title: Clinical significance of the laparoscopic bariatric surgeries for morbid obesity: initial 30 cases at a single institution in Japan.
abstract: BACKGROUND
  Bariatric surgical procedures are becoming a standard treatment for morbid obesity in many western countries and in some Asian countries.
  
  
  OBJECTIVE
  The aim of the current study was to evaluate the efficacy and safety of the initial 30 cases of bariatric surgical procedures performed for morbid obesity at a single institution in Japan.
  
  
  METHODS
  From March 2012 until September 2014, 30 bariatric surgical procedures were performed for morbid obesity at a single medical center (Kyushu University Hospital) in Japan.
  
  
  RESULTS
  All of the operations procedures were planned laparoscopic procedures, and none required conversion to laparotomy. There were no perioperative or postoperative mortalities. Postoperative complications occurred in 3 patients: 1 patient developed an intra-abdominal abscess, 1 patient experienced temporary food intolerance, and 1 patient developed small bowel obstruction. The excessive body weight reduction rates after surgery at 1 month, 3 months, 6 months, and 1 year post-surgery were 26.1%, 39.2%, 41.7%, and 51.2%, respectively. The mean body mass index (BMI) at the same time points were 38.3%, 36.4%, 35.5%, and 31.4%, respectively. Eighteen patients had type II diabetes mellitus (T2DM). The mean preoperative fasting blood glucose levels were 169 ± 37 mg/dL. Following surgery, the blood glucose levels at 3, 6 and 12 months were 113 ± 12, 115 ± 22, and 110 ± 19, mg/dL, respectively. The preoperative HbA1c percentage was 7.9 ± 0.5. Following surgery, the HbA1c percentages at 3, 6, and 12 months were 6.9 ± 0.5, 6.2 ± 0.9, and 5.9 ± 0.6, respectively.
  
  
  CONCLUSIONS
  Bariatric surgical procedures are effective and safe for the treatment of morbid obesity. Our results indicate that the mechanism of improvement of diabetes and related diseases following bariatric surgical procedures is not simply as a result of calorie restriction and weight reduction.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ikeda
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Akahoshi
authors.forename: Morimasa
authors.initials: M
authors.lastname: Tomikawa
authors.forename: Ryouta
authors.initials: R
authors.lastname: Souzaki
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Nomura
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Sonoda
authors.forename: Rinko
authors.initials: R
authors.lastname: Nakayama
authors.forename: Chihiro
authors.initials: C
authors.lastname: Morita
authors.forename: Sadako
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Kenkichi
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
authors.forename: Makoto
authors.initials: M
authors.lastname: Hashizume
mesh_terms: D050110:Bariatric Surgery / Q000009:adverse effects / Q000379:methods; D001786:Blood Glucose / Q000032:analysis; D005215:Fasting; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human