One Year Follow-up of Laparoscopic Single Anastomosis Sleeve Ileal Bypass in Super-morbidly Obese Patients

Abstract

Background: Single anastomosis sleeve ileal (SASI) bypass has been introduced as a novel modification of sleeve gastrectomy by adding a side-to-side single loop anastomosis between the gastric pouch and the ileum. The SASI bypass is still considered an investigational technique that needs more assessment.Aim: this study assessed the short-term operative and postoperative outcomes of laparoscopic "SASI" Bypass in management of patients with super-morbid obesity. Methods And Patients:This cohort retrospective study included 20 adult patients with super-morbid obesity with a body mass index (BMI) more than 50 kg/m 2 who underwent laparoscopic SASI bypass surgery. All patients were scheduled for follow-up regularly at 3, six months, and 12 months post-operatively.Results: Body weight, BMI and waist-hip ratio showed a significant progressive decrease over the one-year follow-up period (p <0.001). Mean preoperative BMI was 53.49 ±2.20 and was significantly reduced to 36.71 ±1.84 at six months and 27.13 ±1.05 at one year. Rates of excess weight loss (EWL) and excess BMI loss showed a significant progressive increase over time (p < 0.001). The mean EWL was 33.11 ±3.33% at 3 months and significant increase to 52.18 ±4.34% at 6 months and 82.02 ±2.11% at 12 months. Evaluation of associated comorbidities 1 73 year following surgery revealed whole remission of hypertension in five out of six cases, with a statistically significant difference.(p = 0.031). At one -year post-operative, quality of life improved to very good (65.0%) or good (25.0%); however, it remained fair in two (10.0%) patients.Conclusions: Laparoscopic SASI is efficient in reducing weight in patients with super-morbidly obesity. It showed progressively significant weight loss over one year and efficacy in controlling associated medical comorbidities. Additionally, it was a relatively safe technique with a reasonably little complication rate.