Long-term outcomes of primary single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S)

Surve, Amit; Cottam, Daniel; Medlin, Walter; Richards, Christina; Belnap, Legrand; Horsley, Benjamin; Cottam, Samuel; Cottam, Austin

doi:10.1016/j.soard.2020.07.019

Cited by 58 publications

(46 citation statements)

References 40 publications

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“…However, a late complication rate and vitamin and micronutrient deficiencies were higher after DS. Surve et al [ 22 ] analyzed the results of 750 primary SADI-S, showing a morbidity rate of 7.8% and effective weight loss results at 60 and 72 months of follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…Concerning long-term outcomes of SADI, a relevant study recently reported data from 750 patients with 5 years of follow-up available on 109 patients (61%) and at 6 years on 87 patients (53%) [22]. The long-term complication rate was 11.7%, including diarrhea, nausea and vomiting, strictures, constipation, cholelithiasis, GERD, retrograde filling of the afferent limb, malnutrition, dilated fundus, gastric outlet obstruction, and hiatal and ventral hernia [22]. After SADI, patients require a strict follow-up, to minimize and promptly treat long-term complications.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy and Drawbacks of Single-Anastomosis Duodeno-Ileal Bypass After Sleeve Gastrectomy in a Tertiary Referral Bariatric Center

et al. 2021

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Background The need for revisional procedures after sleeve gastrectomy (SG) for insufficient weight loss or weight regain, gastroesophageal reflux, or other complications is reported to be 18–36% in studies with 10-year follow-up. Single-anastomosis duodeno-ileal bypass (SADI) may be performed as a revisional procedure after SG. This study aims to evaluate the short- and mid-term outcomes of SADI after SG in a referral center for bariatric surgery. Materials and Methods Data of patients who underwent SADI between March 2015 and March 2020 were collected prospectively and analyzed retrospectively. Follow-up comprised clinical and biochemical assessment at 1, 3, 6, 12, 18, and 24 months postoperatively, and once a year thereafter. Results Overall, 106 patients underwent SADI after a previous SG. The timeframe between SG and SADI was 50 ± 31.3 months. Postoperative mortality was observed in two cases (1.8%) and morbidity in 15.1% of patients. At 24 months, %total weight loss was 37.6 ± 12.3 and %excess weight loss 76.9 ± 25.2 (64 patients). Three patients were treated for malnutrition during follow-up, two with medical treatment and one with SADI reversal. Conclusion SADI after SG provides effective weight loss results in the short-term, even if in the present series the postoperative complication rate was non-negligible. Further trials are needed to establish the more advantageous revisional bariatric procedure after failed SG.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy and Drawbacks of Single-Anastomosis Duodeno-Ileal Bypass After Sleeve Gastrectomy in a Tertiary Referral Bariatric Center

et al. 2021

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“…Nutritional deficiencies were acceptable after five years. However, levels of albumin, total protein, calcium, parathormone and vitamin E had lowered significantly in these patients [ 47 ].…”

Section: Single-anastomosis Duodeno-ileal Bypass With Sleeve Gastrmentioning

confidence: 99%

Bariatric Surgery–How Much Malabsorption Do We Need?—A Review of Various Limb Lengths in Different Gastric Bypass Procedures

Felsenreich

Langer

Eichelter

et al. 2021

JCM

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The number of obese individuals worldwide continues to increase every year, thus, the number of bariatric/metabolic operations performed is on a constant rise as well. Beside exclusively restrictive procedures, most of the bariatric operations have a more or less malabsorptive component. Several different bypass procedures exist alongside each other today and each type of bypass is performed using a distinct technique. Furthermore, the length of the bypassed intestine may differ as well. One might add that the operations are performed differently in different parts of the world and have been changing and evolving over time. This review evaluates the most frequently performed bariatric bypass procedures (and their variations) worldwide: Roux-en-Y Gastric Bypass, One-Anastomosis Gastric Bypass, Single-Anastomosis Duodeno-Ileal Bypass + Sleeve Gastrectomy, Biliopancreatic Diversion + Duodenal Switch and operations due to weight regain. The evaluation of the procedures and different limb lengths focusses on weight loss, remission of comorbidities and the risk of malnutrition and deficiencies. This narrative review does not aim at synthesizing quantitative data. Rather, it provides a summary of carefully selected, high-quality studies to serve as examples and to draw tentative conclusions on the effects of the bypass procedures mentioned above. In conclusion, it is important to carefully choose the procedure and small bowel length excluded from the food passage suited best to each individual patient. A balance has to be achieved between sufficient weight loss and remission of comorbidities, as well as a low risk of deficiencies and malnutrition. In any case, at least 300 cm of small bowel should always remain in the food stream to prevent the development of deficiencies and malnutrition.

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“…Zwei neuere adipositaschirurgische Verfahren wurden in den letzten Jahren häufiger durchgeführt. Hierbei handelt es sich um den Single-Anastomosis-Sleeve-Ileal-Bypass (SASI) [61] und um die Single-Anastomosis-Duodeno-Ileostomy (SADI-S) [62]. Bei ersterem wird eine konventionelle Sleevegastrektomie mit dem Mini-Gastric-Bypass kombiniert.…”

Section: Weitere Intestinale Bypassverfahrenunclassified

Aktuelle Aspekte der Verfahrenswahl bei Adipositas-Chirurgie

Hering¹,

Dietrich

Seyfried³

2020

Adipositas - Ursachen, Folgeerkrankungen, Therapie

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ZusammenfassungDie Adipositas- bzw. metabolische Chirurgie stellt derzeit evidenzbasiert die einzige Therapiemodalität dar, die bei Patienten mit drittgradiger Adipositas zu einem nachhaltigen und auch klinisch relevanten Gewichtsverlust, zu einer Verbesserung der Lebensqualität und Funktionalität sowie zu einer Minderung vorliegender Adipositas-assoziierter Begleiterkrankungen und damit zu einer Verlängerung der Lebenserwartung führt.Die Operationen werden vorzugsweise in zertifizierten Zentren mit niedriger perioperativer Morbidität und Letalität in Schlüsselloch-Technik durchgeführt. Die weltweit am häufigsten durchgeführten adipositaschirurgischen Verfahren sind die Sleevegastrektomie (SG), der Roux-en-Y-Magenbypass (RYGB) und der Omega-Loop-Bypass (oder Mini-Gastric-Bypass) (MGB). Daneben existieren weitere intestinale Bypassverfahren.Die Entscheidung für das jeweilige Operationsverfahren ist im interdisziplinären Konsens von einem Team, bestehend aus Chirurgen, Internisten, Psychiatern/Psychologen und Ökotrophologen, individuell für jeden Patienten in Abhängigkeit der Komorbiditäten und patientenbezogener Daten zu treffen. Im Nachfolgenden werden die verschiedenen Operationsverfahren im Hinblick auf ihre jeweiligen Vor- und Nachteilen miteinander verglichen und auf die für das jeweilige Verfahren am besten geeignete Patientengruppe eingegangen.

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Long-term outcomes of primary single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S)

Cited by 58 publications

References 40 publications

Efficacy and Drawbacks of Single-Anastomosis Duodeno-Ileal Bypass After Sleeve Gastrectomy in a Tertiary Referral Bariatric Center

Efficacy and Drawbacks of Single-Anastomosis Duodeno-Ileal Bypass After Sleeve Gastrectomy in a Tertiary Referral Bariatric Center

Bariatric Surgery–How Much Malabsorption Do We Need?—A Review of Various Limb Lengths in Different Gastric Bypass Procedures

Aktuelle Aspekte der Verfahrenswahl bei Adipositas-Chirurgie

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