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Evaluation of the Efficacy of Single Anastomosis Sleeve Ileal (SASI) Bypass for Patients with Morbid Obesity: a Multicenter Study

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Abstract

Background

Single anastomosis sleeve ileal (SASI) bypass is a newly introduced bariatric and metabolic procedure. The present multicenter study aimed to evaluate the efficacy of the SASI bypass in the treatment of patients with morbid obesity and the metabolic syndrome.

Methods

This is a retrospective, seven-country, multicenter study on patients with morbid obesity who underwent the SASI bypass. Data regarding patients’ demographics, body mass index (BMI), percentage of total weight loss (%TWL), percentage of excess weight loss (%EWL), and improvement in comorbidities at 12 months postoperatively and postoperative complications were collected.

Results

Among 605 patients who underwent the SASI, 54 were excluded and 551 (390; 70.8% female) were included. At 12 months after the SASI, a significant decrease in the BMI was observed (43.2 ± 12.5 to 31.2 ± 9.7 kg/m2; p < 0.0001). The %TWL was 27.4 ± 13.4 and the %EWL was 63.9 ± 29.5. Among the 279 patients with type 2 diabetes mellitus (T2DM), complete remission was recorded in 234 (83.9%) patients and partial improvement in 43 (15.4%) patients. Eighty-six (36.1%) patients with hypertension, 104 (65%) patients with hyperlipidemia, 37 (57.8%) patients with sleep apnea, and 70 (92.1%) patients with GERD achieved remission. Fifty-six (10.1%) complications and 2 (0.3%) mortalities were recorded. Most complications were minor. All patients had 12 months follow-up.

Conclusions

The SASI bypass is an effective bariatric and metabolic surgery that achieved satisfactory weight loss and improvement in medical comorbidities, including T2DM, hypertension, sleep apnea, and GERD, with a low complication rate.

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Authors and Affiliations

  1. General Surgery Department, Mansoura Faculty of Medicine, Mansoura University Hospitals, Mansoura University, 60 El-Gomhoria Street Dakahlia, Mansoura, 35516, Egypt

    Tarek Mahdy, Sameh Hany Emile & Amr Madyan

  2. Aker University Hospital, Oslo, Norway

    Carl Schou

  3. Sharjah University Hospital, Sharjah, United Arab Emirates

    Abdulwahid Alwahidi

  4. Clinica De Santo Antonio, Lusiadas, Amadora, Lisbon, Portugal

    Rui Ribeiro

  5. General Surgery Department, Minia Faculty of Medicine, Minia University, Minya, Egypt

    Alaa Sewefy

  6. Klinikum Vest, Dorstenerstr, 151, 45657, Recklinghausen, Germany

    Martin Büsing

  7. Sidra Hospital, Riggae Area, Kuwait

    Mohammed Al-Haifi

  8. Atakent Hospital, Istanbul, Turkey

    Emad Salih

  9. Brigham and Women’s Hospital, Harvard Medical School, Boston, USA

    Scott Shikora

Authors
  1. Tarek Mahdy
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  2. Sameh Hany Emile
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  5. Abdulwahid Alwahidi
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  8. Martin Büsing
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  11. Scott Shikora
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Contributions

Tarek Mahdy designed the study and participated in data collection, drafting, and revision of the manuscript. Sameh Emile and Amr Madyan conducted data analysis and wrote and revised the manuscript. Carl Scho, Abdulwahid Alwahidi, Rui Ribier, Alaa Elsewefy, Martin Busing, Mohammed AL-Haifi, and Emad Sali performed the procedures, followed the patients, collected the data, and revised the final manuscript. Scott Shikora participated in drafting and critical supervision of the manuscript.

Corresponding author

Correspondence to Sameh Hany Emile.

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The authors declare that they have no conflict of interest.

Statement of Informed Consent

Informed consent was not required for this type of studies (retrospective review of data).

Statement of Human and Animal Rights

This study was conducted in accordance with the declaration of Helsinki. Ethical approval for the study was obtained from the Institutional Ethics Committee.

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Mahdy, T., Emile, S.H., Madyan, A. et al. Evaluation of the Efficacy of Single Anastomosis Sleeve Ileal (SASI) Bypass for Patients with Morbid Obesity: a Multicenter Study. OBES SURG 30, 837–845 (2020). https://doi.org/10.1007/s11695-019-04296-3

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  • DOI: https://doi.org/10.1007/s11695-019-04296-3

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