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Short-term Outcome of Single-Anastomosis Plication Ileal Bypass (SAPI) in Treatment of Morbid Obesity

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Abstract

Purpose

This prospective study aimed to report the short-term outcome of the single-anastomosis plication ileal (SAPI) bypass in the treatment of morbid obesity.

Methods

Adult patients with morbid obesity who underwent SAPI procedure were recruited to this prospective study. SAPI procedure involved plication of the greater curvature of the stomach in two rows then performing a stapled side-to-side anastomosis between an ileal loop and the gastric antrum. Body mass index (BMI), percentage excess weight loss (%EWL), percentage total weight loss (%TWL), and improvement in comorbidities were recorded at 6 and 12 months postoperatively.

Results

The present study included 56 patients (48 female) of a mean age of 37.3 years. There was a significant decrease in BMI at 6 months (37.2 ± 9.3) and 12 months (31.5 ± 7.8) as compared with the baseline BMI (47.9 ± 5.7). The %EWL at 12 months was 72.5 ± 16.2, significantly higher than its value at 6 months (50.1 ± 15.6). The %TWL at 12 months was 36.4 ± 6.4, significantly higher than its value at 6 months (24.9 ± 6.3). All patients with DM showed remission or improvement in their diabetic state. Improvement in hyperlipidemia and hypertension was recorded in 81.8% and 77.8% of patients, respectively. Postoperative complications were recorded in five (8.9%) patients.

Conclusion

SAPI procedure achieved significant reduction in body weight and BMI, significant %EWL, and satisfactory improvement in comorbidities at 12 months after surgery. Longer follow-up of patients is needed to reach more solid conclusions on the efficacy and safety of this new technique.

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References

  1. Talebpour M, Motamedi SMK, Telbpour A, et al. Twelve year experience of laparoscopic gastric plication in morbid obesity: development of the technique and patient outcomes. Ann Surg Innov Res. 2012;22(6):7.

    Article  Google Scholar 

  2. Abdelbaki TN, Huang CK, Ramos A, et al. Gastric plication for morbid obesity: a systematic review. Obes Surg. 2012;22(10):1633–9. https://doi.org/10.1007/s11695-012-0723-z.

    Article  PubMed  Google Scholar 

  3. Ye Q, Chen Y, Zhan X, et al. Comparison of laparoscopic sleeve gastrectomy and laparoscopic greater curvature plication regarding efficacy and safety: a meta-analysis. Obes Surg. 2017;27(5):1358–64. https://doi.org/10.1007/s11695-017-2630-9.

    Article  PubMed  Google Scholar 

  4. Mahdy T, Al Wahedi A, Schou C. Efficacy of single anastomosis sleeve ileal (SASI) bypass for type-2 diabetic morbid obese patients: gastric bipartition, a novel metabolic surgery procedure: a retrospective cohort study. Int J Surg. 2016;34:28–34. https://doi.org/10.1016/j.ijsu.2016.08.018.

    Article  CAS  PubMed  Google Scholar 

  5. Elbanna H, Emile S, Abdel-Razik MA. Single-anastomosis plication ileal bypass (SAPI) in treatment of morbid obesity. Surg Laparosc Endosc Percutan Tech. 2019;29(2):e12–4. https://doi.org/10.1097/SLE.0000000000000600.

    Article  PubMed  Google Scholar 

  6. Brethauer SA, Kim J, el Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis. 2015;11(3):489–506. https://doi.org/10.1016/j.soard.2015.02.003.

    Article  PubMed  Google Scholar 

  7. Santoro S, Castro LC, Velhote MC, et al. Sleeve gastrectomy with transit bipartition: a potent intervention for metabolic syndrome and obesity. Ann Surg. 2012;256(1):104–10. https://doi.org/10.1097/SLA.0b013e31825370c0.

    Article  PubMed  Google Scholar 

  8. Lustig RH. The neuroendocrinology of obesity. Endocrinol Metab Clin N Am. 2001;30(3):765e785.

    Article  Google Scholar 

  9. Emile SH, Madyan A, Mahdy T, Elshobaky A, Elbanna HG, Abdel-Razik MA. Single anastomosis sleeve ileal (SASI) bypass versus sleeve gastrectomy: a case-matched multicenter study. Surg Endosc. 2020 https://doi.org/10.1007/s00464-020-07430-w.

  10. Talebpour M, Amoli BS. Laparoscopic total gastric vertical plication in morbid obesity. J Laparoendosc Adv Surg Tech A. 2007;17(6):793–8.

    Article  Google Scholar 

  11. Doležalova-Kormanova K, Buchwald JN, Skochova D, et al. Five-year outcomes: laparoscopic greater curvature plication for treatment of morbid obesity. Obes Surg. 2017;27:2818–28.

    Article  Google Scholar 

  12. Mahdy T, Emile SH, 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. 2020;30(3):837–45. https://doi.org/10.1007/s11695-019-04296-3.

    Article  PubMed  Google Scholar 

  13. Emile SH, Elfeki H, Elalfy K, et al. Laparoscopic sleeve gastrectomy then and now: an updated systematic review of the progress and short-term outcomes over the last 5 years. Surg Laparosc Endosc Percutan Tech. 2017;27(5):307–17. https://doi.org/10.1097/SLE.0000000000000418.

    Article  PubMed  Google Scholar 

  14. Borgeraas H, Hofsø D, Hertel JK, Hjelmesaeth J. Comparison of the effect of Roux-en-Y gastric bypass and sleeve gastrectomy on remission of type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Obes Rev. 2020. https://doi.org/10.1111/obr.13011.

  15. Emile SH, Elfeki H. Nutritional deficiency after sleeve gastrectomy: a comprehensive literature review. EMJ Gastroenterol. 2017;6(1):99–105.

    Google Scholar 

  16. Bhandari M, Fobi MAL, Buchwald JN, et al. Standardization of bariatric metabolic procedures: world consensus meeting statement. Obes Surg. 2019;29(Suppl 4):309–45. https://doi.org/10.1007/s11695-019-04032-x.

    Article  PubMed  Google Scholar 

  17. Nelson L, Moon RC, Teixeira AF, et al. Safety and effectiveness of single anastomosis duodenal switch procedure: preliminary result from a single institution. Arq Bras Cir Dig. 2016;29(Suppl 1):80–4. https://doi.org/10.1590/0102-6720201600S10020.

    Article  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. General Surgery Department, Faculty of medicine, Mansoura University Hospitals, Mansoura University, Mansoura city, Egypt

    Hosam Elbanna, Mohamed Anwar Abdel-Razik & Sameh Hany Emile

Authors
  1. Hosam Elbanna
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  2. Mohamed Anwar Abdel-Razik
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  3. Sameh Hany Emile
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Contributions

Hossam Elbanna produced the concept of and designed the study, contributed to data collection and writing of the manuscript. Sameh Emile and Mohamed Abdel-Razik contributed to data analysis and writing and revision of the manuscript.

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Correspondence to Hosam Elbanna.

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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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Elbanna, H., Abdel-Razik, M.A. & Emile, S.H. Short-term Outcome of Single-Anastomosis Plication Ileal Bypass (SAPI) in Treatment of Morbid Obesity. OBES SURG 30, 5041–5046 (2020). https://doi.org/10.1007/s11695-020-04961-y

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  • DOI: https://doi.org/10.1007/s11695-020-04961-y

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