Long-Term Results of Single-Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S)

Abstract Background Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is a simplification of the duodenal switch (DS) in which the alimentary limb is eliminated, and the common channel is lengthened from 200 to 300 cm. Short-term results have demonstrated that SADI-S is safe and reproducible and that weight loss and comorbidities resolution are comparable to biliopancreatic diversion or DS. Objective To analyze the long-term outcomes of SADI-S. Methods From May 2007 to December 2015, 164 patients were consecutively submitted to a one-step SADI-S. The mean age was 47 years, and the mean body mass index (BMI) was 45.8 kg/m2. A total of 101 patients had type 2 diabetes, 91 arterial hypertension, 81 obstructive apnea, and 118 dyslipidemia. Limb length was 200 cm in 50 cases, 250 cm in 99, and 300 cm in 15. Results There was no mortality. One patient had a gastric leak, and 2 patients had an anastomotic leak. A total of 25% of the patients were lost to follow-up at 10 years. Excess weight loss and total weight loss were 87% and 38% at 5 years and 80% and 34% at 10 years. A total of 12 patients were submitted to revisional surgery for hypoproteinemia. Preoperatively 41 diabetics were under insulin treatment; at 5 years, 7 remained with insulin and 12 at 10 years. Mean glycemia was 104 mg/dL at 5 years and 118 mg/dL at 10 years. Mean HbA1c was 5.51% at 5 years and 5.86 at 10 years. Conclusion In the long term, SADI-S offers satisfactory weight loss and comorbidities resolution. Graphical Abstract

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A548 Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S): long term results and complications. A single institution experience

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2019.08.486 ◽

2019 ◽

Vol 15 (10) ◽

pp. S227

Author(s):

Renato Roriz Silva ◽

Ramon Vilallonga ◽

Enric Caubet ◽

Oscar Gonzales ◽

Amador Garcia Ruiz de Gordejue ◽

...

Keyword(s):

Sleeve Gastrectomy ◽

Long Term Results ◽

Single Institution ◽

Single Anastomosis ◽

Ileal Bypass

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Five-year outcomes for laparoscopic sleeve gastrectomy from a single center in Turkey

Annals of Saudi Medicine ◽

10.5144/0256-4947.2020.310 ◽

2020 ◽

Vol 40 (4) ◽

pp. 310-315

Author(s):

Hakan Seyit ◽

Halil Alis

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Weight Gain ◽

Laparoscopic Sleeve Gastrectomy ◽

Major Complication ◽

Long Term Results ◽

Randomized Controlled Studies ◽

The Mean

ABSTRACT BACKGROUND: There are no long-term results for laparoscopic sleeve gastrectomy (LSG) from Turkey. OBJECTIVES: Assess the outcomes of LSG at 5 years. DESIGN: Retrospective. SETTING: Training and research hospital. PATIENTS AND METHODS: The study included patients with LSG performed from August 2012 to December 2013. The data was prospectively collected with the aim of providing 5-year outcomes. MAIN OUTCOME MEASURES: Changes in percentage excessive weight loss (%EWI) and BMI. Changes in the pharmacological treatment status of patients with type 2 diabetes mellitus and hypertension. SAMPLE SIZE AND CHARACTERISTICS: 120 patients (89 female) completed follow up; mean age 37 years (range, 19-63 years), mean preoperative BMI 48.3 kg/m 2 (range 40-80.4 kg/m 2 ). RESULTS: After a mean 5.6-year follow-up, the mean (SD) postoperative weight loss was 43.5 (11.8) kg and the mean (SD) BMI loss was 16.1 (4.4). The mean %EWL value was 62.9% (range, 30-101%). Most patients (87.5%, n=105) achieved satisfactory %EWL values. The major complication rate was 6.6%. After surgery, 74.2% of patients taking medication for hypertension were able to stop treatment, while 12.9% reduced the dose, of patients that took medication for diabetes, all had a dosage reduction. CONCLUSIONS: We showed that LSG is an acceptable bariatric procedure, but in the long-term there may be weight gain and frequent reflux symptoms. We think renewed weight gain can be partially prevented by close clinical follow-up. There is a need for long-term randomized controlled studies with long-term follow-up to clearly define the indications for LSG. LIMITATIONS: Retrospective, incomplete clinical visits, GERD symptoms not objectively assessed. CONFLICT OF INTEREST: None.

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Single Anastomosis Duodenoileal Bypass or Roux-en-Y Gastric Bypass After Failed Sleeve Gastrectomy: Medium-Term Outcomes

Obesity Surgery ◽

10.1007/s11695-021-05609-1 ◽

2021 ◽

Author(s):

Phillip J. Dijkhorst ◽

May Al Nawas ◽

Laura Heusschen ◽

Eric J. Hazebroek ◽

Dingeman J. Swank ◽

...

Keyword(s):

Quality Of Life ◽

Weight Loss ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Revisional Surgery ◽

Complication Rates ◽

Total Weight Loss ◽

Micronutrient Deficiencies ◽

Single Anastomosis

Abstract Background Although the sleeve gastrectomy (SG) has good short-term results, it comes with a significant number of patients requiring revisional surgery because of insufficient weight loss or functional complications. Objective To investigate the effectiveness of the single anastomosis duodenoileal bypass (SADI-S) versus the Roux-en-Y gastric bypass (RYGB) on health outcomes in (morbidly) obese patients who had previously undergone SG, with up to 5 years of follow-up. Methods Data from patients who underwent revisional SADI-S or RYGB after SG were retrospectively compared on indication of surgery, weight loss, quality of life, micronutrient deficiencies, and complications. Results From 2007 to 2017, 141 patients received revisional laparoscopic surgery after SG in three specialized Dutch bariatric hospitals (SADI-S n=63, RYGB n=78). Percentage total weight loss following revisional surgery at 1, 2, 3, 4, and 5 years was 22%, 24%, 22%, 18%, and 15% for SADI-S and 10%, 9%, 7%, 8%, and 2% for RYGB (P<.05 for 1–4 years). Patients who underwent RYGB surgery for functional complications experienced no persistent symptoms of GERD or dysphagia in 88% of cases. No statistical difference was found in longitudinal analysis of change in quality of life scores or cross-sectional analysis of complication rates and micronutrient deficiencies. Conclusion Conversion of SG to SADI-S leads to significantly more total weight loss compared to RYGB surgery with no difference in quality of life scores, complication rates, or micronutrient deficiencies. When GERD in sleeve patients has to be resolved, RYGB provides adequate outcomes. Graphical abstract

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Gamma Knife surgery for trigeminal schwannoma

Journal of Neurosurgery ◽

10.3171/jns.2007.106.5.839 ◽

2007 ◽

Vol 106 (5) ◽

pp. 839-845 ◽

Cited By ~ 44

Author(s):

Jason Sheehan ◽

Chun Po Yen ◽

Yasser Arkha ◽

David Schlesinger ◽

Ladislau Steiner

Keyword(s):

Gamma Knife ◽

Gamma Knife Surgery ◽

Long Term Results ◽

University Of Virginia ◽

Trigeminal Schwannoma ◽

The Mean ◽

The University ◽

Lost To Follow Up

Object Trigeminal schwannomas are rare intracranial tumors. In the past, resection and radiation therapy were the mainstays of their treatment. More recently, neurosurgeons have begun to use radiosurgery in the treatment of trigeminal schwannomas because of its successful use in the treatment of vestibular schwannomas. In this article the authors evaluate the radiological and clinical outcomes in a series of patients in whom Gamma Knife surgery (GKS) was used to treat trigeminal schwannomas. Methods Twenty-six patients with trigeminal schwannomas underwent GKS at the University of Virginia Lars Lek-sell Gamma Knife Center between 1989 and 2005. Five of these patients had neurofibromatosis and one patient was lost to follow up. The median tumor volume was 3.96 cm3, and the mean follow-up period was 48.5 months. The median prescription radiation dose was 15 Gy, and the median prescription isodose configuration was 50%. There was clinical improvement in 18 patients (72%), a stable lesion in four patients (16%), and worsening of the disease in three patients (12%). On imaging, the schwannomas shrank in 12 patients (48%), remained stable in 10 patients (40%), and increased in size in three patients (12%). These results were comparable for primary and adjuvant GKSs. No tumor growth following GKS was observed in the patients with neurofibromatosis. Conclusions Gamma Knife surgery affords a favorable risk-to-benefit profile for patients harboring trigeminal schwannomas. Larger studies with open-ended follow-up review will be necessary to determine the long-term results and complications of GKS in the treatment of trigeminal schwannomas.

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Gamma Knife thalamotomy for treatment of essential tremor: long-term results

Journal of Neurosurgery ◽

10.3171/2009.10.jns09332 ◽

2010 ◽

Vol 112 (6) ◽

pp. 1311-1317 ◽

Cited By ~ 70

Author(s):

Ronald F. Young ◽

Francisco Li ◽

Sandra Vermeulen ◽

Robert Meier

Keyword(s):

Surgical Treatment ◽

Essential Tremor ◽

Gamma Knife ◽

Surgical Intervention ◽

Long Term Results ◽

The Mean ◽

Lost To Follow Up ◽

Deep Brain

Object The goal of this report was to describe the safety and effectiveness of nucleus ventralis intermedius (VIM) thalamotomy performed with the Leksell Gamma Knife (GK) for the treatment of essential tremor (ET). Methods One hundred seventy-two patients underwent a total of 214 VIM thalamotomy procedures with the Leksell GK between February 1994 and March 2007 for treatment of disabling ET. Eleven patients were lost to follow-up less than 1 year after the procedures, so that in this report the authors describe the results in 161 patients who underwent a total of 203 thalamotomies (119 unilateral and 42 bilateral). Results There were statistically significant decreases (p < 0.0001) in tremor scores for both writing and drawing. The mean postoperative follow-up duration for all patients was 44 ± 33 months. Fifty-four patients have been followed for more than 60 months posttreatment. There were 14 patients who suffered neurological side effects that were temporary (6) or permanent (8), which accounted for 6.9% of the 203 treatments. All complications were related to lesions that grew larger than expected. Conclusions A VIM thalamotomy with the Leksell GK offers a safe and effective alternative for surgical treatment of ET. It is particularly applicable to patients who are not ideal candidates for deep brain stimulation but can be offered to all patients who are considering surgical intervention for ET.

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Comparative analysis of the single-anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) to established bariatric procedures: an assessment of 2-year postoperative data illustrating weight loss, type 2 diabetes, and nutritional status in a single US center

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2019.10.008 ◽

2020 ◽

Vol 16 (1) ◽

pp. 24-33 ◽

Cited By ~ 5

Author(s):

Paul Enochs ◽

Jaime Bull ◽

Amit Surve ◽

Daniel Cottam ◽

Scott Bovard ◽

...

Keyword(s):

Type 2 Diabetes ◽

Weight Loss ◽

Sleeve Gastrectomy ◽

Comparative Analysis ◽

Nutritional Status ◽

Single Anastomosis ◽

Ileal Bypass

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Laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy (SADJB-SG): Surgical risk and long-term results

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2018.11.020 ◽

2019 ◽

Vol 15 (2) ◽

pp. 236-243 ◽

Cited By ~ 2

Author(s):

Kong-Han Ser ◽

Wei-Jei Lee ◽

Jung-Chien Chen ◽

Pei-Ling Tsai ◽

Shu-Chun Chen ◽

...

Keyword(s):

Sleeve Gastrectomy ◽

Long Term Results ◽

Surgical Risk ◽

Single Anastomosis ◽

Jejunal Bypass

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Revisional One Anastomosis Gastric Bypass with a 150-cm Biliopancreatic Limb After Failure of Adjustable Gastric Banding: Mid-Term Outcomes and Comparison Between One- and Two-Stage Approaches

Obesity Surgery ◽

10.1007/s11695-021-05728-9 ◽

2021 ◽

Author(s):

Niccolò Petrucciani ◽

Francesco Martini ◽

Marine Benois ◽

Radwan Kassir ◽

Hubert Boudrie ◽

...

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Gastric Banding ◽

Adjustable Gastric Banding ◽

Postoperative Morbidity ◽

Biliopancreatic Limb ◽

The Mean ◽

Lost To Follow Up

Abstract Purpose Laparoscopic adjustable gastric banding (LAGB) was a common procedure worldwide but associated with a high rate of long-term failure. This study aims to evaluate the safety and effectiveness of conversion to one anastomosis gastric bypass (OAGB) after failed LAGB. Materials and Methods We undertook a retrospective analysis of a prospectively maintained database in a tertiary referral center for bariatric surgery. All cases of revisional OAGB with a biliopancreatic limb (BPL) of 150 cm after failed LAGB performed between 2010 and 2016 were analyzed. Results Overall, 215 patients underwent conversion from LAGB to OAGB. Indication for surgery was primary weight loss (WL) failure in 30.7% of cases and long-term complications in the remaining patients, with or without associated weight regain. At the time of OAGB, the mean age was 43.2 ± 10.5 years and the mean BMI was 42 ± 6.9. Overall postoperative morbidity was 13.5%. The postoperative abscess ± leak rate was 5.9% in the overall population. Two years after OAGB, 9.7% of patients were lost to follow-up, % excess weight loss (EWL) was 88.2 ± 23.9, and % total weight loss (TWL) was 38.7 ± 9.3. At 5 years, 16.6% of patients were lost to follow-up, %EWL was 82.4 ± 25, and %TWL was 36.1 ± 10. There was no statistical difference in complication rates or WL results between the one-stage and two-stage approaches. Conclusion OAGB with a 150-cm BPL represents a safe and effective option after failed LAGB. Both synchronous OAGB and two-step revisional OAGB guarantee satisfying results in terms of postoperative morbidity and WL outcomes. Graphical abstract (PLEASE CORRECT THE GRAPHICAL ABSTRACT !!! 215 PATIENTS INSTEAD OF 250

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Weight Loss Outcomes following Roux-en-Y Gastric Bypass and Sleeve Gastrectomy in an Ethnically Diverse Bariatric Population: Which Is More Effective?

Minimally Invasive Surgery ◽

10.1155/2021/9702976 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Saqib Saeed ◽

Leaque Ahmed ◽

Khuram Khan ◽

Sanjiv Gray ◽

Kashif Saeed ◽

...

Keyword(s):

New York ◽

Weight Loss ◽

Gastric Bypass ◽

African American ◽

Sleeve Gastrectomy ◽

Ethnically Diverse ◽

Diverse Patient Population ◽

Weight Loss Outcomes ◽

The Mean

Background. Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) have comparable weight loss outcomes in a general bariatric population. Objectives. This study aimed to investigate whether similar outcomes can be observed in Hispanic and African American population. Settings. Community Hospital in New York, New York, United States. Methods. The 5-year prospective data of patients who underwent LRYGB and LSG at a single center were retrospectively reviewed. The long-term weight loss outcomes between patients who had LRYGB and LSG were compared after adjusting for age, sex, race, diabetes mellitus, and hypertension with the linear mixed-effects or logistic regression model. Results. Most patients were Hispanic (59.2%) and African American (22.7%). The mean% total weight loss (%TWL) values of patients with BMI <45 kg/m2 who underwent LRYGB and LSG were 73% and 62% after 1 year, 69% and 56% after 2 years, and 71% and 54% after 5 years, respectively. In patients with a BMI of 45–50 kg/m2 who underwent LRYGB and LSG, the mean %TWL values were 69% and 56% after 1 year, 75% and 58% after 2 years, and 57% and 45% after 5 years, respectively. Meanwhile, the %TWL values of patients with BMI >50 kg/m2 who had LRYGB and LSG were 53% and 42% after 1 year, 53% and 45% after 2 years, and 49% and 36% after 5 years, respectively. All results were statistically significant p < 0.0001 and remained valid after adjusting for cofactors. Conclusion. Thus, LRYGB had consistent and sustained long-term weight loss outcomes compared with LSG in a predominantly ethnically diverse patient population with different BMI. Our study had several limitations in that it is retrospective in nature and some patients were lost to follow-up during the study period.

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