Long-Term (> 6 Years) Outcomes of Duodenal Switch (DS) Versus Single-Anastomosis Duodeno-Ileostomy with Sleeve Gastrectomy (SADI-S): a Matched Cohort Study

Overview

Journal Obes Surg

Date 2021 Sep 15

PMID 34523085

Citations 9

Authors

Amit Surve

Daniel Cottam

Legrand Belnap

Christina Richards

Walter Medlin

Affiliations

Soon will be listed here.

Abstract

Background: There are no comparative studies on the long-term outcomes after the primary traditional duodenal switch (DS) and single-anastomosis duodeno-ileostomy with sleeve gastrectomy (SADI-S).

Purpose: This study aims to compare the long-term outcomes in a matched cohort.

Setting: This study took place in a single private institute, in the USA.

Materials And Methods: Data from 266 patients who underwent a primary laparoscopic traditional DS or primary laparoscopic SADI-S from September 2011 to December 2015 by four surgeons were used for a retrospective matched cohort. Data were obtained by matching every DS patient to a SADI-S patient of the same age, sex, and body mass index (BMI). In addition, only patients that were out at least 5 years and had a minimum 5-year follow-up were included in the study.

Results: The matched cohort included 30 DS and 30 SADI-S patients. There were no statistically significant differences in the preoperative characteristics and baseline comorbidities between both groups. The SADI-S patients had significantly shorter operative time and length of stay. The overall long-term complications, especially the long-term Clavien-Dindo grade IIIb complications, were significantly fewer with SADI-S. At 6 years, the DS patients had statistically higher %EWL; however, the ending BMIs were statistically similar between both groups. There were no significant differences in the long-term comorbidity and nutritional outcomes of both groups. The long-term failure rates were comparable.

Conclusions: Most long-term outcomes of SADI-S were either similar or significantly better than DS. Part of the reasons could be the surgeon's learning curve and the small sample sizes of both groups.

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Axer S, Al-Tai S, Ihle C, Alwan M, Hoffmann L Obes Surg. 2024; 34(9):3382-3389.

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Deffain A, Denis R, Pescarus R, Garneau P, Atlas H, Studer A Obes Surg. 2024; 34(4):1207-1216.

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References

Surve A, Zaveri H, Cottam D, Belnap L, Cottam A, Cottam S . A retrospective comparison of biliopancreatic diversion with duodenal switch with single anastomosis duodenal switch (SIPS-stomach intestinal pylorus sparing surgery) at a single institution with two year follow-up. Surg Obes Relat Dis. 2017; 13(3):415-422. DOI: 10.1016/j.soard.2016.11.020. View

Cottam A, Cottam D, Portenier D, Zaveri H, Surve A, Cottam S . A Matched Cohort Analysis of Stomach Intestinal Pylorus Saving (SIPS) Surgery Versus Biliopancreatic Diversion with Duodenal Switch with Two-Year Follow-up. Obes Surg. 2016; 27(2):454-461. DOI: 10.1007/s11695-016-2341-7. View

Sanchez-Pernaute A, Rubio Herrera M, Perez-Aguirre E, Garcia Perez J, Cabrerizo L, Valladares L . Proximal duodenal-ileal end-to-side bypass with sleeve gastrectomy: proposed technique. Obes Surg. 2007; 17(12):1614-8. DOI: 10.1007/s11695-007-9287-8. View

Marceau P, Biron S, Hould F, Lebel S, Marceau S, Lescelleur O . Duodenal switch: long-term results. Obes Surg. 2008; 17(11):1421-30. DOI: 10.1007/s11695-008-9435-9. View

Sethi M, Chau E, Youn A, Jiang Y, Fielding G, Ren-Fielding C . Long-term outcomes after biliopancreatic diversion with and without duodenal switch: 2-, 5-, and 10-year data. Surg Obes Relat Dis. 2016; 12(9):1697-1705. DOI: 10.1016/j.soard.2016.03.006. View

Anthone G, Lord R, DeMeester T, Crookes P . The duodenal switch operation for the treatment of morbid obesity. Ann Surg. 2003; 238(4):618-27. PMC: 1360120. DOI: 10.1097/01.sla.0000090941.61296.8f. View

Topart P, Becouarn G, Delarue J . Weight Loss and Nutritional Outcomes 10 Years after Biliopancreatic Diversion with Duodenal Switch. Obes Surg. 2017; 27(7):1645-1650. DOI: 10.1007/s11695-016-2537-x. View

Skogar M, Sundbom M . Weight loss and effect on co-morbidities in the long-term after duodenal switch and gastric bypass: a population-based cohort study. Surg Obes Relat Dis. 2019; 16(1):17-23. DOI: 10.1016/j.soard.2019.09.077. View

Yashkov Y, Bordan N, Torres A, Malykhina A, Bekuzarov D . SADI-S 250 vs Roux-en-Y Duodenal Switch (RY-DS): Results of 5-Year Observational Study. Obes Surg. 2020; 31(2):570-579. DOI: 10.1007/s11695-020-05031-z. View

10.

Sanchez-Pernaute A, Rubio M, Cabrerizo L, Ramos-Levi A, Perez-Aguirre E, Torres A . Single-anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S) for obese diabetic patients. Surg Obes Relat Dis. 2015; 11(5):1092-8. DOI: 10.1016/j.soard.2015.01.024. View

11.

Surve A, Cottam D, Medlin W, Richards C, Belnap L, Horsley B . Long-term outcomes of primary single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S). Surg Obes Relat Dis. 2020; 16(11):1638-1646. DOI: 10.1016/j.soard.2020.07.019. View

12.

Surve A, Cottam D, Richards C, Medlin W, Belnap L . A Matched Cohort Comparison of Long-term Outcomes of Roux-en-Y Gastric Bypass (RYGB) Versus Single-Anastomosis Duodeno-ileostomy with Sleeve Gastrectomy (SADI-S). Obes Surg. 2020; 31(4):1438-1448. DOI: 10.1007/s11695-020-05131-w. View

13.

Surve A, Cottam D, Sanchez-Pernaute A, Torres A, Roller J, Kwon Y . The incidence of complications associated with loop duodeno-ileostomy after single-anastomosis duodenal switch procedures among 1328 patients: a multicenter experience. Surg Obes Relat Dis. 2018; 14(5):594-601. DOI: 10.1016/j.soard.2018.01.020. View

14.

Topart P, Becouarn G . The single anastomosis duodenal switch modifications: a review of the current literature on outcomes. Surg Obes Relat Dis. 2017; 13(8):1306-1312. DOI: 10.1016/j.soard.2017.04.027. View

15.

Dindo D, Demartines N, Clavien P . Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004; 240(2):205-13. PMC: 1360123. DOI: 10.1097/01.sla.0000133083.54934.ae. View

16.

Surve A, Zaveri H, Cottam D, Belnap L, Medlin W, Cottam A . Mid-term outcomes of gastric bypass weight loss failure to duodenal switch. Surg Obes Relat Dis. 2016; 12(9):1663-1670. DOI: 10.1016/j.soard.2016.03.021. View

17.

Surve A, Zaveri H, Cottam D . A safer and simpler technique of duodenal dissection and transection of the duodenal bulb for duodenal switch. Surg Obes Relat Dis. 2016; 12(4):923-924. DOI: 10.1016/j.soard.2016.02.022. View

18.

Born P . Carbohydrate malabsorption in patients with non-specific abdominal complaints. World J Gastroenterol. 2007; 13(43):5687-91. PMC: 4171253. DOI: 10.3748/wjg.v13.i43.5687. View

19.

Surve A, Zaveri H, Cottam D . A step-by-step surgical technique video with two reported cases of common channel lengthening in patients with previous stomach intestinal pylorus sparing surgery to treat chronic diarrhea. Surg Obes Relat Dis. 2017; 13(4):706-709. DOI: 10.1016/j.soard.2016.10.012. View