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Single-Anastomosis Sleeve Jejunal Bypass, a Novel Bariatric Surgery, Versus Other Familiar Methods: Results of a 6-Month Follow-up—a Comparative Study

  • Masoud Sayadishahraki
  • Mohammad Taghi RezaeiEmail author
  • Mohsen Mahmoudieh
  • Behrouz Keleydari
  • Shahab Shahabi
  • Mostafa Allami
New Concept
  • 45 Downloads

Abstract

Background

Obesity and its associated morbidities have become a significant concern all over the world. Bariatric surgery, regardless of its type, is the most effective approach for treating morbid obesity. Single-anastomosis sleeve jejunal (SASJ) bypass is a novel bariatric surgery technique and can be considered for patients with former background of severe gastroesophageal symptoms. The purpose of this research was to compare SASJ bypass outcomes with other techniques during a 6-month follow-up.

Methods

This is a non-randomized clinical trial conducted on 100 patients, who underwent four types of bariatric surgery (classic Roux-en-Y bypass, SASJ bypass, omega gastric bypass, and sleeve gastrectomy), and each one of these types contained 25 cases, during the time period of 2 years from 2016 to 2018. Patients’ information including age, gender, height, basal weight, body mass index (BMI), serum albumin, and hemoglobin A1C were recorded, within 1, 3, and 6 months after their surgery, and also were compared with each other.

Results

Members of the four groups were similar due to their age, gender distribution, height, baseline BMI, hemoglobin A1C, albumin, and also excess weight (P value > 0.05); however, the sleeve gastrectomy group baseline weight was significantly higher compared with the other three groups (P value = 0.013). All of the groups significantly lost weight during this 6-month period, but the comparison between them indicated no statistical difference regarding excess weight loss, BMI, hemoglobin A1C, and albumin (P value > 0.05). The excess weight loss mean during 6 months in SASJ bypass was 34.2 ± 5.4%, which was comparable with other groups.

Conclusions

The weight loss trend after the SASJ bypass was similar to that of older techniques; consequently this technique can be considered for cases with particular indications due to the reversibility and also more accessible gastric follow-up studies in the SASJ approach. Further researches with longer follow-ups are strongly recommended.

Keywords

Bariatric surgery Metabolic surgery Jejunal bypass Body mass index 

Notes

Compliance with Ethical Standards

The Isfahan University Ethics Committee approved this study protocol based on the code of IR.MUI.MED.REC.1397089. After the comprehensive information provision about bariatric surgeries, their complications, and long-term outcomes, patients were reassured about their personal information confidentiality and were requested to sign their participation in the study informed consent form.

Conflict of Interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Dixon J. The global burden of obesity and diabetes. In: Minimally invasive bariatric surgery. New York: Springer; 2015. p. 1–6.Google Scholar
  2. 2.
    Nguyen NT, Varela JE. Bariatric surgery for obesity and metabolic disorders: state of the art. Nat Rev Gastroenterol Hepatol. 2017;14(3):160–9.CrossRefGoogle Scholar
  3. 3.
    Picot J, Jones J, Colquitt J, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13(41):1–214.CrossRefGoogle Scholar
  4. 4.
    Colquitt JL, Pickett K, Loveman E, et al. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014;8Google Scholar
  5. 5.
    Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25(10):1822–32.CrossRefGoogle Scholar
  6. 6.
    Santoro S, Milleo FQ, Malzoni CE, et al. Enterohormonal changes after digestive adaptation: five-year results of a surgical proposal to treat obesity and associated diseases. Obes Surg. 2008;18(1):17–26.CrossRefGoogle Scholar
  7. 7.
    Reames BN, Finks JF, Bacal D, et al. Changes in bariatric surgery procedure use in Michigan, 2006-2013. Jama. 2014;312(9):959–61.CrossRefGoogle Scholar
  8. 8.
    Alamo MA, Torres CS, Perez LZ. Vertical isolated gastroplasty with gastro-enteral bypass: preliminary results. Obes Surg. 2006;16(3):353–8.CrossRefGoogle Scholar
  9. 9.
    de Menezes JEMT, Azaro E, Mello CAB, et al. Analysis of the vertical isolated gastroplasty: a new bariatric operation. Obes Surg. 2006;16(9):1263–5.CrossRefGoogle Scholar
  10. 10.
    Huang C-K, Mahendra R, Hsin M-C, et al. Novel metabolic surgery: first Asia series and short-term results of laparoscopic proximal jejunal bypass with sleeve gastrectomy. Ann Laparosc Endosc Surg. 2016;1(7)Google Scholar
  11. 11.
    Alamo M, Sepúlveda M, Gellona J, et al. Sleeve gastrectomy with jejunal bypass for the treatment of type 2 diabetes mellitus in patients with body mass index<35 kg/m 2. A Cohort Study. Obes Surg. 2012;22(7):1097–103.CrossRefGoogle Scholar
  12. 12.
    Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux en-Y-500 patients: technique and results, with 3-60 month follow-up. Obes Surg. 2000;10(3):233–9.CrossRefGoogle Scholar
  13. 13.
    Pazouki A, Kermansaravi M. Single anastomosis sleeve-jejunal bypass: a new method of bariatric/metabolic surgery. Obes Surg. 2019:1–2.Google Scholar
  14. 14.
    Madan AK, Harper JL, Tichansky DS. Techniques of laparoscopic gastric bypass: on-line survey of American Society for Bariatric Surgery practicing surgeons. Surg Obes Relat Dis. 2008;4(2):166–72.CrossRefGoogle Scholar
  15. 15.
    Roa PE, Kaidar-Person O, Pinto D, et al. Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obes Surg. 2006;16(10):1323–6.CrossRefGoogle Scholar
  16. 16.
    Deitel M, Greenstein RJ. Recommendations for reporting weight loss. Obes Surg. 2003;13(2):159–60.CrossRefGoogle Scholar
  17. 17.
    O’Brien PE, MacDonald L, Anderson M, et al. Long-term outcomes after bariatric surgery: fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature. Ann Surg. 2013;257(1):87–94.CrossRefGoogle Scholar
  18. 18.
    Birkmeyer JD, Finks JF, O’reilly A, et al. Surgical skill and complication rates after bariatric surgery. N Engl J Med. 2013;369(15):1434–42.CrossRefGoogle Scholar
  19. 19.
    Pories WJ. Bariatric surgery: risks and rewards. J Clin Endocrinol Metab. 2008;93(11_supplement_1):s89–96.CrossRefGoogle Scholar
  20. 20.
    Lustig RH. The neuroendocrinology of obesity. Endocrinol Metab Clin N Am. 2001;30(3):765–85.CrossRefGoogle Scholar
  21. 21.
    Tang-Christensen M, Vrang N, Larsen P. Glucagon-like peptide containing pathways in the regulation of feeding behaviour. Int J Obes. 2002;25(S5):S42.CrossRefGoogle Scholar
  22. 22.
    Layer P, Holst JJ, Grandt D, et al. Ileal release of glucagon-like peptide-1 (GLP-1). Dig Dis Sci. 1995;40(5):1074–82.CrossRefGoogle Scholar
  23. 23.
    Neumiller JJ. Differential chemistry (structure), mechanism of action, and pharmacology of GLP-1 receptor agonists and DPP-4 inhibitors. J Am Pharm Assoc. 2009;49(5):S16–29.CrossRefGoogle Scholar
  24. 24.
    Kasama K, Tagaya N, Kanehira E, et al. Laparoscopic sleeve gastrectomy with duodenojejunal bypass: technique and preliminary results. Obes Surg. 2009;19(10):1341–5.CrossRefGoogle Scholar
  25. 25.
    Fried M, Ribaric G, Buchwald J, et al. Metabolic surgery for the treatment of type 2 diabetes in patients with BMI< 35 kg/m 2: an integrative review of early studies. Obes Surg. 2010;20(6):776–90.CrossRefGoogle Scholar
  26. 26.
    Mahdy T, 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.CrossRefGoogle Scholar
  27. 27.
    Melissas J, Peppe A, Askoxilakis J, et al. Sleeve gastrectomy plus side-to-side jejunoileal anastomosis for the treatment of morbid obesity and metabolic diseases: a promising operation. Obes Surg. 2012;22(7):1104–9.CrossRefGoogle Scholar
  28. 28.
    Zachariah PJ, Chen C-Y, Lee W-J, et al. Compared to sleeve gastrectomy, duodenal–jejunal bypass with sleeve gastrectomy gives better glycemic control in T2DM patients, with a lower β-cell response and similar appetite sensations: mixed-meal study. Obes Surg. 2016;26(12):2862–72.CrossRefGoogle Scholar
  29. 29.
    Lee W-J, Almulaifi AM, Tsou J-J, et al. Duodenal–jejunal bypass with sleeve gastrectomy versus the sleeve gastrectomy procedure alone: the role of duodenal exclusion. Surg Obes Relat Dis. 2015;11(4):765–70.CrossRefGoogle Scholar
  30. 30.
    Sánchez-Pernaute A, Rubio MÁ, Cabrerizo L, et al. Single-anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S) for obese diabetic patients. Surg Obes Relat Dis. 2015;11(5):1092–8.CrossRefGoogle Scholar
  31. 31.
    Jammu GS, Sharma R. A 7-year clinical audit of 1107 cases comparing sleeve gastrectomy, Roux-En-Y gastric bypass, and mini-gastric bypass, to determine an effective and safe bariatric and metabolic procedure. Obes Surg. 2016;26(5):926–32.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Isfahan University of Medical SciencesIsfahanIran

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