A matched cohort analysis of single anastomosis loop duodenal switch versus Roux-en-Y gastric bypass with 18-month follow-up

Cottam, Austin; Cottam, Daniel; Medlin, Walter; Richards, Christina; Cottam, Samuel; Zaveri, Hinali; Surve, Amit

doi:10.1007/s00464-015-4707-7

Cited by 50 publications

(33 citation statements)

References 26 publications

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“…In this study, the 2-year follow-up is important since the nadir of weight loss after DS is at 18 months statistically; thus, we are reporting the maximum weight loss a revisional DS patient can experience after this surgery. However, a vital point of this paper is the fact that this procedure has very good weight loss, but it in no way approaches the weight loss seen when SADS or RYDS are done as a primary procedure [29][30][31][32][33].…”

Section: Discussionmentioning

confidence: 97%

Mid-term outcomes of gastric bypass weight loss failure to duodenal switch

Surve¹,

Zaveri²,

Cottam³

et al. 2016

Surgery for Obesity and Related Diseases

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Section: Discussionmentioning

confidence: 97%

Mid-term outcomes of gastric bypass weight loss failure to duodenal switch

Surve¹,

Zaveri²,

Cottam³

et al. 2016

Surgery for Obesity and Related Diseases

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“…Recently, there have been several reports on the outcomes of SADI-S procedure [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. One of the articles published by Neichoy et al [16] on the midterm outcomes of SADI-S reported EWL of 88% at 24 months.…”

Section: Discussionmentioning

confidence: 99%

“…More importantly, it decreases the technical complexity associated with duodenal switch without compromising outcomes. Cottam et al [30] published a matched cohort between SADI-S and RYGB with 18-month follow-up and found the weight loss profile to be similar between the 2 procedures. While the complication rates were lower with SADI-S [30].…”

Section: Discussionmentioning

confidence: 99%

“…Based on clinical knowledge, expert opinion, and published peer-reviewed scientific evidence, the International Federation for the Surgery of Obesity and Metabolic Disorders considered the SADI-S (and its variant [stomach intestinal pylorus-sparing surgery]) an established bariatric procedure [14]. In recent years, there have been few reports on the short-and mid-term outcomes of this procedure [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. In terms of weight loss, the SADI-S and RYGB had statistically similar weight loss; however, the weight loss was statistically higher in patients undergoing SADI-S procedure than SG [21,30].…”

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Comparative analysis of the single-anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) to established bariatric procedures: an assessment of 2-year postoperative data illustrating weight loss, type 2 diabetes, and nutritional status in a single US center

Enochs

Bull

Surve³

et al. 2020

Surgery for Obesity and Related Diseases

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“…We have called this modification "stomach intestinal pylorus sparing" (SIPS) surgery to help differentiate it from the common complication of the traditional Roux-en-Y duodenal switch. The preservation of more intestine, along with the ileocecal valve, reduces the risk for malnutrition and diarrhea often associated with the duodenal switch [3,4]. The lack of a distal small bowel enteroenterostomy should eliminate or decrease the chances of internal hernias.…”

mentioning

confidence: 99%

A step-by-step surgical technique video with two reported cases of common channel lengthening in patients with previous stomach intestinal pylorus sparing surgery to treat chronic diarrhea

Surve

Zaveri

Cottam

2017

Surgery for Obesity and Related Diseases

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Surgical procedures are currently the only effective longterm way to treat morbid obesity. However, these procedures all carry risks, with each procedure having its own unique risks.In 2007, Dr. Sanchez in Spain first performed a modification of the traditional duodenal switch using a single anastomosis instead of Roux-en-Y reconstruction with the sleeve done over a 56 French bougie [1]. We have modified this further by creating a smaller sleeve (40 French bougie sizing instead of 56) and less malabsorption (300-cm common channel instead of 250 cm) [2]. We have called this modification "stomach intestinal pylorus sparing" (SIPS) surgery to help differentiate it from the common complication of the traditional Roux-en-Y duodenal switch. The preservation of more intestine, along with the ileocecal valve, reduces the risk for malnutrition and diarrhea often associated with the duodenal switch [3,4]. The lack of a distal small bowel enteroenterostomy should eliminate or decrease the chances of internal hernias. Since 2013, we have performed over 300 SIPS surgeries. However, we have encountered 2 patients that developed chronic diarrhea without malnutrition that resulted in the need for common channel lengthening. Chronic diarrhea was defined as loose stools that last for at least 4 weeks. This usually means 4 or more loose stools per day.We present a step-by-step surgical technique of common channel lengthening (CCL) to treat chronic diarrhea after SIPS surgery. This is the first report in the literature that demonstrates the CCL technique after a SIPS surgery and also reports the first 2 cases. Patient 1A 41-year-old woman with a body mass index (BMI) of 42.9 kg/m 2 had planned SIPS in 2014. Her current BMI is 26.5 kg/m 2 . Six months after surgery, she began to experience smelly flatulence, bloating, and severe diarrhea (6-8 loose stools/d). Her nutritional status (vitamins A, D, E, K, B1, B12, and copper and zinc) was normal. Her albumin and prealbumin were also normal. Dietary intervention and medical interventions of Lomotil and probiotics did not help. Patient 2The second patient was a 63-year-old man with a history of inflammatory bowel syndrome who underwent SIPS surgery a year prior for morbid obesity with insulin dependent diabetes and a BMI of 38.6 kg/m 2 . The patient had remarkable weight loss after the SIPS surgery (current BMI, 22.5 kg/m 2 ) with resolution of pre-existing diabetes and gastroesophageal reflux disease. However, 5 months after surgery the patient began experiencing postprandial diarrhea (6-8 loose stools/d) that was unresponsive to both dietary manipulation and medical interventions of http://dx.

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A matched cohort analysis of single anastomosis loop duodenal switch versus Roux-en-Y gastric bypass with 18-month follow-up

Abstract: LDS has comparable weight loss results to GBP. However, LDS has fewer 30-day and 18-month complications and patients suffer from less nausea postoperatively.

Cited by 50 publications

References 26 publications

Mid-term outcomes of gastric bypass weight loss failure to duodenal switch

Mid-term outcomes of gastric bypass weight loss failure to duodenal switch

Comparative analysis of the single-anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) to established bariatric procedures: an assessment of 2-year postoperative data illustrating weight loss, type 2 diabetes, and nutritional status in a single US center

A step-by-step surgical technique video with two reported cases of common channel lengthening in patients with previous stomach intestinal pylorus sparing surgery to treat chronic diarrhea

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