Kevin Verhoeff1, Valentin Mocanu2, Aiden Zalasky3, Jerry Dang2, Janice Y Kung4, Noah J Switzer2, Daniel W Birch5, Shahzeer Karmali5. 1. Department of Surgery, University of Alberta, Edmonton, AB, Canada. verhoeff@ualberta.ca. 2. Department of Surgery, University of Alberta, Edmonton, AB, Canada. 3. University of Alberta, Edmonton, AB, Canada. 4. John W. Scott Health Sciences Library, University of Alberta, Edmonton, AB, Canada. 5. Centre for Advancement of Surgical Education and Simulation (CASES), Royal Alexandra Hospital, Edmonton, AB, Canada.
Abstract
PURPOSE: Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) offers a novel bariatric procedure. This systematic review and meta-analysis evaluates observational and comparative studies evaluating SADI-S, with meta-analysis comparing outcomes to other malabsorptive procedures (MPs). MATERIALS AND METHODS: Systematic search of MEDLINE, Embase, Scopus, and Web of Science was conducted in March 2021. The study followed PRISMA guidelines. Studies evaluating SADI-S with n > 5 were included. Primary outcome was diabetes (DM) remission, and secondary outcomes included perioperative outcomes, comorbidity resolution, and weight loss. RESULTS: We reviewed 2285 studies with 16 included evaluating 3319 patients and 1704 (51.3%) undergoing SADI-S. SADI-S patients had increased BMI (49.6 kg/m2 vs 48.8 kg/m2) and weight (139.7 kg vs 137.1 kg), were more likely to have DM (46.3% vs 42.1%), and dyslipidemia (36.6% SADI-S vs 32.7%). SADI-S had a shorter operative duration than MPs (MD - 36.74, p < 0.001), 0.85-day shorter post-operative stay (p < 0.001), and trended towards fewer complications (OR 0.69, p = 0.06). Rate of reoperation (OR 0.83, p = 0.59) was similar and DM remission was similar (OR 0.07, p = 0.1). Subgroup analysis suggested greater DM remission than Roux-en-Y gastric bypass (OR 4.42, p = 0.04). SADI-S had fewer malabsorptive complications, though follow-up was shorter. Weight loss was 37.3% compared to 35.6% total weight loss after SADI-S and MPs, respectively. CONCLUSION: SADI-S demonstrates improved metabolic and weight loss outcomes with lower perioperative risks. SADI-S represents a promising bariatric procedure but long-term outcomes are needed to guide future uptake.
PURPOSE: Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) offers a novel bariatric procedure. This systematic review and meta-analysis evaluates observational and comparative studies evaluating SADI-S, with meta-analysis comparing outcomes to other malabsorptive procedures (MPs). MATERIALS AND METHODS: Systematic search of MEDLINE, Embase, Scopus, and Web of Science was conducted in March 2021. The study followed PRISMA guidelines. Studies evaluating SADI-S with n > 5 were included. Primary outcome was diabetes (DM) remission, and secondary outcomes included perioperative outcomes, comorbidity resolution, and weight loss. RESULTS: We reviewed 2285 studies with 16 included evaluating 3319 patients and 1704 (51.3%) undergoing SADI-S. SADI-S patients had increased BMI (49.6 kg/m2 vs 48.8 kg/m2) and weight (139.7 kg vs 137.1 kg), were more likely to have DM (46.3% vs 42.1%), and dyslipidemia (36.6% SADI-S vs 32.7%). SADI-S had a shorter operative duration than MPs (MD - 36.74, p < 0.001), 0.85-day shorter post-operative stay (p < 0.001), and trended towards fewer complications (OR 0.69, p = 0.06). Rate of reoperation (OR 0.83, p = 0.59) was similar and DM remission was similar (OR 0.07, p = 0.1). Subgroup analysis suggested greater DM remission than Roux-en-Y gastric bypass (OR 4.42, p = 0.04). SADI-S had fewer malabsorptive complications, though follow-up was shorter. Weight loss was 37.3% compared to 35.6% total weight loss after SADI-S and MPs, respectively. CONCLUSION: SADI-S demonstrates improved metabolic and weight loss outcomes with lower perioperative risks. SADI-S represents a promising bariatric procedure but long-term outcomes are needed to guide future uptake.
Authors: Romulo P Lind; Muhammad Ghanem; Andre F Teixeira; Muhammad A Jawad; Javier Osorio; Claudio Lazzara; Lucia Sobrino; David Ortiz-Ciruela; Amador Garcia Ruiz de Gordejuela Journal: Obes Surg Date: 2022-10-24 Impact factor: 3.479