Single Anastomosis Sleeve Ileal Bypass (SASI Bypass): Short-Term Outcomes and Concerns

Romero, Rey Jesús; Colorado-Subizar, Raquel; Uriarte-Lorente, Maripi De; Barradas-Lagunes, Marisol; Ávila, Paola Bravo-De; Romero-Espejo, Julio Jorge

doi:10.1007/s11695-020-05145-4

Cited by 15 publications

(14 citation statements)

References 10 publications

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“…This was in line with the findings of Khalaf et al (8) and Romero et al (10) who found that the average operating time for the SASI operation was 98.8 minutes and 116.3 minutes, respectively (range, 60-270 minutes). The SASJ method was shown to have a significantly longer operating time in different research by Arslan et al (11) with a mean value of 192.8 minutes.…”

Section: Discussionsupporting

confidence: 91%

Laparoscopic Single Anastomosis Sleeve-Jejunal Bypass vs Laparoscopic Mini-Gastric Bypass in Morbid Obese Patients and Resolution of Diabetes Mellitus, A Single Centre Experience

Helmy¹,

Nagy

Afifi³

2022

The Egyptian Journal of Hospital Medicine

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Background: The most effective therapy for morbid obese patients now available is bariatric surgery, which can help patients losing weight effectively and sustainably while also improving their quality of life and comorbidities associated with obesity. Worldwide, the one anastomosis gastric bypass (OAGB) technique is one of the most performed bariatric surgeries. Objective: The study's objective was to compare the outcomes of the OAGB, with those of the single anastomosis sleeve jejunal bypass (SASJ) as a new method in terms of weight reduction, operating time, postoperative complications, and impact on comorbidities three years following surgery. Patients and Methods: This prospective randomized study included a total of 200 morbidly obese patients undergoing OAGB or SASJ for the treatment of morbid obesity and comorbidities, attending at Department of the bariatric Surgery, tertiary care hospital, Ain Shams University Hospitals. The included subjects were divided into two equal groups: 100 each; SASJ and OAGB groups. Results: The operative time was prolonged in SASJ group (104.7 minutes) compared to OAGB group (76.4 minutes). OAGB group had significant lower Body mass index (BMI) mean as well as significant lower body weight mean at all time intervals through the 3 years follow up. OAGB group had 92% resolution of comorbidities while 68% of SASJ group had resolution. Post-operative HbA1c showed rapid improvement in both groups. Concerning the post-operative complications, no statistically significant differences. Conclusion: It could be concluded that OAGB and SASJ bypass are efficient bariatric surgeries for weight reduction and comorbidities resolution with favorable outcomes in OAGB group.

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Section: Discussionsupporting

confidence: 91%

Laparoscopic Single Anastomosis Sleeve-Jejunal Bypass vs Laparoscopic Mini-Gastric Bypass in Morbid Obese Patients and Resolution of Diabetes Mellitus, A Single Centre Experience

Helmy¹,

Nagy

Afifi³

2022

The Egyptian Journal of Hospital Medicine

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“…Romero et al reported that operative time had a mean value of 116.3 minutes (range, 60-270 minutes) [25]. Another study reported much prolonged operative time for the SASJ procedure, which had a mean value of 192.8 minutes [26].…”

Section: Discussionmentioning

confidence: 99%

“…Romero et al reported that one out of 83 cases had dropped in hemoglobin at 11 months post-surgery due to iron de ciency and hypermenorrhea and therefore required blood transfusion. Another patient had hypoalbuminemia [25]. Kermansaravi et al revised SASI bypass to SG in 2/24 patients (8.3%) due to excessive weight loss and hypoalbuminemia [33].…”

Section: Discussionmentioning

confidence: 99%

Comparative Study between Single Anastomosis Sleeve Jejunal Bypass, Sleeve Gastrectomy and One Anastomosis Gastric Bypass: A Prospective Randomized trial

Elrefai

Ibrahim

Zeid

et al. 2022

Preprint

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Background: A variety of bariatric procedures are being practiced nowadays. Laparoscopic sleeve gastrectomy (LSG) and one anastomosis gastric bypass (OAGB) are two commonly practiced bariatric procedures. Recently, single anastomosis sleeve jejunal bypass (SASJ) has emerged as a novel effective procedure with a decreased risk of malnutrition due to the presence of two pathways for food. Herein, we compared outcomes of these three procedures regarding short-term weight loss, complications, comorbidity resolution and quality of life.Patients and methods: We included a total of 60 cases in this prospective randomized study, and they were divided into three equal groups; SASJ, LSG and OAGB groups. The three procedures were performed by the same surgical team adapting standardized techniques. Weight loss parameters were our primary objectives, while secondary outcomes included post-operative complications, nutritional status, improvement/resolution of comorbidities and quality of life.Results: Operative time was significantly prolonged in the SASJ group, compared to the other two groups. Nevertheless, the incidence of post-operative complications did not significantly differ between the three groups, apart from GERD, that was more encountered in LSG group (20% of cases). Percentage of total weight loss (%TWL) were comparable among the 3 procedures; (SASJ 39.4 and 56.85%), (LSG 46.05 and 65.6%) and (OAGB 43 and 61.4%) at 6 and 12 months respectively. Comorbidity improvement, quality of life and nutritional status didn’t differ among the three study groups.Conclusion: SASJ bypass is an effective bariatric procedure regarding weight loss and comorbidity resolution, with a safe perioperative outcome comparable to OAGB and LSG.

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“…A dedicated presentation of the possible theories elucidating the excellent metabolic effect of the SASI bypass procedure was reported by Romero et al [16]. They described that the bipartition technique preserves the normal food pathway and permits a little amount of the taken food to be absorbed in the proximal part of the gut.…”

Section: Discussionmentioning

confidence: 99%

“…In 2016, Mahdy et al declared that they had adjusted the SG + TB procedure by conducting a loop instead of a Roux-en-Y bipartition that would limit the incidence of postoperative leakage, considering the single anastomosis site, and they evaluated this singleanastomosis sleeve ileal (SASI) bypass efficacy as a functional as well as mechanical restrictive procedure, with a neuroendocrine modulation effect, in patients with obesity and type 2 diabetes mellitus (T2DM), and they found excellent promising outcomes [15]. SASI bypass procedure has shown satisfactory weight loss and metabolic comorbidities remission in other studies [16], [17]. It is hypothesized that SASI bypass procedure involves the appetite reduction by two devices; SG related ghrelin decline and distal bowel stimulation by the fast passage of food [15], [18], [19].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Single Anastomosis Sleeve Ileal Bypass with Follow-up of Weight Loss and Metabolic Impact

Abdalaziz

Sarhan²,

Abou-Eisha³

et al. 2022

Open Access Maced J Med Sci

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Background: Bariatric surgery has been an effective safe management for severe obesity. The newly developed single-anastomosis sleeve ileal (SASI) bypass has shown efficacy as a functional as well as mechanical restrictive bariatric procedure, with a neuroendocrine modulation effect. SASI bypass is still an investigational procedure, hence, more evidence is needed till it is declared as a standard bariatric procedure by the IFSO. Aim of the study: The current work aimed to describe our experience regarding the technical steps, the efficacy and the short-term outcome of SASI bypass procedure in patients with severe obesity. Patients and methods: Forty seven patients with severe obesity underwent SASI bypass procedure. They were followed till 1 year postoperatively. The weight loss, comorbidities and laboratory changes were assessed. Results: Patients evaluation at the 1-year postoperative follow up revealed a mean %TWL of 37.55 ± 6.17 and a mean %EBWL of 76.21 ± 9.8. The remission rates of T2DM, hyperlipidemia and hypertension were 85.7%, 94.7% and 89.66%, respectively, with statistically high significant differences between the preoperative and 1-year postoperative comorbidities rate. Stepwise regression analysis demonstrated that only the preoperative HbA1C remained in the model predicting the %TWL, and the preoperative BMI was the remaining factor in the model predicting the %EBWL in the study patients. Conclusion: The present study adds a new evidence to the promising outcome of the newly introduced SASI bypass procedure. After one year, the study patients showed excellent weight loss and comorbidities remission together with acceptable major complication rates.

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Single Anastomosis Sleeve Ileal Bypass (SASI Bypass): Short-Term Outcomes and Concerns

Cited by 15 publications

References 10 publications

Laparoscopic Single Anastomosis Sleeve-Jejunal Bypass vs Laparoscopic Mini-Gastric Bypass in Morbid Obese Patients and Resolution of Diabetes Mellitus, A Single Centre Experience

Laparoscopic Single Anastomosis Sleeve-Jejunal Bypass vs Laparoscopic Mini-Gastric Bypass in Morbid Obese Patients and Resolution of Diabetes Mellitus, A Single Centre Experience

Comparative Study between Single Anastomosis Sleeve Jejunal Bypass, Sleeve Gastrectomy and One Anastomosis Gastric Bypass: A Prospective Randomized trial

Laparoscopic Single Anastomosis Sleeve Ileal Bypass with Follow-up of Weight Loss and Metabolic Impact

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