomy, heart surgery and total knee replacement between 2007 and 2012. The complication and mortality rates of these procedures were compared to those of the 16,509 patients in the group who had laparoscopic gastric bypass.

Moreover, the doctors found that the patients with Type 2 diabetes could have a nearly immediate effect of gastric bypass procedures – in a matter of hours or days, long before weight loss occurs. The doctors further told, at times patients left the hospital without medications. The New England Journal of Medicine published another Cleveland Clinic study this year stating, “diabetes remission rates three years after bariatric surgery were 35%, compared to zero for patients treated with pharmacotherapy.”

Gastric bypass surgery reduces the size of the stomach and allows food to bypass part of the small intestine, reducing the amount of food patients can eat at one time and limiting the absorption of food.

John M. Morton, Chief, Bariatric and Minimally Invasive Surgery, Stanford University School of Medicine, who was not involved in the study said, “This study demonstrates that surgical treatment of obesity and diabetes is as safe as other commonly performed surgical procedures. This study, along with many others, can help patients with diabetes and their doctors make better informed and realistic decisions about the potential risks and clear benefits of metabolic surgery. Metabolic surgery is a safe and effective treatment, and the data shows, it’s only getting safer.”