Sleeve Gastrectomy, One-Anastomosis Gastric Bypass (OAGB), and Single Anastomosis Sleeve Ileal (SASI) Bypass in Treatment of Morbid Obesity: a Retrospective Cohort Study.

Abstract:

PURPOSE:Bariatric surgery is the most effective treatment for morbid obesity. The present study aimed to assess three bariatric procedures with different mechanisms of actions; sleeve gastrectomy (SG), one-anastomosis gastric bypass (OAGB), and single anastomosis sleeve ileal (SASI) bypass, in terms of efficacy and safety. METHODS:This was a retrospective cohort study on patients with morbid obesity who underwent SG, OAGB, or SASI bypass. The main outcome measures were weight loss and improvement in comorbidities at 6 and 12 months postoperatively, and complications. RESULTS:A total of 264 patients (186 female) with mean preoperative body mass index (BMI) of 43.6 ± 9.9 kg/m2were included to the study. Significant weight loss was recorded at 6 and 12 months after the three procedures. At 6 and 12 months postoperatively, body weight and BMI were significantly lower after SASI bypass than after SG and OAGB. The %total weight loss (%TWL) and %excess weight loss (%EWL) were significantly higher after SASI bypass than after SG and OAGB. SASI bypass was associated with a significantly higher rate of improvement in DM than SG and OAGB (97.7% vs 71.4% vs 86.7%; p = 0.04) whereas improvement in other comorbidities was similar. The short-term complication rate was similar between the three procedures, yet SASI bypass was followed by higher long-term complication rate. CONCLUSION:Based on retrospective review of data, SASI bypass was associated with more reduction in body weight and BMI, higher %TWL and %EWL, better improvement in T2DM, and more long-term nutritional complications than SG and OAGB.

journal_name

Obes Surg

journal_title

Obesity surgery

authors

Mahdy T,Gado W,Alwahidi A,Schou C,Emile SH

doi

10.1007/s11695-020-05159-y

subject

Has Abstract

pub_date

2021-01-06 00:00:00

eissn

0960-8923

issn

1708-0428

pii

10.1007/s11695-020-05159-y

pub_type

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