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Shin TH, Medhati P, Dang J, Wasden K, Sheu EG, Tavakkoli A. From Bands to Bypasses: Navigating Safety of Band Conversions to Roux-en-Y Gastric Bypass and Single Anastomosis Duodenoileostomy Versus Sleeve Gastrectomy. Obes Surg 2024; 34:2627-2633. [PMID: 38837020 DOI: 10.1007/s11695-024-07340-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 05/24/2024] [Accepted: 05/29/2024] [Indexed: 06/06/2024]
Abstract
INTRODUCTION Revisional bariatric surgery is associated with higher perioperative complications over primary procedures. Adjustable gastric bands (AGB) continue to be the most frequently converted bariatric configuration. This study examines trends in current clinical indication and safety profile of the most frequently pursued AGB conversions. MATERIALS AND METHODS MBSAQIP data from 2020 to 2022 was retrospectively analyzed in a cohort study examining 30-day postoperative outcomes after AGB conversion to sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), or single anastomosis duodenoileostomy (SADI). Descriptive statistics were used, including multivariable and 2:1 nearest neighbor matching analysis. RESULTS This study included 19,335 AGB conversions, of which most were to SG (n = 11,736) followed by RYGB (n = 7442) and SADI (n = 157). While a majority were completed for weight loss, there were differences in distribution of primary indication for each conversion cohort, such as higher proportion of RYGB conversion for gastroesophageal reflux disease (18.7%) compared to SG (7.92%) and SADI (5.10%). Multivariable analysis demonstrates conversion to RYGB has significantly higher odds of 30-day major complications (OR 1.75, p < 0.001), reoperation (OR 2.08; p = 0.001), readmission (OR 1.69; p = 0.001), and emergency department visits (OR 1.50; p = 0.001) over SG. These risks and odds of reintervention (OR 1.75; p < 0.001) remained significantly higher after conversion to RYGB versus SG on matched analysis. None of these risks is significantly different between conversions to SADI versus SG in either multivariable or matched analysis. CONCLUSIONS Compared to AGB conversion to SG, single-stage conversion to RYGB had increased odds of perioperative complications while risks of conversion to SADI were not significantly different.
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Affiliation(s)
- Thomas H Shin
- Laboratory for Surgical and Metabolic Research, Division of General and Gastrointestinal Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
| | - Pourya Medhati
- Laboratory for Surgical and Metabolic Research, Division of General and Gastrointestinal Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Jerry Dang
- Digestive Diseases Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Katherine Wasden
- Laboratory for Surgical and Metabolic Research, Division of General and Gastrointestinal Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Eric G Sheu
- Laboratory for Surgical and Metabolic Research, Division of General and Gastrointestinal Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Ali Tavakkoli
- Laboratory for Surgical and Metabolic Research, Division of General and Gastrointestinal Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
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Marincola G, Velluti V, Voloudakis N, Gallucci P, Ciccoritti L, Greco F, Sessa L, Salvi G, Iaconelli A, Aquilanti B, Guidone C, Capristo E, Mingrone G, Pennestrì F, Raffaelli M. Medium-Term Nutritional and Metabolic Outcome of Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S). Nutrients 2023; 15:nu15030742. [PMID: 36771446 PMCID: PMC9921544 DOI: 10.3390/nu15030742] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/23/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy (SADI-S), like other hypoabsorptive procedures, could be burdened by long-term nutritional deficiencies such as malnutrition, anemia, hypocalcemia, and hyperparathyroidism. OBJECTIVES We aimed to report our experience in terms of mid-term (2 years) bariatric, nutritional, and metabolic results in patients who underwent SADI-S both as a primary or revisional procedure. METHODS One hundred twenty-one patients were scheduled for SADI-S as a primary or revisional procedure from July 2016 to February 2020 and completed at least 2 years of follow-up. Demographic features, bariatric, nutritional, and metabolic results were analyzed during a stepped follow-up at 3 months, 6 months, 1 year and 2 years. RESULTS Sixty-six patients (47 female and 19 male) were included. The median preoperative BMI was 53 (48-58) kg/m2. Comorbidities were reported in 48 (72.7%) patients. At 2 years, patients had a median BMI of 27 (27-31) kg/m2 (p < 0.001) with a median %EWL of 85.3% (72.1-96.1), a TWL of 75 (49-100) kg, and a %TWL of 50.9% (40.7-56.9). The complete remission rate was 87.5% for type 2 diabetes mellitus, 83.3% for obstructive sleep apnea syndrome and 64.5% for hypertension. The main nutritional deficiencies post SADI-S were vitamin D (31.82%) and folic acid deficiencies (9.09%). CONCLUSION SADI-S could be considered as an efficient and safe procedure with regard to nutritional status, at least in mid-term (2 years) results. It represents a promising bariatric procedure because of the excellent metabolic and bariatric outcomes with acceptable nutritional deficiency rates. Nevertheless, larger studies with longer follow-ups are necessary to draw definitive conclusions.
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Affiliation(s)
- Giuseppe Marincola
- U.O.C. Chirurgia Endocrina e Metabolica, Centro Dipartimentale di Chirurgia Endocrina e dell’Obesità, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
| | - Valeria Velluti
- U.O.S.D. Medicina Bariatrica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Nikolaos Voloudakis
- U.O.C. Chirurgia Endocrina e Metabolica, Centro Dipartimentale di Chirurgia Endocrina e dell’Obesità, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
- Centro di Ricerca in Chirurgia delle Ghiandole Endocrine e dell’Obesità, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Pierpaolo Gallucci
- U.O.C. Chirurgia Endocrina e Metabolica, Centro Dipartimentale di Chirurgia Endocrina e dell’Obesità, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
| | - Luigi Ciccoritti
- U.O.C. Chirurgia Endocrina e Metabolica, Centro Dipartimentale di Chirurgia Endocrina e dell’Obesità, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
| | - Francesco Greco
- U.O.C. Chirurgia Endocrina e Metabolica, Centro Dipartimentale di Chirurgia Endocrina e dell’Obesità, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
| | - Luca Sessa
- Centro di Ricerca in Chirurgia delle Ghiandole Endocrine e dell’Obesità, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
- Centro Malattie Endocrine e Obesità, Fondazione Gemelli Giglio Cefalù, 90015 Cefalù, Italy
| | - Giulia Salvi
- U.O.C. Chirurgia Endocrina e Metabolica, Centro Dipartimentale di Chirurgia Endocrina e dell’Obesità, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
- Centro di Ricerca in Chirurgia delle Ghiandole Endocrine e dell’Obesità, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Amerigo Iaconelli
- U.O.S.D. Medicina Bariatrica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
| | - Barbara Aquilanti
- U.O.S.D. Medicina Bariatrica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
| | - Caterina Guidone
- U.O.C. Patologie dell’Obesità, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
| | - Esmeralda Capristo
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
- U.O.C. Patologie dell’Obesità, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
| | - Geltrude Mingrone
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
- U.O.C. Patologie dell’Obesità, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
| | - Francesco Pennestrì
- U.O.C. Chirurgia Endocrina e Metabolica, Centro Dipartimentale di Chirurgia Endocrina e dell’Obesità, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
- Centro di Ricerca in Chirurgia delle Ghiandole Endocrine e dell’Obesità, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
- Correspondence: ; Tel.: +39-06-30154199; Fax: +39-06-30156086
| | - Marco Raffaelli
- U.O.C. Chirurgia Endocrina e Metabolica, Centro Dipartimentale di Chirurgia Endocrina e dell’Obesità, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
- Centro di Ricerca in Chirurgia delle Ghiandole Endocrine e dell’Obesità, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
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Duodenal Switch Conversion in Non-responders or Weight Recurrence Patients. Obes Surg 2022; 32:3984-3991. [PMID: 36209345 DOI: 10.1007/s11695-022-06297-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/23/2022] [Accepted: 09/28/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Several modalities have been proposed to tackle insufficient weight loss and weight regain after bariatric surgery; we aimed to evaluate efficacy and safety of duodenal switch conversion as a salvage procedure. MATERIAL AND METHODS Data from patients who underwent duodenal switch conversions (n = 50) were retrospectively studied. Excess weight loss % and total body weight loss % were compared between primary procedure and duodenal switch conversion. Overall complication, emergency department visits, readmissions, reoperation, and mortality rates were described, analyzed, and compared to the current literature. RESULTS Every excess weight loss % and total body weight loss % comparison at 6, 12, and 24 months, demonstrated a statistically significant superiority in weight loss after duodenal switch conversion (p < 0.05). The mean operative time of adjustable gastric band, sleeve gastrectomy, Roux-en-Y gastric bypass (1 and 2 stages) conversions to duodenal switch were 208, 146, 187, and 152 min, respectively, while the mean length of stay was 3.38 days. No statistically significant differences were perceived regarding the primary procedure. The overall complication rate was 18% (9 patients); 3 patients (6%) had 1 emergency department visit; readmissions accounted for 12% of cases (6 patients); the reoperation rate was 10% (5 patients); no fatal outcomes were recorded. CONCLUSION Duodenal switch conversions are an effective salvage procedure for insufficient weight loss and/or weight regain after adjustable gastric band, sleeve gastrectomy, and Roux-en-Y gastric bypass; it is also safe, associated to low readmission, reoperation, and mortality rates.
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A C, N C, A I. Postoperative morbidity and weight loss after revisional bariatric surgery for primary failed restrictive procedure: A systematic review and network meta-analysis. Int J Surg 2022; 102:106677. [PMID: 35589051 DOI: 10.1016/j.ijsu.2022.106677] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 04/29/2022] [Accepted: 05/03/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND revisional bariatric surgery is gaining increasing interest as long term follow-up studies demonstrate an elevated failure rate of primary surgery due to insufficient weight loss, weight regain or complications. This particularly concerns restrictive bariatric surgery which has been widely adopted from the '80s till present through different procedures, notably vertical banded gastroplasty, laparoscopic adjusted gastric banding and sleeve gastrectomy. The aim of this study is to define which revisional bariatric procedure performs the best after failure of primary restrictive surgery. METHODS a systematic review and network meta-analysis of 39 studies was conducted following the PRISMA guidelines and the Cochrane protocol. RESULTS biliopancreatic diversion with duodenal switch guarantees the best results in terms of weight loss (1 and 3-years %TWL MD: 12.38 and 28.42) followed by single-anastomosis duodenoileal bypass (9.24 and 19.13), one-anastomosis gastric bypass (7.16 and 13.1), and Roux-en-Y gastric bypass (4.68 and 7.3) compared to re-sleeve gastrectomy. Duodenal switch and Roux-en-Y gastric bypass are associated to an increased risk of late major morbidity (OR: 3.07 and 2.11 respectively) compared to re-sleeve gastrectomy while no significant difference was highlighted for the other procedures. Re-sleeve gastrectomy is the revisional intervention most frequently burdened by weight recidivism; compared to it, patients undergoing single-anastomosis duodenoileal bypass have the lowest risk of weight regain (OR: 0.07). CONCLUSION considering the analyzed outcomes altogether, single-anastomosis duodenoileal bypass and one-anastomosis gastric bypass are the most performing revisional procedures after failure of restrictive surgery due to satisfying short and mid-term weight loss and low early and late morbidity. Moreover, single-anastomosis duodenoileal bypass has low risk of weight recidivism.
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Affiliation(s)
- Chierici A
- Service de Chirurgie Digestive, Centre Hospitalier D'Antibes Juan-les-Pins, 107, av. de Nice, 06600, Antibes, France
| | - Chevalier N
- Inserm U1065, C3M, Nice, France; Université Côte D'Azur, Nice, France; Service D'Endocrinologie, Diabétologie et Médecine de la Reproduction, Archet 2 Hospital, Nice, France
| | - Iannelli A
- Université Côte D'Azur, Nice, France; Centre Hospitalier Universitaire de Nice - Digestive Surgery and Liver Transplantation Unit, Archet 2 Hospital, Nice, France; Inserm, U1065, Team 8 "Hepatic complications of Obesity and alcohol", France.
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5
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Sang Q, Wang L, Wuyun Q, Zheng X, Wang D, Zhang N, Du D. Retrospective Comparison of SADI-S Versus RYGB in Chinese with Diabetes and BMI< 35kg/m 2: a Propensity Score Adjustment Analysis. Obes Surg 2021; 31:5166-5175. [PMID: 34591261 DOI: 10.1007/s11695-021-05708-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND As a modification of the duodenal switch (DS), single-anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) has recently become very popular and is successful for weight loss and T2DM remission. However, current studies have been mostly aimed at patients with severe obesity. OBJECTIVES In this study, we firstly compare primary SADI-S to the Roux-en-Y gastric bypass (RYGB) in Chinese with diabetes and BMI< 35 kg/m2. METHODS Using a propensity score (PS) matching analysis, we analyzed all patients with diabetes and BMI< 35 kg/m2 who underwent primary SADI-S or RYGB. All surgeries were conducted by a single surgeon at a Chinese center from June 2017 to January 2019. RESULTS Twenty-six patients who underwent SADI-S and 65 patients who underwent RYGB were included in our analysis. Of these, 26 (100%) of patients in the SADI-S group and 43 (66%) of patients in the RYGB group completed the 24-month follow-up. No severe perioperative complication was observed in either group. There was a statistically higher percentage of total weight loss with SADI-S at the 2-year follow-up when compared to RYGB (p = 0.017 after PS correction). After PS adjustment, 76.5% of patients in the SADI-S group and 82.4% of patients in the RYGB group achieved complete remission of T2DM (p = 1.000). Nutritional outcomes were similar in the two groups. CONCLUSION In Chinese with diabetes and BMI< 35 kg/m2, with comparable T2DM remission and nutritional outcomes, primary SADI-S allows for better weight loss than RYGB. Compared with RYGB, SADI-S is also a safe, effective, and feasible treatment for these patients.
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Affiliation(s)
- Qing Sang
- Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, 100038, China
| | - Liang Wang
- Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, 100038, China
| | - Qiqige Wuyun
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, China
| | - Xuejing Zheng
- Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, 100038, China
| | - Dezhong Wang
- Department of General Surgery, Aerospace Center Hospital, Beijing, 100049, China
| | - Nengwei Zhang
- Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, 100038, China.
| | - Dexiao Du
- Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, 100038, China.
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Vilallonga R, Nedelcu A, Cirera de Tudela A, Palermo M, Pérez-Aguirre E, Josa-Martínez BM, Armengol Carrasco M, Noel P, Torres A, Nedelcu M. Single Anastomosis Duodeno-ileal Bypass As a Revisional Procedure Following Sleeve Gastrectomy: Review of the Literature. J Laparoendosc Adv Surg Tech A 2021. [PMID: 34569824 DOI: 10.1089/lap.2021.0511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Laparoscopic sleeve gastrectomies (LSGs) can experience weight-loss failure and conversion to another bariatric procedure. An analysis of the bariatric literature concerning the single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) as revisional surgery after LSG in terms of safety and efficacy identified 607 studies. Fifty-nine studies were analyzed for full content review and 9 primary studies (398 patients) were included. Revisional single anastomosis duodeno-ileal bypass (SADI) was performed in 294 patients at a mean interval of 37.7 months (range 11-179). Total weight loss (%) varies from 20.5% to 46.2%. Early complications after surgery occurred in 4.1% surgeries including leak (7 cases -1.9%). Mortality was nil. SADI after LSG, after failed sleeve gastrectomy or as a sequential procedure, offers a satisfactory weight loss result. Both early and late term complications are acceptable.
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Affiliation(s)
- Ramon Vilallonga
- General Surgery Department and Universitat Autònoma de Barcelona, General Surgery and Advanced Laparoscopy Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Anamaria Nedelcu
- General Surgery Department, Clinique Saint-Michel, Toulon, France
| | - Arturo Cirera de Tudela
- Universitat Autònoma de Barcelona, Department of General and Digestive Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Mariano Palermo
- Department of Surgery, University of Buenos Aires, Centro CIEN-Diagnomed, Buenos Aires, Argentina
| | - Elia Pérez-Aguirre
- Department of Surgery, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, Hospital Clinico Universitario San Carlos, Madrid, Spain
| | - Benito Miguel Josa-Martínez
- Department of Surgery, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, Hospital Clinico Universitario San Carlos, Madrid, Spain
| | - Manuel Armengol Carrasco
- Universitat Autònoma de Barcelona, Department of General and Digestive Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Patrick Noel
- Department of Surgery, Centre Chirurgical de l'Obesite, Clinique Saint-Michel, Toulon, France
| | - Antonio Torres
- Department of Surgery, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, Hospital Clinico Universitario San Carlos, Madrid, Spain
| | - Marius Nedelcu
- Department of Surgery, Centre Chirurgical de l'Obesite, Clinique Saint-Michel, Toulon, France
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Spinos D, Skarentzos K, Esagian SM, Seymour KA, Economopoulos KP. The Effectiveness of Single-Anastomosis Duodenoileal Bypass with Sleeve Gastrectomy/One Anastomosis Duodenal Switch (SADI-S/OADS): an Updated Systematic Review. Obes Surg 2021; 31:1790-1800. [PMID: 33452998 DOI: 10.1007/s11695-020-05188-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/09/2020] [Accepted: 12/21/2020] [Indexed: 11/28/2022]
Abstract
Single-anastomosis duodenoileal bypass with sleeve gastrectomy/one anastomosis duodenal switch (SADI-S/OADS) was developed as a bariatric operation with reduced overall morbidity and lasting weight loss results. We performed a systematic review of the literature, including 14 studies reporting on weight loss, comorbidity resolution, postoperative complications, and nutritional deficiencies following SADI-S. Twelve months after SADI-S, the mean total body weight lost ranged from 21.5 to 41.2%, with no weight regain being observed after 24 months. The comorbidity resolution rate was 72.6% for diabetes, 77.2% for dyslipidemia, and 59.0% for hypertension cases. The need for reoperation was the most common postoperative complication. While several patients developed nutrient deficiencies, SADI-S seems to be an overall safe and effective bariatric operation.
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Affiliation(s)
- Dimitrios Spinos
- Derby Royal Hospital, University Hospitals of Derby and Burton NHS Trust, Derby, UK.,Surgery Working Group, Society of Junior Doctors, Athens, Greece
| | - Konstantinos Skarentzos
- Surgery Working Group, Society of Junior Doctors, Athens, Greece.,Department of Medicine, School of Health Sciences, Democritus University of Thrace, Alexandroupolis, Greece
| | - Stepan M Esagian
- Surgery Working Group, Society of Junior Doctors, Athens, Greece
| | - Keri A Seymour
- Department of Surgery, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, 27710, USA
| | - Konstantinos P Economopoulos
- Surgery Working Group, Society of Junior Doctors, Athens, Greece. .,Department of Surgery, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, 27710, USA.
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Brown WA, de Leon Ballesteros GP, Ooi G, Higa K, Himpens J, Torres A, Shikora S, Kow L, Herrera MF. Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy/One Anastomosis Duodenal Switch (SADI-S/OADS) IFSO Position Statement-Update 2020. Obes Surg 2021; 31:3-25. [PMID: 33409979 DOI: 10.1007/s11695-020-05134-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/12/2020] [Accepted: 11/23/2020] [Indexed: 12/11/2022]
Abstract
PreambleThe International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) has played an integral role in educating both the metabolic surgical and the medical communities at large about the role of innovative and new surgical and or endoscopic interventions in treating adiposity-based chronic diseases. The single anastomosis duodenal-ileal bypass with sleeve gastrectomy/one anastomosis duodenal switch (SADI-S/OADS) is a relatively new procedure that has been proposed as an alternative to the conventional duodenal switch (DS) procedure. The IFSO published a position paper on SADI-S/OADS in 2018 with which concluded that this procedure was likely to be a safe and efficacious treatment for adiposity and its related diseases. However, it noted that there was insufficient long-term data and minimal high-level evidence available. The position statement called for patients to be enrolled in long-term multidisciplinary care encouraged the registration of patients in national registries, and called for more randomized controlled trials (RCT) (Obes Surg 28:1207-16, 2018) involving the procedure. The following position statement is an update of the previous position statement. It is issued by the IFSO SADI-S/OADS task force and has been reviewed and approved by both the IFSO Scientific Committee and Executive Board. This statement is based on current clinical knowledge, expert opinion, and published peer-reviewed scientific evidence. It will be reviewed again in 2 years.
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Affiliation(s)
- Wendy A Brown
- International Federation for Surgery of Obesity and Metabolic Disorders, Rione Sirignano, 5, 80121, Naples, Italy.
| | | | - Geraldine Ooi
- International Federation for Surgery of Obesity and Metabolic Disorders, Rione Sirignano, 5, 80121, Naples, Italy
| | - Kelvin Higa
- International Federation for Surgery of Obesity and Metabolic Disorders, Rione Sirignano, 5, 80121, Naples, Italy
| | - Jacques Himpens
- International Federation for Surgery of Obesity and Metabolic Disorders, Rione Sirignano, 5, 80121, Naples, Italy
| | - Antonio Torres
- International Federation for Surgery of Obesity and Metabolic Disorders, Rione Sirignano, 5, 80121, Naples, Italy
| | - Scott Shikora
- International Federation for Surgery of Obesity and Metabolic Disorders, Rione Sirignano, 5, 80121, Naples, Italy
| | - Lilian Kow
- International Federation for Surgery of Obesity and Metabolic Disorders, Rione Sirignano, 5, 80121, Naples, Italy
| | - Miguel F Herrera
- International Federation for Surgery of Obesity and Metabolic Disorders, Rione Sirignano, 5, 80121, Naples, Italy
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