Background:
The sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and single-anastomosis duodenal-ileal bypass with SG (SADI-S) are recognized bariatric procedures. A comparison has never been made between these 3 procedures and especially in different body mass index (BMI) categories.
Objective:
The study aimed to analyze a large cohort of patients undergoing either laparoscopic (L) SG, LRYGB, or LSADI-S to evaluate and compare weight loss and glycosylated hemoglobin level. The secondary aim was to compare the nutritional outcomes between LRYGB and LSADI-S.
Setting:
Private practice, United States.
Methods:
This is a retrospective review of 878 patients who underwent LSG, LRYGB, or LSADI-S from April 2014 through October 2015 by 5 surgeons in a single institution. For weight loss analysis, the patients were categorized into 4 different categories as follows: patients regardless of their preoperative BMI, patients with preoperative BMI <45 kg/m, patients with preoperative BMI 45 to 55 kg/m, and patients with preoperative BMI >55 kg/m.
Results:
A total of 878 patients were identified for analysis. Of 878 patients, 448 patients, 270 patients, and 160 patients underwent LSG, LRYGB, and LSADI-S, respectively. Overall, at 12 and 24 months, the weight loss was highest with LSADI-S, followed by LRYGB and LSG in all 4 categories. At 2 years, the patients lost 19.5, 16.1, and 11.3 BMI points after LSADI-S, LRYGB, and LSG, respectively. In addition, the weight loss was highest in patients with preoperative BMI <45 kg/m and lowest in patients with preoperative BMI >55 kg/m at 12 and 24 months. Also, there were no statistically significant differences between the nutritional outcomes between LRYGB and LSADI-S. The LSADI-S had significantly lower rates of abnormal glycosylated hemoglobin than LRYGB and LSG at 12 months (P < .001).
Conclusions:
The weight loss outcomes and glycosylated hemoglobin rates were better with LSADI-S than LRYGB or LSG. The nutritional outcomes between LRYGB and LSADI-S were similar.
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DOI: 10.1007/s11695-024-07642-2.
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DOI: 10.1007/s11695-024-07490-0.
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DOI: 10.1007/s11695-024-07421-z.
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Zhang Z, Wang L, Wei Z, Zhang Z, Cui L, Jiang T
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DOI: 10.1038/s41598-024-60983-x.
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DOI: 10.1038/s41598-024-57289-3.
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DOI: 10.1007/s11695-023-06602-6.
Medium-Term Nutritional and Metabolic Outcome of Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S).
Marincola G, Velluti V, Voloudakis N, Gallucci P, Ciccoritti L, Greco F
Nutrients. 2023; 15(3).
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PMC: 9921544.
DOI: 10.3390/nu15030742.
Metabolic Efficacy and Diabetes Remission Predictors Following 'Sleeve Gastrectomy with Loop Duodenojejunal Bypass' Surgery.
Vennapusa A, Panchangam R, Kesara C, Madivada M
J Metab Bariatr Surg. 2023; 9(2):33-41.
PMID: 36688116
PMC: 9847657.
DOI: 10.17476/jmbs.2020.9.2.33.
Patient Selection and 30-Day Outcomes of SADI-S Compared to RYGB: a Retrospective Cohort Study of 47,375 Patients.
Verhoeff K, Mocanu V, Jogiat U, Forbes H, Switzer N, Birch D
Obes Surg. 2022; 32(7):1-8.
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PMC: 9022408.
DOI: 10.1007/s11695-022-06068-y.
Retrospective Comparison of SADI-S Versus RYGB in Chinese with Diabetes and BMI< 35kg/m: a Propensity Score Adjustment Analysis.
Sang Q, Wang L, Wuyun Q, Zheng X, Wang D, Zhang N
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DOI: 10.1007/s11695-021-05708-z.
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Mousavimaleki A, Gholizadeh B, Kermansaravi M
Obes Surg. 2021; 31(10):4634-4636.
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DOI: 10.1007/s11695-021-05491-x.
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Felsenreich D, Langer F, Eichelter J, Jedamzik J, Gensthaler L, Nixdorf L
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DOI: 10.3390/jcm10040674.
Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy/One Anastomosis Duodenal Switch (SADI-S/OADS) IFSO Position Statement-Update 2020.
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DOI: 10.1007/s11695-020-05134-7.
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DOI: 10.1136/bmjopen-2020-037576.
Single Anastomosis Duodenal Switch: 1-Year Outcomes.
Cottam D, Roslin M, Enochs P, Metz M, Portenier D, Smith D
Obes Surg. 2020; 30(4):1506-1514.
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DOI: 10.1007/s11695-019-04352-y.
