Mid-term 4-Year Outcomes with Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy Surgery at a Single US Center

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

doi:10.1007/s11695-018-3358-x

Cited by 58 publications

(48 citation statements)

References 34 publications

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“…These results continue in other studies without significant weight regain out to 4 years. In our study, especially in the patients with preoperative BMI of 45 to 55 kg/m 2 , the EWL at 12 and 24 months were 81.2% and 86.2%, respectively, and were similar to the study by Zaveri et al [36].…”

Section: Discussionsupporting

confidence: 91%

“…In our study, especially in the patients with preoperative BMI ,45 kg/m 2 , the EWL at 12 and 24 months were higher than the ones reported by Pernaute et al [34]. Recently, a midterm outcome study on SADI-S by Zaveri et al [36] reported 77.6% and 85.9% EWL at 12 and 24 months, respectively, with the preoperative BMI of 49.8 kg/m 2 . These results continue in other studies without significant weight regain out to 4 years.…”

Section: Discussioncontrasting

confidence: 65%

“…We believe this could be a reason why our patients who underwent LSADI-S achieved the greatest weight loss and had better HbA1C values. Apart from weight loss, the gastric restriction, a bypass of duodeno-pancreas, selective fat malabsorption, and a rapid entrance of undigested chyme into the distal intestine explain the mechanism of higher T2D remission rate after SADI-S surgery [36]. The RYGB has been shown to be effective for those with T2D.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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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“…There is not much difference in the operating time between both procedures, reflecting the improvement of our learning curve [13]. Multiple studies had investigated the effectiveness of SADI-S, RYGB, or biliopancreatic diversion with DS in unsuccessful LSG [14][15][16]. It was generally agreed that the mechanism of failure should guide the selection of the second procedure.…”

Section: Discussionmentioning

confidence: 99%

Single Anastomosis Duodeno-ileostomy (SADI-S) Versus One Anastomosis Gastric Bypass (OAGB-MGB) as Revisional Procedures for Patients with Weight Recidivism After Sleeve Gastrectomy: a Comparative Analysis of Efficacy and Outcomes

et al. 2020

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Purpose Many revisional procedures are available for unsuccessful laparoscopic sleeve gastrectomy (LSG) in patients with complications or weight recidivism. Single anastomosis duodeno-ileal bypass (SADI-S) and one anastomosis gastric bypass (OAGB-MGB) are two revisional procedures to address the problem of weight recidivism. We aimed to evaluate the efficacy and outcomes of the 2 revisional approaches (SADI-S vs. OAGB-MGB). Materials and Methods A retrospective analysis of prospectively collected database of patients who underwent SADI-S or OAGB-MGB as a revisional procedure for weight recidivism after primary LSG with a minimum 1-year follow-up. Weight loss, comorbidities, nutritional deficiencies, complications, and outcomes were compared in the 2 procedures. Results Ninety-one patients were included in the study (42 SADI-S and 49 OAGB-MGB). There was a significant weight loss (total weight loss percentage, TWL%) at 1-year follow-up observed for SADI-S when compared to OAGB-MGB (23.7 ± 5.7 vs. 18.7 ± 8.5, p = 0.02). However, this difference was not statistically significant at 18 months (26.4 ± 7.3 vs. 21.2 ± 11.0, p = 0.25). Remission of comorbidities (diabetes mellitus and hypertension) was comparable. Although OAGB-MGB had higher complication rate than SADI-S, the difference was not statistically significant (p = 0.39). No mortality was reported in the study groups. Conclusion Both SADI-S and OAGB-MGB are effective and safe revisional procedures for weight regain after LSG. The shortterm outcomes are comparable; however, SADI-S is associated with less upper gastrointestinal complications and could be a better option for patients suffering from GERD post-LSG. Moreover, the underlying bile reflux may get worse with OAGB-MGB. However, further prospective larger studies are needed. Keywords Revisional surgery. Sleeve gastrectomy. Single anastomosis duodeno-ileostomy. One anastomosis gastric bypass Abbreviations BMI Body mass index LSG Laparoscopic sleeve gastrectomy SADI-S Single anastomosis duodeno-ileostomy OAGB-MGB One anastomosis gastric bypass/mini gastric bypass EWL% Excess weight loss percentage TWL% Total weight loss percentage GERD Gastroesophageal reflux disease T2D Type 2 diabetes mellitus A1C Glycated hemoglobin A1C Electronic supplementary material The online version of this article (

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“…Procedures which take advantage of this scenario include the biliopancreatic diversion/duodenal switch. Based upon these previous observations and notions, more recent modifications to this malabsorption procedure have shown favorable results in treatment of metabolic diseases, with up to 4 years of follow up[ 66 , 67 ]. Further refinements in these procedures will likely yield more promising results which may be able to be individualized for specific patient needs.…”

Section: Bariatric Procedures Under Developmentmentioning

confidence: 99%

Current and future impact of clinical gastrointestinal research on patient care in diabetes mellitus

Koch

Shope

Camilleri

2018

WJD

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The worldwide rise in the prevalence of obesity supports the need for an increased interaction between ongoing clinical research in the allied fields of gastrointestinal medicine/surgery and diabetes mellitus. There have been a number of clinically-relevant advances in diabetes, obesity, and metabolic syndrome emanating from gastroenterological research. Gastric emptying is a significant factor in the development of upper gastrointestinal symptoms. However, it is not the only mechanism whereby such symptoms occur in patients with diabetes. Disorders of intrinsic pacing are involved in the control of stomach motility in patients with gastroparesis; on the other hand, there is limited impact of glycemic control on gastric emptying in patients with established diabetic gastroparesis. Upper gastrointestinal functions related to emptying and satiations are significantly associated with weight gain in obesity. Medications used in the treatment of diabetes or metabolic syndrome, particularly those related to pancreatic hormones and incretins affect upper gastrointestinal tract function and reduce hyperglycemia and facilitate weight loss. The degree of gastric emptying delay is significantly correlated with the weight loss in response to liraglutide, a glucagon-like peptide-1 analog. Network meta-analysis shows that liraglutide is one of the two most efficacious medical treatments of obesity, the other being the combination treatment phentermine-topiramate. Interventional therapies for the joint management of obesity and diabetes mellitus include newer endoscopic procedures, which require long-term follow-up and bariatric surgical procedure for which long-term follow up shows advantages for individuals with diabetes. Newer bariatric procedures are presently undergoing clinical evaluation. On the horizon, combination therapies, in part directed at gastrointestinal functions, appear promising for these indications. Ongoing and future gastroenterological research when translated to care of individuals with diabetes mellitus should provide additional options to improve their clinical outcomes.

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Mid-term 4-Year Outcomes with Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy Surgery at a Single US Center

Abstract: SADI-S is a safe and effective procedure in both short- and mid-term data points. Diabetes resolution and weight loss appear similar to traditional RYDS and better than RYGB.

Cited by 58 publications

References 34 publications

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

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

Single Anastomosis Duodeno-ileostomy (SADI-S) Versus One Anastomosis Gastric Bypass (OAGB-MGB) as Revisional Procedures for Patients with Weight Recidivism After Sleeve Gastrectomy: a Comparative Analysis of Efficacy and Outcomes

Current and future impact of clinical gastrointestinal research on patient care in diabetes mellitus

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