ANZ journal of surgery · 2026
Public Metabolic Bariatric Surgery in Adults With Obesity and Diabetes: 2-Year Safety, Weight and Diabetes Outcomes.
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Abou-Sleiman Rayana, Chan Daniel, Chan Kevin, Dodd Benjamin, Hopkins George, Finch Robert, Mitchell David
Аннотация
BACKGROUND: Metabolic bariatric surgery (MBS) is a safe and effective treatment for severe obesity and type 2 diabetes. However, access to MBS in Australia, remains largely confined to the private healthcare sector. We examined 2-year safety and efficacy outcomes of MBS performed in adults affected by obesity and diabetes, within a high-volume, public hospital in Queensland, Australia.
METHODS: A retrospective review of a prospectively collated database encompassing all patients who underwent MBS at the Royal Brisbane and Women's Hospital's Statewide Bariatric Service between 5 December 2017 and 31 December 2021 was performed. Eligibility for MBS required a BMI ≥ 35 kg/m2 and diagnosis of type 2 diabetes. Patient demographics, 90-day postoperative complications, and 1- and 2-year weight and diabetes outcomes were collated.
RESULTS: A total of 226 patients (61.5% female; mean age 52.5 (SD: 9.2) years; mean BMI 46.0 (6.9) kg/m2) underwent MBS. Preoperatively, mean HbA1c was 9.0 (1.5) % and 65% of patients required insulin. Procedures included Roux-en-Y gastric bypass (78.8%), sleeve gastrectomy (15.7%) and one-anastomosis gastric bypass (5.3%). All patients were followed up to 1 year, and 219 patients (96.9%) were followed up to 2 years. Median length of stay was 2 days (range: 2-18). Seven patients (3.1%) developed a clinically significant postoperative complication within 90 days. There was no mortality. Mean percentage total body weight loss was 29.6 (8.2) % and 31 (11.4) % at 1 and 2 years. 120 patients (54.8%) achieved complete diabetes remission at 2 years.
CONCLUSION: Public MBS is safe and effective, producing significant and sustained weight loss and improvements in diabetes at 2 years.
METHODS: A retrospective review of a prospectively collated database encompassing all patients who underwent MBS at the Royal Brisbane and Women's Hospital's Statewide Bariatric Service between 5 December 2017 and 31 December 2021 was performed. Eligibility for MBS required a BMI ≥ 35 kg/m2 and diagnosis of type 2 diabetes. Patient demographics, 90-day postoperative complications, and 1- and 2-year weight and diabetes outcomes were collated.
RESULTS: A total of 226 patients (61.5% female; mean age 52.5 (SD: 9.2) years; mean BMI 46.0 (6.9) kg/m2) underwent MBS. Preoperatively, mean HbA1c was 9.0 (1.5) % and 65% of patients required insulin. Procedures included Roux-en-Y gastric bypass (78.8%), sleeve gastrectomy (15.7%) and one-anastomosis gastric bypass (5.3%). All patients were followed up to 1 year, and 219 patients (96.9%) were followed up to 2 years. Median length of stay was 2 days (range: 2-18). Seven patients (3.1%) developed a clinically significant postoperative complication within 90 days. There was no mortality. Mean percentage total body weight loss was 29.6 (8.2) % and 31 (11.4) % at 1 and 2 years. 120 patients (54.8%) achieved complete diabetes remission at 2 years.
CONCLUSION: Public MBS is safe and effective, producing significant and sustained weight loss and improvements in diabetes at 2 years.