Type 2 Diabetes Mellitus, Obesity
Conditions
Interventions
The patient will undergo general anesthesia. Prophylactic antibiotic therapy. The procedures will be performed by laparoscopy and / or laparotomy.
The GVII surgery consists of the following steps:
Pre
cavity inventory
ligation of the gastroepiploic arcade and short gastric vessels section of the stomach vertically to make the gastric reservoir of approximately 100-150 ml
section of the first duodenal portion 2 cm distal from the pylorus
section of the splanchnic nerves bilaterally with denervation along the hepatic artery and portal vein
section of the ileum at 30 cm and 200 cm from the ileocecal valve
an ileal-ileal anastomosis 30 cm from the ileocecal valve
anastomosis of the ileal segment transposed proximally with the proximal duodenal segment
anastomosis of the ileal segment transposed distally 50 cm from the Treitz angle
synthesis of the holes of the mesentery (under the entero-enteroanastomoses)
Hepatic biopsy with needle.
review of surgery and synthesis of aponeurosis and skin.
Procedure/surgery
E04.210.419
Sponsors
Hospital Federal de Bonsucesso
Hospital Federal de Bonsucesso
Eligibility
Age
20 Years to 65 Years
Inclusion criteria
Inclusion criteria: Documented diagnosis of type 2 diabetes mellitus; Patients of both sexes treated with oral antidiabetic agents and / or insulins; Stable antidiabetic medication in the last 8 weeks prior to selection, if the therapy includes insulin, the mean daily dose should not have been changed by more than 10% in the last 8 weeks; HbA1c> 7.0%; Age> 20 years and <65 years;Body mass index (BMI) of 25 to 35 kg / m²; Agree to sign the TCLE;
Exclusion criteria
Exclusion criteria: Diabetes mellitus type 1 (anti-GAD positive) or anti-GAD negative body with low ?-cell function (peptide C after stimulation <0.5 ng / ml); Recent vascular event (myocardial infarction, coronary angioplasty or encephalic vascular accident in the last 6 months); Malignant neoplasm; Portal hypertension; Difficulty to cooperate with segment; Low ability to understand surgery; Unrealistic expectations of results; Cognitive deficit; Current pregnancy; Moderate or severe mood disorder; severe anxiety; eating disorders (based on DSM-V criteria); Chemical dependence or alcoholism (based on DSM-V criteria).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To evaluate the remission rate of DM2 characterized by serum glycosylated hemoglobin (A1C) less than 6.0%, without the use of anti-diabetic drugs. To evaluate the control of DM2: HbA1c lower than 6.5% but still in use of oral antidiabetic and / or insulin. | — |
Secondary
| Measure | Time frame |
|---|---|
| To evaluate quality of life of patients before and after GVII.;To evaluate the complications of the surgical treatment.;To evaluate the evolution of other comorbidities such as hypercholesterolemia, hypertriglyceridemia, hepatic steatosis and arterial hypertensio | — |
Countries
Brazil
Contacts
Public ContactLeonardo Ferraz
Hospital Federal de Bonsucesso
Outcome results
None listed