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1-Year Follow-up of Single Anastomosis Sleeve Ileal (SASI) Bypass in Morbid Obese Patients: Efficacy and Concerns

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Abstract

Background

Single anastomosis sleeve ileal (SASI) bypass is a new bariatric and metabolic procedure that has both restrictive and malabsorptive effects. This study was conducted to assess both the efficacy and safety of this procedure in a short-term follow-up.

Methods

This retrospective cohort study examined weight loss- and obesity-related comorbidities and complications in patients who had undergone SASI bypass from October 2017 to March 2018 at a center of excellence for bariatric/metabolic surgery.

Results

Twenty-four patients had undergone SASI bypass due to some existing risk factors of gastric cancer or premalignant lesions in the esophagogastroduodenoscopy. The mean BMI of the patients was 44.2 (median 43.7, range 37.0–54.8) kg/m2. Six and 12 months after surgery, the mean (median) excessive weight loss (EWL) was 67.8% (63.3) and 86.2% (82.9) and total weight loss (TWL) was 28.5% (27.6) and 36.46% (35.8), respectively. Most patients had complete remission in type 2 diabetes mellitus (89%), arterial hypertension (86%), dyslipidemia (100%), obstructive sleep apnea (100%), and non-alcoholic fatty liver disease (73%) during the 1 year after surgery. One case of extra-luminal bleeding and one case of trocar site hernia occurred after surgery. Moreover, two patients converted to sleeve gastrectomy because of hypoalbuminemia and EWL about 1 year after SASI.

Conclusion

SASI bypass is a newly introduced investigational procedure for improving weight loss and comorbidities; however, it may result in EWL and protein malnutrition and should only be performed for select patients and by well-experienced bariatric surgeons.

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Funding

This work was funded and supported by the Iran University of Medical Sciences (IUMS) on January 7, 2019, with this code number: 97-4-39-13791.

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Authors and Affiliations

  1. Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran

    Mohammad Kermansaravi & Abdolreza Pazouki

  2. Iran National Center of Excellence for Minimally Invasive Surgery Education, Iran University of Medical Sciences, Tehran, Iran

    Mohammad Kermansaravi & Abdolreza Pazouki

  3. Center of Excellence of European Branch of International Federation for Surgery of Obesity, Tehran, Iran

    Mohammad Kermansaravi & Abdolreza Pazouki

  4. Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Mansoury Alley, Niyayesh St., Sattarkhan St, Tehran, Iran

    Mohammad Kermansaravi & Ali Kabir

Authors
  1. Mohammad Kermansaravi
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  2. Ali Kabir
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  3. Abdolreza Pazouki
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Correspondence to Mohammad Kermansaravi or Ali Kabir.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Kermansaravi, M., Kabir, A. & Pazouki, A. 1-Year Follow-up of Single Anastomosis Sleeve Ileal (SASI) Bypass in Morbid Obese Patients: Efficacy and Concerns. OBES SURG 30, 4286–4292 (2020). https://doi.org/10.1007/s11695-020-04781-0

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  • DOI: https://doi.org/10.1007/s11695-020-04781-0

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