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, Paul; Bull, Jaime; Surve, Amit; Cottam, Daniel; Bovard, Scott; Bruce, Jon; Tyner, Michael; Pilati, David; Cottam, Samuel

doi:10.1016/j.soard.2019.10.008

Cited by 37 publications

(15 citation statements)

References 51 publications

(80 reference statements)

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“…The study had a 3-year follow-up data, and they found SADS to be more effective in treating the T2DM than RYGB. In a recent study by Enochs et al, the A1C values between these two procedures were compared [15]. It was found that the SADS had significantly lower rates of abnormal A1C than RYGB at 12 months.…”

Section: Discussionmentioning

confidence: 99%

Single Anastomosis Duodenal Switch: 1-Year Outcomes

Cottam¹,

Roslin

Enochs³

et al. 2020

OBES SURG

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Introduction Single-anastomosis duodenal switch has been suggested to be an effective bariatric procedure that offers excellent weight loss and by lengthening the common channel the potential to reduce micronutrient deficiencies. Purpose To evaluate the weight loss, comorbidity resolution and the 1-year nutritional outcomes of the single-anastomosis duodenal switch (SADS) procedure. Setting Multiple US Hospitals. Methods From October 2014 to January 2017, 120 patients were enrolled at six sites across the USA and underwent the SADS procedure. Weight loss, comorbidities, quality of life, and adverse events were followed post-procedure for 12 months. Results At 1, 6, and 12 months, 98.3%, 85.5%, and 77.1% of the patients were available for assessment, respectively. At 12 months, patients showed significantly reduced body mass index when compared to baseline (46.8 ± 5.8 vs 29.8 ± 4.4, P < 0.001 respectively). Sixty-five patients had type 2 diabetes at baseline; however, 11 patients lost to follow-up. Of the available data (54 patients), 96.3% of the patients had a resolution of type 2 diabetes by 12 months with a mean A1C reduction from 7.8 ± 1.6 to 5.3 ± 0.7. Additionally, there were reductions in hyperlipidemia, sleep apnea, and hypertension at 12 months. Patient gastroesophageal reflux disease satisfaction and quality of life (SF-36) scores were significantly higher at 12 months postprocedure (P < 0.001 in all cases) while 12-month protein levels remained at normal values. There were abnormalities of parathyroid hormone and vitamin D at 1 year with all other nutritional markers being not significantly different at 1 year from baseline. There were 10, IIIb, or greater complications according to the Clavien-Dindo scoring system during the study period, not all of which were related to the surgery. Conclusions SADS is a highly efficacious weight loss procedure with significant comorbidity reduction at 1 year. At 1 year, complications and vitamin and mineral deficits appear to be consistent with other malabsorption operations. Long-term follow-up is needed, especially around complications and vitamin deficiencies.

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Section: Discussionmentioning

confidence: 99%

Single Anastomosis Duodenal Switch: 1-Year Outcomes

Cottam¹,

Roslin

Enochs³

et al. 2020

OBES SURG

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“…Both current systematic reviews evaluating SADI-S, one evaluating observational studies and the other comparative studies, both found that patients undergoing SADI-S had increased rates of DM and higher BMI compared to other procedures including RYGB [ 9 , 13 , 14 ]. Studies comparing demographics specifically between patients receiving SADI-S and RYGB have had similar findings [ 15 , 16 ]. Because DS procedures were previously reported to be highly effective in terms of metabolic comorbidity reversal, and that SADI-S has been purported as a safer surgical option with similar benefits, these patient selection findings make sense [ 9 , 17 ].…”

Section: Discussionmentioning

confidence: 74%

Patient Selection and 30-Day Outcomes of SADI-S Compared to RYGB: a Retrospective Cohort Study of 47,375 Patients

et al. 2022

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Purpose Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) offers a novel bariatric procedure with few comparative studies evaluating patient selection or perioperative outcomes. We aim to compare SADI-S to Roux-en-Y gastric bypass (RYGB). Materials and Methods The 2020 Metabolic and Bariatric Accreditation and Quality Improvement Program (MBSAQIP) registry was analyzed, comparing SADI-S to RYGB. Bivariate analysis was performed to determine intergroup differences. Multivariable logistic regression determined factors associated with serious complications and mortality. Results We evaluated 47,375 patients, with 501 (1.1%) receiving SADI-S. Patients undergoing SADI-S had higher body mass index (51.4 ± 9.7 kg/m 2 SADI-S vs. 44.6 ± 7.9 kg/m 2 RYGB; p < 0.001), and more metabolic comorbidities including non-insulin dependent diabetes (21.7% SADI-S vs 19.0% RYGB; p = 0.011), insulin dependent diabetes (12.0% SADI-S vs. 8.6% RYGB; p = 0.011), and hypertension (54.9% SADI-S vs 47.6% RYGB; p < 0.001). Patients undergoing SADI-S experienced more anastomotic leaks (2.2% vs. 0.5%; p < 0.001), reoperations (5.0% vs 2.6%; p < 0.001), pneumonias (1.6% vs 0.5%; p < 0.001), had sepsis more frequently (1.4% vs 0.3%; p < 0.001), and required more unplanned reintubations (1.2% vs 0.3%; p = 0.004). SADI-S was independently associated with serious complications ( OR 1.45, CI 1.09–1.95, p < 0.001) but was not a predictor of mortality ( OR 3.29, p = 0.060). Conclusions In comparison to RYGB, patients undergoing SADI-S were found to have more metabolic comorbidities. Compared to RYGB, SADI-S has worse perioperative outcomes and is independently associated with serious complications. It remains unclear whether this represents a learning curve or true findings and prospective studies analyzing the risk–benefit ratio following SADI-S are needed. Graphical abstract

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“…The SADI‐S surgical procedure is a modification of the DS. Instead of dividing the ileum as in the DS, a loop of ileum 200‐300 cm proximal to the ileocecal valve is brought up to be connected to the first portion of the duodenum once an SG and duodenal division is performed 22,23 …”

Section: Procedures Descriptionsmentioning

confidence: 99%

Metabolic surgery: A clinical update

Wilson

Aminian

Tahrani

2021

Diabetes Obesity Metabolism

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Metabolic and bariatric surgery has grown beyond ‘experimental’ weight‐loss surgery. As techniques have advanced over the last few decades, so has the growing body of research and evidence, proving that both weight‐loss and metabolic health improvement are induced. Metabolic surgery has become the more appropriate term for weight‐loss surgery because of the altered gastrointestinal anatomy and subsequent beneficial metabolic effects. Although the tool of metabolic surgery has been well refined, a large portion of the global population does not have adequate access to it. This clinical update aims to (a) inform healthcare providers from all disciplines about the myriad of benefits of metabolic surgery and (b) equip them with the necessary knowledge to bridge the gap between patients in need of metabolic treatment and the therapies in metabolic surgery available to them.

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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

Cited by 37 publications

References 51 publications

Single Anastomosis Duodenal Switch: 1-Year Outcomes

Single Anastomosis Duodenal Switch: 1-Year Outcomes

Patient Selection and 30-Day Outcomes of SADI-S Compared to RYGB: a Retrospective Cohort Study of 47,375 Patients

Metabolic surgery: A clinical update

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