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The Alarming Rate of Malnutrition after Single Anastomosis Sleeve Ileal Bypass. A single Centre Experience

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Abstract

Background

Single anastomosis sleeve ileal (SASI) bypass is a modification of sleeve gastrectomy with transit bipartition (SG + TB). This study aims to assess the safety and efficacy of SASI as a primary metabolic and bariatric surgery (MBS).

Methods

This is a retrospective case series of 30 patients who underwent SASI bypass from January to December 2021. All patients completed at least 12 months of follow-up.

Results

Among the 30 patients, 93.3% were women, the mean age was 37.4 years, and the mean body mass index (BMI) was 45.6 kg/m2. The percentage of total body weight loss (TWL%) was 42.7%, the percent excess body weight loss (EWL%) was 92.7%, and the mean BMI at 12 months went from 45.6(35.2–58.4) to 25.8 kg/m2 (19.2–33.4). The obesity-associated complications remission rate was 87.5% for type 2 diabetes (T2D), 71.4% for hypertension (HTN) and 100% for obstructive sleep apnea (OSA). Thirteen patients (43.3%) had diarrhea, 7 (23.3%) had hypoalbuminemia, defined as serum albumin < 3 g/dl, and 6 (20%) underwent reversal of their index SASI. As for other nutritional issues, iron deficiency anemia was present in 21 patients (70%), while 19 patients (63.3%) had vitamin D, and 2(6.6%) had vitamin B12 deficiency.

Conclusion

Despite good short-term weight loss and improvement of obesity-associated complications, SASI is accompanied by high alarming malnutrition, even in short-term follow-up. Novel MBS should be judged for their long-term effects and compared to well-tested standard operations before they are used in routine clinical practice.

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Funding

There was no funding received for this manuscript.

Author information

Authors and Affiliations

  1. Aljazeera International Hospital, Misurata University School of Medicine, Misurata, Libya

    Ala Wafa

  2. Gastrointestinal Bariatric and Metabolic Surgery Center (GBMC), Jordan Hospital, Amman, Jordan

    Ahmad Bashir & Ashraf Haddad

  3. The Center for Obesity and Diabetes, Hospital Alemao Oswaldo Cruz, Sao Paulo, Brazil

    Ricardo V. Cohen

Authors
  1. Ala Wafa
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  2. Ahmad Bashir
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  3. Ricardo V. Cohen
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  4. Ashraf Haddad
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Corresponding author

Correspondence to Ala Wafa.

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For this type of study formal consent is not required.

Conflict of interest

Ala Wafa and Ahmad Bashir have no conflict of interest.

Ricardo V Cohen Coordenador-Centro de Obesidade e Diabetes, Hospital.

Alemão Oswaldo Cruz, São Paulo. Director, The Center for Obesity and Diabetes, Oswaldo Cruz.

German Hospital, São Paulo, Brazil.

Ashraf Haddad is a consultant for Medtronic. RVC received research grants from Medtronic, Johnson&Johnson Medtech. Speaker for Medtronic, Johnson&Johnson Medtech and NovoNordisk. Scientific advisory board for Morphic Medical.

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Key Points

• SASI is a modification of SG + TB.

• Has good short-term weight loss, TWL% was 42.7%, and EWL% was 92.7%.

• Has good short-term improvement of obesity-associated complications.

• Is accompanied by high alarming malnutrition in short-term follow-up.

Supplementary Information

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Supplementary file1 (MP4 108262 KB)

Supplementary file2 (MP4 53695 KB)

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Wafa, A., Bashir, A., Cohen, R.V. et al. The Alarming Rate of Malnutrition after Single Anastomosis Sleeve Ileal Bypass. A single Centre Experience. OBES SURG 34, 1742–1747 (2024). https://doi.org/10.1007/s11695-024-07192-7

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  • DOI: https://doi.org/10.1007/s11695-024-07192-7

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