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Ponce de Leon-Ballesteros G, Romero-Velez G, Higa K, Himpens J, O' Kane M, Torres A, Prager G, Herrera MF. Single Anastomosis Duodeno-Ileostomy with Sleeve Gastrectomy/Single Anastomosis Duodenal Switch (SADI-S/SADS) IFSO Position Statement-Update 2023. Obes Surg 2024; 34:3639-3685. [PMID: 39264553 DOI: 10.1007/s11695-024-07490-0] [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: 06/25/2024] [Revised: 06/28/2024] [Accepted: 08/28/2024] [Indexed: 09/13/2024]
Abstract
The single anastomosis duodeno-ileostomy with sleeve gastrectomy/single anastomosis duodenal switch (SADI-S/SADS) has gained attention as an alternative to the traditional biliopancreatic diversion with duodenal switch (BPD-DS). In 2021, IFSO endorsed SADI-S/SADS as a safe and effective procedure, underscoring the necessity for long-term multidisciplinary care and randomized controlled trials (RCTs). A task force was established to conduct a systematic review of current evidence on SADI-S/SADS to guide clinical practice. A systematic review was conducted across three databases, focusing on studies examining SADI-S/SADS and its outcomes. A total of 93 studies were analyzed. SADI-S/SADS demonstrated efficacy in weight loss and medium-to-long-term control of type 2 diabetes mellitus (T2DM), along with positive outcomes regarding hypertension and hyperlipidemia. However, its impact on other comorbidities remains inconclusive. Frequent nutritional deficiencies were identified, particularly in fat-soluble vitamins, anemia, and hypoalbuminemia. Despite significant efforts, high-quality evidence on SADI-S/SADS remains scarce, prompting IFSO to advocate for increased registry participation, publication of long-term studies, and more RCTs. Lifelong supplementation and monitoring for nutritional deficiencies are recommended. The current position statement will be reviewed in 2 years.
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Affiliation(s)
| | - Gustavo Romero-Velez
- International Federation for Surgery of Obesity and Metabolic Disorders, Naples, Italy
| | - Kelvin Higa
- International Federation for Surgery of Obesity and Metabolic Disorders, Naples, Italy
| | - Jacques Himpens
- International Federation for Surgery of Obesity and Metabolic Disorders, Naples, Italy
| | - Mary O' Kane
- International Federation for Surgery of Obesity and Metabolic Disorders, Naples, Italy
| | - Antonio Torres
- International Federation for Surgery of Obesity and Metabolic Disorders, Naples, Italy
| | - Gerhard Prager
- International Federation for Surgery of Obesity and Metabolic Disorders, Naples, Italy
| | - Miguel F Herrera
- International Federation for Surgery of Obesity and Metabolic Disorders, Naples, Italy.
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Teke E, Güneş Y, Çoruhlu B, Esen Bulut N, Fersahoglu MM, Ergin A, Sancak S. Effects of laparoscopic sleeve gastrectomy on thyroid hormones and relationship between metabolic parameters and long-term total weight loss. Surg Endosc 2024; 38:1807-1812. [PMID: 38291160 DOI: 10.1007/s00464-024-10693-2] [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: 11/04/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Bariatric surgery has significant effects on metabolic parameters and hormone levels. However, the specific impact of laparoscopic sleeve gastrectomy (LSG) on thyroid hormones and other metabolic parameters remains unclear. This study aimed to investigate the short and long-term effects of LSG on thyroid hormone levels, HbA1c, and other metabolic parameters. METHODS A total of 619 euthyroid patients without a history of thyroid disease or thyroid hormone replacement therapy were included in the study. Patients with diabetes were excluded from the study. Preoperative, 1-year postoperative, and 5-year postoperative levels of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), HbA1c, and other metabolic parameters were recorded and analyzed. RESULTS LSG resulted in significant weight loss and improvements in metabolic parameters. At 1 year postoperatively, there were significant reductions in BMI, HbA1c, TSH, fT3, and triglyceride levels, while fT4 levels increased. A statistically significant negative correlation was found between preoperative HbA1c level and percentage of total weight loss (%TWL) value at the fifth postoperative year. Additionally, a statistically significant negative correlation was found between the 5-year change in TSH and %TWL. CONCLUSION Being the first study to predict long-term total weight loss based on preoperative HbA1c, it is significant. This finding has important implications for personalized patient management and could aid clinicians in identifying individuals who may benefit most from sleeve gastrectomy as a treatment modality. This is valuable in that it emphasizes multidisciplinary work, including the endocrinologist and dietician.
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Affiliation(s)
- Emre Teke
- General Surgery Department, Haydarpaşa Numune Training and Research Hospital, Tıbbiyecaddesi No:23, Üsküdar, 34668, Istanbul, Turkey.
| | - Yasin Güneş
- General Surgery Department, Fatih Sultan Mehmet Training and Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8, Ataşehir, 34752, Istanbul, Turkey
| | - Bedirhan Çoruhlu
- General Surgery Department, Fatih Sultan Mehmet Training and Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8, Ataşehir, 34752, Istanbul, Turkey
| | - Nuriye Esen Bulut
- General Surgery Department, Fatih Sultan Mehmet Training and Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8, Ataşehir, 34752, Istanbul, Turkey
| | - Mehmet Mahir Fersahoglu
- General Surgery Department, Fatih Sultan Mehmet Training and Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8, Ataşehir, 34752, Istanbul, Turkey
| | - Anıl Ergin
- General Surgery Department, Fatih Sultan Mehmet Training and Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8, Ataşehir, 34752, Istanbul, Turkey
| | - Seda Sancak
- Department of Endocrinology and Metabolic Diseases, Fatih Sultan Mehmet Training and Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8, Ataşehir, 34752, Istanbul, Turkey
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