Highlights
- •SADI-S and BPD/DS showed similar efficacy and safety
- •BPD/DS showed greater total weight loss
- •SADI-S is technically simpler and less time consuming
- •SADI-S can represent an advantage over BPD/DS
Abstract
Background
Biliopancreatic diversion with duodenal switch (BPD/DS) is the most effective bariatric
surgery in super-obese patients, although technically complex and time consuming.
As a primary surgery, single anastomosis duodeno-ileal bypass with sleeve gastrectomy
(SADI-S) is similar to BPD/DS in terms of short-term outcomes, but long-term and comparative
data are lacking.
Objectives
The aim of this study was to compare the outcomes of patients submitted to SADI-S
and BPD/DS.
Setting
Public hospital.
Methods
Obese patients (n = 112) submitted to SADI-S (n = 83) and BPD/DS (n = 29) for obesity
treatment were prospectively compared.
Results
The mean preoperative body mass indexes (BMIs) were 53.41 ± .93 for BPD/DS and 50.61
± .52 kg/m2 for SADI-S. Follow-up of 48 months was achieved in 18% (n = 21) of patients, with
a nonsignificant difference in the percentage of excess BMI loss (%EBMIL; 81.20 ±
3.71 for BPD/DS; 74.82 ± 3.45 for SADI-S). Operative time (164.30 ± 7.78 minutes for
BPD/DS; 132.70 ± 7.19 minutes for SADI-S; P = .006) and hospital stay (4.90 ± 1.10 days for BPD/DS; 4.35 ± .70 days for SADI-S;
P = .006) were significantly shorter for SADI-S. There was no significant difference
in the 30-day postoperative complication rate. No mortality was reported. After surgery,
significant improvements were observed in glucose and lipid profiles for both groups.
The type 2 diabetes remission rate was 100% for BPD/DS and ranged from 60 to 80% for
SADI-S across follow-up times. Dyslipidemia remission followed a similar pattern.
Protein deficiency was observed in up to 50% of patients after BPD/DS and 20% after
SADI-S, without statistically significances.
Conclusion
SADI-S and BPD/DS as primary surgery for obesity treatment result in no significant
differences in %EBMIL, improvement in obesity-related diseases, nutritional deficiencies,
and postoperative morbidity. Nevertheless, there was greater total weight loss after
BPD/DS. SADI-S, being less time consuming and technically simpler, can represent an
advantage over BPD/DS.
Key words
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Article info
Publication history
Published online: September 23, 2020
Accepted:
September 16,
2020
Received:
July 1,
2020
Identification
Copyright
© 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Comment on: Single and dual anastomosis duodenal switch for obesity treatment: a single center experienceSurgery for Obesity and Related DiseasesVol. 17Issue 1
- PreviewThe quest for the ideal or perfect bariatric procedure continues. Perhaps it is an unachievable goal. Whereas the objective of the vast majority of surgical procedures is to remove disease or reconstruct a damaged area, bariatric and metabolic surgery does the opposite. It alters normal tissue to create a controlled abnormality. The stomach is reduced in size and the amount of the intestine in contact with food is shortened. While the objective is to reduce hunger and promote early satiety, these alterations have repercussions.
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- Preview
- Comment on: Single and dual anastomosis duodenal switch for obesity treatment: a single center experienceSurgery for Obesity and Related DiseasesVol. 17Issue 1
- PreviewI read with interest the article entitled “Single and Dual Anastomosis Duodenal Switch for Obesity Treatment: A Single Centre Experience,” in which single-anastomosis duodeno-ileostomy (SADI-S) was compared with duodenal switch (DS) in a single, public hospital in a nonrandomized fashion [1]. Although the patients who underwent DS had a slighter higher mean preoperative body mass index (BMI) of 53.4 kg/m2, versus 50.6 kg/m2 in the patients who underwent SADI-S, this difference was not significant.
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