Diabetic Neuropathy Improves After Laparoscopic Diverted Sleeve Gastrectomy With Ileal Interposition: A Single Arm Electrophysiological Follow-Up Study
Eylem Cagiltay1, Alper Celik2, Nurten Adatepe Uzun3, Ali Riza Sonkaya4, Surendra Ugale5, Turgut Adatepe6, Mustafa Ertas71Department of Endocrinology, Sultan Abdulhamid Han Education and Research Hospital , Istanbul, Turkey, 2Department of General Surgery, Metabolic Surgery Clinic, Istanbul, Turkey and Department of Electroneurophysiology, Beykent University, 3Department of Neurology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey, 4Department of Neurology, Okmeydanı Education and Research Hospital, Istanbul, Turkey, 5Kirloskar Hospital, Bariatric & Metabolic Surgery Clinic, Hyderabad, India, 6Electromyography Laboratory, Istanbul Education and Training Hospital, Istanbul, Turkey, 7Consultant Neurologist at Private Office, Istanbul, Turkey
Objectives: The aim of the present study was to analyze the effect of laparoscopic diverted sleeve gastrectomy with ileal transposition (DSIT) surgery on diabetic neuropathy (DN) in patients with type 2 diabetes mellitus (T2DM). Methods: This cross sectional, non-blinded, prospective, pilot study included 55 diabetic non-responders, who fail to achieve adequate glycemic control despite appropriate medical treatment. Electrophysiological tests including motor and sensory nerve conduction studies (NCS), sympathetic skin response (SSR) and R-R interval analysis of patients scheduled for metabolic surgical treatments were performed pre- and postoperatively. The differences in metabolic and electrophysiological parameters were also analyzed. Results: Preoperative NCS evaluation revealed presence of polyneuropathy in 27 (49%) individuals; however, postoperative NCS values showed decreased distal conduction time in 61%, increased response amplitudes in 40% and increased conduction velocity in 57% of patients for motor nerves. As for sensory nerves, decreased distal conduction time was found in 55% and increased response amplitudes were detected in 57% of patients. In addition, significant improvements were observed in the of SSR and R-R interval analysis postoperatively. Conclusion: Beyond the improvements in metabolic parameters and BMI in our diabetic patients who underwent DSIT, we also observed improved NCS results. Keywords: Bariatric surgery, diabetic neuropathies, electrophysiological processes, neural conduction
Cite This Article
Cagiltay E, Celik A, Adatepe Uzun N, Sonkaya A, Ugale S, Adatepe T, Ertas M. Diabetic Neuropathy Improves After Laparoscopic Diverted Sleeve Gastrectomy With Ileal Interposition: A Single Arm Electrophysiological Follow-Up Study. EJMI. 2019; 3(2): 103-110
Corresponding Author: Eylem Cagiltay