Abstract
Background
Single anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) is a modification of Roux-en-Y duodenal switch (RYDS). Long-term data on this operation is lacking in the literature. We reviewed our mid-term data of this RYDS modification.
Purpose
To analyze the outcomes with SADI-S at 4 years.
Methods
Data from patients who underwent a primary SADI-S procedure performed by three surgeons at a single institution from June 2013 through February 2018 were retrospectively reviewed. All revision bariatric surgeries were excluded. Regression analyses were performed for all follow-up weight loss data.
Results
There were 437 patients in our database. The pre-operative mean body mass index (BMI) was 49.8 ± 8.8 kg/m2. The 30-day complication rate was 7.7%. The 30-day readmission, reoperation, and mortality rates were 1.8, 1.3, and 0.2%, respectively. The long-term complication rate was 10.9%. Seventy-nine patients were 4 years post SADI-S surgery and follow-up was possible for 44 patients (55.7%). At 4 years, patients had an average change in BMI of 18.1 ± 6 units with an excess weight loss (EWL) of 85.7 ± 27.3%. At 4 years, 97.6% patients were able to maintain HbA1c < 6% with or without the use of diabetic medication. There was a statistically significant difference between most of the pre-operative and post-operative nutritional data.
Conclusions
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.
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Daniel Cottam, the corresponding author reports personal fees and other from Medtronic, outside the submitted work.
Hinali Zaveri has no conflict of interest to declare.
Amit Surve has no conflict of interest to declare.
Austin Cottam has no conflict of interest to declare.
Walter Medlin has no conflict of interest to declare.
Christina Richards has no conflict of interest to declare.
LeGrand Belnap has no conflict of interest to declare.
Samuel Cottam has no conflict of interest to declare.
Benjamin Horsley has no conflict of interest to declare.
All other authors have no commercial associations that might be a conflict of interest in relation to this article.
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Zaveri, H., Surve, A., Cottam, D. et al. Mid-term 4-Year Outcomes with Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy Surgery at a Single US Center. OBES SURG 28, 3062–3072 (2018). https://doi.org/10.1007/s11695-018-3358-x
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DOI: https://doi.org/10.1007/s11695-018-3358-x