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Single anastomosis sleeve ileal (SASI) bypass versus sleeve gastrectomy: a case-matched multicenter study

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Abstract

Background

The present study aimed to compare the outcome of single anastomosis sleeve ileal (SASI) bypass and sleeve gastrectomy (SG) in regards weight loss, improvement in comorbidities at 12 months of follow-up, and postoperative complications.

Methods

This was a case-matched, multicenter analysis of the outcome of patients who underwent SG or SASI bypass. Patients who underwent SASI bypass were matched with an equal number of patients who underwent SG in terms of age, sex, BMI, and comorbidities. The main outcome measures were excess weight loss (EWL) at 6 and 12 months after surgery, improvement in medical comorbidities, and complications.

Results

A total of 116 patients (97 female) of a mean age of 35.8 years were included. Fifty-eight patients underwent SASI bypass and an equal number underwent SG. %EWL at 6 months postoperatively was similar between the two groups. SASI bypass conferred significantly higher %EWL at 12 months than SG (72.6 Vs 60.4, p < 0.0001). Improvement in type 2 diabetes mellitus (T2DM) and gastroesophageal reflux disease (GERD) after SASI bypass was better than SG (95.8% Vs 70% and 85.7% Vs 18.2%, respectively). SASI bypass required longer operation time than SG (108.7 Vs 92.8 min, p < 0.0001). Complications occurred in 12 (20.7%) patients after SG and 4 (6.9%) patients after SASI bypass (p = 0.056).

Conclusion

The %EWL at 12 months after SASI bypass was significantly higher than after SG. SASI bypass conferred better improvement in T2DM and GERD than SG. Both procedures had similar weight loss at 6 months postoperatively and comparable complication rates.

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Authors and Affiliations

  1. General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt

    Sameh Hany Emile, Amr Madyan, Tarek Mahdy, Ayman Elshobaky, Hosam Ghazy Elbanna & Mohamed Anwar Abdel-Razik

  2. General Surgery Department, Al Qassimi Hospital, Sharjah, United Arab Emirates

    Tarek Mahdy

Authors
  1. Sameh Hany Emile
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  2. Amr Madyan
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  3. Tarek Mahdy
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  4. Ayman Elshobaky
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  5. Hosam Ghazy Elbanna
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  6. Mohamed Anwar Abdel-Razik
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Contributions

SE and HE designed the study. SE, AM, MAR, and TM contributed to data collection, data analysis, writing and revising the manuscript. HE, SE, AE, and MAR, AM, and TM performed the procedures and contributed to data interpretation and critical revision of the manuscript. Mohamed Abdel-Razik supervised data collection, and critically revised the manuscript.

Corresponding author

Correspondence to Sameh Hany Emile.

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Conflict of interests

Sameh Emile, Amr Madyan, Tarek Mahdy, Ayman Elshobaky, Hosam Elbanna, and Mohamed Abdel-Razik had no conflicts of interests to disclose.

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Emile, S.H., Madyan, A., Mahdy, T. et al. Single anastomosis sleeve ileal (SASI) bypass versus sleeve gastrectomy: a case-matched multicenter study. Surg Endosc 35, 652–660 (2021). https://doi.org/10.1007/s00464-020-07430-w

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  • DOI: https://doi.org/10.1007/s00464-020-07430-w

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