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133. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

26.04. - 29.04.2016, Berlin

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OPTIMIZE: Mentoring in bariatric surgery and type II diabetes remission

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  • Katharina Grupp - UKE, Allgemein-, Viszeral- und Thoraxchirurgie, Hamburg, Deutschland
  • Anna Dupree - UKE, Allgemein-, Viszeral- und Thoraxchirurgie, Hamburg, Deutschland
  • Stefan Wolter - UKE, Allgemein-, Viszeral- und Thoraxchirurgie, Hamburg, Deutschland
  • Philipp Busch - UKE, Allgemein-, Viszeral- und Thoraxchirurgie, Hamburg, Deutschland
  • Silke Müller - Schwarzwald-Baar klinikum, Allgemein- und Viszeralchirurgie, Villingen-Schwenningen, Deutschland
  • Johannes Heimbucher - Marienkrankenhaus Kassel, Allgemein- und Viszeralchirurgie, Kassel, Deutschland
  • Alexander Tarek El Gammal - UKE, Allgemein-, Viszeral- und Thoraxchirurgie, Hamburg, Deutschland
  • Jameel Tariq Miro - UKE, Allgemein-, Viszeral- und Thoraxchirurgie, Hamburg, Deutschland
  • Oliver Mann - UKE, Allgemein-, Viszeral- und Thoraxchirurgie, Hamburg, Deutschland

Deutsche Gesellschaft für Chirurgie. 133. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 26.-29.04.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc16dgch392

doi: 10.3205/16dgch392, urn:nbn:de:0183-16dgch3922

Published: April 21, 2016

© 2016 Grupp et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Background: Effective mentoring is critical in the training of surgeons, especially in morbidly obese patients. In this prospective observational study, the effect of bariatric surgery on type 2 diabetes was analysed. Thereby, results were compared between experienced centers and inexperienced centers mentored by high volume centers.

Materials and methods: In this study, 137 obese subjects who underwent laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGBP) in inexperienced centers mentored by high volume centers were matched with 186 of those who were surgically treated in experienced centers. The matching procedure created four groups which were very similar. At baseline, the mean baseline body-mass index was 46.9 +/- 5.2 Kg/m2 and type II diabetes was prevalent in 32.3% of patients. Remission of type 2 diabetes was a pre-specified secondary end point of the trial and was assessed at one year.

Results: At 12 months, the mean BMI reduction of patients in the inexperienced center group was 15 +/- 4.4 Kg/m2 after LSG and 14.7 +/- 5.4 Kg/m2 after RYGBP, and in the experienced center group 14.5 +/- 4 Kg/m2 after LSG and 14.4 +/- 3.2 Kg/m2 after RYGBP (LSG: P = 0.7402; RYGBP: P = 0.8399). Among individuals with diabetes at baseline, type II diabetes remitted in a total of 46.7% and 57.6% of the patients who underwent LSG and RYGBP in mentored low volume centers as compared with 57.6% and 21.1% of those who underwent surgery in high volume centers (LSG: P = 0.0132 and RYGBP: P = 0.4721). Additionally, were no significant differences of discontinuation rates of oral diabetic and insulin if patients underwent surgery in inexperienced or experienced centers (oral medication: LSG: 64% vs 62.5% (P = 0.2377) and RYGBP: 71.4% vs 81.8% (P = 0.8074); insulin: LSG: 50% vs 44.4% (P = 0.9599) and RYGBP: 77.8% vs 41.7% (P = 0.1283)).

Conclusion: The results of our study demonstrate that a professional mentoring program is a useful tool in terms of accelerating the development of bariatric centers without compromising quality of outcome.

Table 1 [Tab. 1], Figure 1 [Fig. 1]