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SADI-S 250 vs Roux-en-Y Duodenal Switch (RY-DS): Results of 5-Year Observational Study

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Abstract

Purpose

There are only a small number of studies providing a comparison between SADI-S and Hess-Marceau’s BPD/Duodenal Switch (RY-DS) operations. We aimed to compare 5-year results of SADI-S 250 (common limb 250 cm) with RY-DS.

Material and Methods

Data of patients who underwent open SADI-S (n 226) and RY-DS (n 528) were retrospectively studied. EWL(%), EBMIL(%), TWL(%), antidiabetic effect, complications, and revision rate were compared between the two groups.

Results

After the first 12 months, EWL% (77.0% vs 73.3%) and TWL% (39.4% vs 38.9%) were statistically significantly better after SADI-S (p < 0.01, and p < 0.05 respectively), but not EBMIL% (p > 0.05). At nadir to 24–36 months, EWL, TBWL, and EBMIL after SADI-S was comparable to the RY-DS group. Up to the fourth and fifth year, better weight loss (TBWL, EBMIL, EWL) was observed after RY-DS than after SADI-S. Early complication rate was less (2.65%) in the SADI-S group vs 5.1% in the RY-DS. Protein deficiency and small bowel obstruction rates were also lower after SADI-S. 93.4% of patients achieved total remission of their diabetes. 7.5% of patients in the SADI-S group had symptoms of bile reflux, which was a main indication for revisions.

Conclusion

SADI-S has many advantages over RY-DS. However, weight loss and antidiabetic effects after the third year were marginally lower after SADI-S compared to RY-DS. SADI-S is less dangerous in terms of malabsorption and looks to be a reasonable alternative to RY-DS as a metabolic operation. RY-DS could be implemented for weight regain and/or bile reflux after SADI-S.

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References

  1. Buchwald H, Estok R, Fahrbach K, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122(3):248–56.

    Article  Google Scholar 

  2. Ramos A, Kow L, Brown W. et al. Fifth IFSO Global registry report 2019. Published by Dendrite Clinical Systems 2019

  3. Scopinaro N, Adami GF, Marinari GM, et al. Biliopancreatic diversion. World J Surg. 1998;22(9):936–46.

    Article  CAS  Google Scholar 

  4. Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obes Surg. 1998;8(3):267–82.

    Article  CAS  Google Scholar 

  5. Marceau P, Biron S, Georges RS, et al. Biliopancreatic diversion with gastrectomy as surgical treatment of morbid obesity. Obes Surg. 1991;1(4):381–7.

    Article  CAS  Google Scholar 

  6. Hess DS, Hess DW, Oakley RS. The biliopancreatic diversion with the duodenal switch: results beyond 10 years. Obes Surg. 2005;15:408–16.

    Article  Google Scholar 

  7. Marceau P, Biron S, Hould FS, et al. Duodenal switch: long-term results. Obes Surg. 2007;17:1421–30.

    Article  Google Scholar 

  8. Sanchez-Pernaute A, Rubio Herrera MA, Pérez-Aguirre E, et al. Proximal duodenal-ileal end-to-side bypass with sleeve gastrectomy: proposed technique. Obes Surg. 2007;17:1614–8.

    Article  Google Scholar 

  9. Sánchez-Pernaute A, Herrera MAR, Pérez-Aguirre, et al. Single anastomosis duodeno–ileal bypass with sleeve gastrectomy (SADI-S). One to three-year follow-up. Obes Surg. 2010;20(12):1720–6.

    Article  Google Scholar 

  10. Sanchez-Pernaute A, Rubio MA, Cabrerizo L, et al. Single anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S) for obese diabetic patients. Surg Obes Relat Dis. 2015;11:1092–8.

    Article  Google Scholar 

  11. Sánchez-Pernaute A, Rubio MÁ, Pérez Aguirre E, et al. Single-anastomosis duodenoileal bypass with sleeve gastrectomy: metabolic improvement and weight loss in first 100 patients. Surg Obes Rel Dis. 2013;9(5):731–5.

    Article  Google Scholar 

  12. Gagner M. Hypoabsorption not malabsorption, hypoabsorptive surgery and not malabsorptive surgery. Obes Surg. 2016;26:2783–4. https://doi.org/10.1007/s11695-016-2350-6.

    Article  PubMed  Google Scholar 

  13. Mitzman B, Cottam D, Goriparthi R, et al. Stomach intestinal pylorus sparing (SIPS) surgery for morbid obesity: retrospective analyses of our preliminary experience. Obes Surg. 2016;26:2098–104.

    Article  Google Scholar 

  14. Shoar S, Poliakin L, Rubenstein R, et al. Single anastomosis duodeno-ileal switch (SADIS): a systematic review of efficacy and safety. Obes Surg. 2018;28(1):104–13.

    Article  Google Scholar 

  15. Topart P, Becouarn G. The single anastomosis duodenal switch modifications: a review of the current literature on outcomes. Surg Obes Rel Dis. 2017;13:1306–12.

    Article  Google Scholar 

  16. Brown WA, Ooi G, Higa K, et al. Single anastomosis duodenal-ileal bypass with sleeve gastrectomy/one anastomosis duodenal switch (SADI-S/OADS) IFSO position statement. Obes Surg. 2018;28:1207–16.

    Article  Google Scholar 

  17. Prachand VN, Ward M, Alverdy JC. Duodenal switch provides superior resolution of metabolic comorbidities independent of weight loss in the super-obese (BMI ≥ 50 kg/m2) compared with gastric bypass. J Gastrointest Surg. 2010;14(2):211–20.

    Article  Google Scholar 

  18. Lee Y, Ellenbogen Y, Doumouras AG, et al. Single or double-anastomosis duodenal switch versus Roux-en-Y gastric bypass as a revisional procedure for sleeve gastrectomy: a systematic review and meta-analysis. Surg Obes Rel Dis. 2019;15(4):556–66.

    Article  Google Scholar 

  19. Ruiz AG, Sanchez-Pernaute A, Badia AC, et al. Laparoscopic duodenal switch: one or two loops? SOARD. 2015;11(6):S74.

    Google Scholar 

  20. Zaveri H, Surve A, Cottam D, et al. Mid-term 4-year outcomes with single anastomosis duodenal-Ileal bypass with sleeve gastrectomy surgery at a single US center. Obes Surg. 2018;28(10):3062–72. https://doi.org/10.1007/s11695-018-3358-x.

    Article  PubMed  Google Scholar 

  21. Finno P, Osorio J, Garsia-Ruiz-de-Gordejuela A, et al. Single versus double-anastomosis duodenal switch: single-site comparative cohort study in 440 consecutive patients. Obes Surg. 2020;30:3309–16. https://doi.org/10.1007/s11695-020-04566-5.

    Article  PubMed  Google Scholar 

  22. Brethauer SA, Kim J, Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis. 2015;11(3):489–506.

    Article  Google Scholar 

  23. Buse JB, Caprio S, Cefalu WT, et al. How we define cure of diabetes? Diabetes Care. 2009;32:2133–5.

    Article  Google Scholar 

  24. Ershova ЕV, Yashkov YI. Status of carbohydrate and lipid metabolism in obese patients with type 2 diabetes mellitus after biliopancreatic diversion surgery. Obes Metab. 2013;10(3):28–36.

    Article  Google Scholar 

  25. Cottam A, Cottam D, Portenier D, et al. A matched cohort analysis of stomach intestinal pylorus saving (SIPS) surgery versus biliopancreatic diversion with duodenal switch with two -year follow-up. Obes Surg. 2016;27:454–61.

    Article  Google Scholar 

  26. Balibrea JM, Vilallonga R, Hidalgo M, et al. Mid-term results and responsiveness predictors after two-step single-anastomosis duodeno-ileal bypass with sleeve gastrectomy. Obes Surg. 2017;27(5):1302–8.

    Article  Google Scholar 

  27. Sánchez-Pernaute A, Rubio MÁ, Conde M, et al. Single-anastomosis duodenoileal bypass as a second step after sleeve gastrectomy. Surg Obes Rel Dis. 2015;11(2):351–5.

    Article  Google Scholar 

  28. Wu A, Tian J, Cao L, et al. Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) as a revisional surgery. Surg Obes Rel Dis. 2018;14(11):1686–90.

    Article  Google Scholar 

  29. Scopinaro N. Biliopancreatic diversion: mechanisms of action and long-term results. Obes Surg. 2006;16(6):683–9.

    Article  Google Scholar 

  30. Kim J. American Society for Metabolic and Bariatric Surgery Clinical Issue Committee. Statement on single-anastomosis duodenal switch. Surg Obes Rel Dis. 2016;12(5): 944–945.

  31. De Luca M, Tie T, Ooi G, et al. Mini gastric bypass – one anastomosis gastric bypass (MGB-OAGB) – IFSO position statement. Obes Surg. 2018;28:1188–206.

    Article  Google Scholar 

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Authors and Affiliations

  1. Center of Endosurgery and Lithotripsy (CELT), Moscow, Russian Federation

    Yury Yashkov, Alexandra Malykhina & Dmitry Bekuzarov

  2. Institute of Plastic Surgery and Cosmetology, Moscow, Russian Federation

    Natalya Bordan

  3. Hospital Clínico San Carlos, IdISC Complutense University of Madrid, Madrid, Spain

    Antonio Torres

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  1. Yury Yashkov
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  2. Natalya Bordan
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  3. Antonio Torres
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  4. Alexandra Malykhina
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  5. Dmitry Bekuzarov
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Correspondence to Yury Yashkov.

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Yashkov, Y., Bordan, N., Torres, A. et al. SADI-S 250 vs Roux-en-Y Duodenal Switch (RY-DS): Results of 5-Year Observational Study. OBES SURG 31, 570–579 (2021). https://doi.org/10.1007/s11695-020-05031-z

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  • DOI: https://doi.org/10.1007/s11695-020-05031-z

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