To explore the application value of different approaches of laparoscopic sleeve gastrectomy ( LSG ) in the treatment of obesity patients with type 2 diabetes mellitus ( T2DM ).

The data of 158 obese patients with T2 DM who underwent LSG from January 2021 to January 2023 were retrospectively analyzed. They were divided into two groups according to different surgical approaches, with 79 cases in each group. The observation group was treated with bikini line incision approach, and the control group was treated with routine incision. SPSS 22.0 statistical software package was used for data analysis. Measurement data such as perioperative related indicators, inflammatory stress indicators[ norepinephrine ( NE ), cortisol ( COR ), C-reactive protein ( CRP ), interleukin ( IL-6 ) ], glucose and lipid metabolism indicators[ fasting blood glucose ( FPG ), glycosylated hemoglobin ( HbA1c ), triglyceride ( TG ), total cholesterol ( TC ) ], body mass index ( BMI ) and incision aesthetic satisfaction ( CS ) scores were expressed as (), and independent t test. The number of additional holes and complications of the count data were expressed as a percentage, and the χ² test was used. P < 0.05 indicated that the difference was statistically significant. P < 0.05 indicated that the difference was statistically significant. The baseline data of the two groups were collected. The operation and postoperative recovery indexes, inflammatory stress indexes , glucose and lipid metabolism indexes, body mass index ( BMI ) before and after surgery and cosmetic score ( CS ) , complications were observed.

The number of additional holes in the observation group was less than that in the control group, and the postoperative exhaust time and hospitalization days were shorter than those in the control group ( P < 0.05 ). The levels of serum COR, NE, CRP and IL-6 in the observation group were lower than those in the control group at 1 d and 3 d after operation ( P < 0.05 ). There was no significant difference in FPG, HbAlc, TG, TC and BMI between the two groups at 1 month and 3 months after operation ( P > 0.05 ). The CS score of the observation group was higher than that of the control group at 3 months after operation ( P < 0.05 ). There was no significant difference in the total incidence of complications between the two groups ( P > 0.05 ).

Both the bikini line incision approach and the conventional incision approach for LSG are safe and effective treatments for obesity with T2DM, which can promote glucose and lipid metabolism and reduce the weight of patients. However, the former can reduce tissue damage and promote early postoperative recovery, and the incision is more beautiful.