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20.08.2024 | Original Contributions

Comparison of the Effectiveness of Single Anastomosis Sleeve Ileal Bypass and Roux-en-Y Gastric Bypass in Obese Patients with Type 2 Diabetes

verfasst von: Mehmet Fatih Erol, Huseyin Ayhan Kayaoglu

Erschienen in: Obesity Surgery | Ausgabe 10/2024

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Abstract

Introduction

The rapid increase in obesity and related problems has heightened the importance of obesity and metabolic surgery, resulting in a continuing search for the ideal surgical method. This study aimed to compare the effectiveness of Roux-en-Y gastric bypass (RYGB), which is the gold standard method, and the relatively newer method of single anastomosis sleeve ileal (SASI) bypass.

Methods

The medical records of patients who underwent RYGB and SASI bypass were reviewed and compared regarding excess weight loss (EWL) and HgA1c, fasting glucose, serum iron, ferritin, hemoglobin (Hgb), and vitamin B12 levels.

Results

The body mass index was significantly lower (p = 0.003), and the %EWL was significantly higher (p = 0.023) at 6 months postoperative in patients who underwent SASI bypass. Both groups had similar results at the other follow-up visits. The mean HgA1c levels at the 6- and 12-month follow-up visits were significantly lower in SASI patients (p = 0.037 and p = 0.012, respectively). At the 24-month follow-up, no difference was detected in HgA1c levels between the groups (p = 0.476). In patients who underwent RYGB, ferritin (p < 0.001), plasma iron (p = 0.001), and Hgb levels (p = 0.001) were significantly lower at 12, 24, and 12 months postoperatively, respectively.

Conclusion

SASI bypass is effective and comparable to RYGB in terms of EWL and metabolic control and has the advantage of not producing excluded segments and reducing nutritional deficiencies.

Graphical Abstract

Literatur
1.
Zurück zum Zitat De Luca M, Zese M, Bandini G, et al. Metabolic bariatric surgery as a therapeutic option for patients with type 2 diabetes: a meta-analysis and network meta-analysis of randomized controlled trials. Diabetes Obes Metab. 2023;25(8):2362–73.CrossRefPubMed De Luca M, Zese M, Bandini G, et al. Metabolic bariatric surgery as a therapeutic option for patients with type 2 diabetes: a meta-analysis and network meta-analysis of randomized controlled trials. Diabetes Obes Metab. 2023;25(8):2362–73.CrossRefPubMed
2.
Zurück zum Zitat Aghajani E, Schou C, Gislason H, et al. Mid-term outcomes after single anastomosis sleeve ileal (SASI) bypass in treatment of morbid obesity. Surg Endosc. 2023;37(8):6220–7.CrossRefPubMedPubMedCentral Aghajani E, Schou C, Gislason H, et al. Mid-term outcomes after single anastomosis sleeve ileal (SASI) bypass in treatment of morbid obesity. Surg Endosc. 2023;37(8):6220–7.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Stefater MA, Wilson-Pérez HE, Chambers AP, et al. All bariatric surgeries are not created equal: insights from mechanistic comparisons. Endocr Rev. 2012;33(4):595–622.CrossRefPubMedPubMedCentral Stefater MA, Wilson-Pérez HE, Chambers AP, et al. All bariatric surgeries are not created equal: insights from mechanistic comparisons. Endocr Rev. 2012;33(4):595–622.CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Pucci A, Batterham RL. Mechanisms underlying the weight loss effects of RYGB and SG: similar, yet different. J Endocrinol Invest. 2019;42(2):117–28.CrossRefPubMed Pucci A, Batterham RL. Mechanisms underlying the weight loss effects of RYGB and SG: similar, yet different. J Endocrinol Invest. 2019;42(2):117–28.CrossRefPubMed
5.
Zurück zum Zitat Currie AC, Askari A, Fangueiro A, et al. Network meta-analysis of metabolic surgery procedures for the treatment of obesity and diabetes. Obes Surg. 2021;31(10):4528–41.CrossRefPubMedPubMedCentral Currie AC, Askari A, Fangueiro A, et al. Network meta-analysis of metabolic surgery procedures for the treatment of obesity and diabetes. Obes Surg. 2021;31(10):4528–41.CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat McTigue KM, Wellman R, Nauman E, et al. Comparing the 5-year diabetes outcomes of sleeve gastrectomy and gastric bypass: the National Patient-Centered Clinical Research Network (PCORNet) bariatric study. JAMA Surg. 2020;155(5):e200087.CrossRefPubMedPubMedCentral McTigue KM, Wellman R, Nauman E, et al. Comparing the 5-year diabetes outcomes of sleeve gastrectomy and gastric bypass: the National Patient-Centered Clinical Research Network (PCORNet) bariatric study. JAMA Surg. 2020;155(5):e200087.CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
8.
Zurück zum Zitat Syn NL, Cummings DE, Wang LZ, et al. Association of metabolic-bariatric surgery with long-term survival in adults with and without diabetes: a one-stage meta-analysis of matched cohort and prospective controlled studies with 174 772 participants. Lancet. 2021;397(10287):1830–41.CrossRefPubMed Syn NL, Cummings DE, Wang LZ, et al. Association of metabolic-bariatric surgery with long-term survival in adults with and without diabetes: a one-stage meta-analysis of matched cohort and prospective controlled studies with 174 772 participants. Lancet. 2021;397(10287):1830–41.CrossRefPubMed
9.
Zurück zum Zitat Stroh C, Manger T, Benedix F. Metabolic surgery and nutritional deficiencies. Minerva Chir. 2017;72(5):432–41.PubMed Stroh C, Manger T, Benedix F. Metabolic surgery and nutritional deficiencies. Minerva Chir. 2017;72(5):432–41.PubMed
10.
Zurück zum Zitat Angrisani L, Santonicola A, Iovino P, et al. IFSO Worldwide survey 2016: primary, endoluminal, and revisional procedures. Obes Surg. 2018;28(12):3783–94.CrossRefPubMed Angrisani L, Santonicola A, Iovino P, et al. IFSO Worldwide survey 2016: primary, endoluminal, and revisional procedures. Obes Surg. 2018;28(12):3783–94.CrossRefPubMed
11.
Zurück zum Zitat Kermansaravi M, Davarpanah Jazi AH, ShahabiShahmiri S, et al. Revision procedures after initial Roux-en-Y gastric bypass, treatment of weight regain: a systematic review and meta-analysis. Updat Surg. 2021;73(2):663–78.CrossRef Kermansaravi M, Davarpanah Jazi AH, ShahabiShahmiri S, et al. Revision procedures after initial Roux-en-Y gastric bypass, treatment of weight regain: a systematic review and meta-analysis. Updat Surg. 2021;73(2):663–78.CrossRef
12.
13.
Zurück zum Zitat Meek CL, Lewis HB, Reimann F, et al. The effect of bariatric surgery on gastrointestinal and pancreatic peptide hormones. Peptides. 2016;77:28–37.CrossRefPubMed Meek CL, Lewis HB, Reimann F, et al. The effect of bariatric surgery on gastrointestinal and pancreatic peptide hormones. Peptides. 2016;77:28–37.CrossRefPubMed
14.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
15.
Zurück zum Zitat Kabahizi A, Wallace B, Lieu L, et al. Glucagon-like peptide-1 (GLP-1) signalling in the brain: from neural circuits and metabolism to therapeutics. Br J Pharmacol. 2022;179(4):600–24.CrossRefPubMed Kabahizi A, Wallace B, Lieu L, et al. Glucagon-like peptide-1 (GLP-1) signalling in the brain: from neural circuits and metabolism to therapeutics. Br J Pharmacol. 2022;179(4):600–24.CrossRefPubMed
17.
Zurück zum Zitat Franken RJ, Sluiter NR, Franken J, et al. Treatment options for weight regain or insufficient weight loss after sleeve gastrectomy: a systematic review and meta-analysis. Obes Surg. 2022;32(6):2035–46.CrossRefPubMed Franken RJ, Sluiter NR, Franken J, et al. Treatment options for weight regain or insufficient weight loss after sleeve gastrectomy: a systematic review and meta-analysis. Obes Surg. 2022;32(6):2035–46.CrossRefPubMed
18.
Zurück zum Zitat Savassi-Rocha AL, Diniz MT, Vilela EG, et al. Changes in intestinal permeability after Roux-en-Y gastric bypass. Obes Surg. 2014;24(2):184–90.CrossRefPubMed Savassi-Rocha AL, Diniz MT, Vilela EG, et al. Changes in intestinal permeability after Roux-en-Y gastric bypass. Obes Surg. 2014;24(2):184–90.CrossRefPubMed
19.
Zurück zum Zitat Romero RJ, Colorado-Subizar R, De Uriarte-Lorente M, et al. Single anastomosis sleeve ileal bypass (SASI Bypass): short-term outcomes and concerns. Obes Surg. 2021;31(5):2339–43.CrossRefPubMed Romero RJ, Colorado-Subizar R, De Uriarte-Lorente M, et al. Single anastomosis sleeve ileal bypass (SASI Bypass): short-term outcomes and concerns. Obes Surg. 2021;31(5):2339–43.CrossRefPubMed
20.
Zurück zum Zitat Tarnowski W, Barski K, Jaworski P, et al. Single anastomosis sleeve ileal bypass (SASI): a single-center initial report. Wideochir Inne Tech Maloinwazyjne. 2022;17(2):365–71.PubMedPubMedCentral Tarnowski W, Barski K, Jaworski P, et al. Single anastomosis sleeve ileal bypass (SASI): a single-center initial report. Wideochir Inne Tech Maloinwazyjne. 2022;17(2):365–71.PubMedPubMedCentral
21.
Zurück zum Zitat Emile SH, Mahdy T, Schou C, et al. Systematic review of the outcome of single-anastomosis sleeve ileal (SASI) bypass in treatment of morbid obesity with proportion meta-analysis of improvement in diabetes mellitus. Int J Surg. 2021;92:106024.CrossRefPubMed Emile SH, Mahdy T, Schou C, et al. Systematic review of the outcome of single-anastomosis sleeve ileal (SASI) bypass in treatment of morbid obesity with proportion meta-analysis of improvement in diabetes mellitus. Int J Surg. 2021;92:106024.CrossRefPubMed
22.
Zurück zum Zitat Khalaf M, Hamed H. Single-anastomosis sleeve ileal (SASI) bypass: hopes and concerns after a two-year follow-up. Obes Surg. 2021;31(2):667–74.CrossRefPubMed Khalaf M, Hamed H. Single-anastomosis sleeve ileal (SASI) bypass: hopes and concerns after a two-year follow-up. Obes Surg. 2021;31(2):667–74.CrossRefPubMed
23.
Zurück zum Zitat Emile SH, Madyan A, Mahdy T, et al. Single anastomosis sleeve ileal (SASI) bypass versus sleeve gastrectomy: a case-matched multicenter study. Surg Endosc. 2021;35(2):652–60.CrossRefPubMed Emile SH, Madyan A, Mahdy T, et al. Single anastomosis sleeve ileal (SASI) bypass versus sleeve gastrectomy: a case-matched multicenter study. Surg Endosc. 2021;35(2):652–60.CrossRefPubMed
24.
Zurück zum Zitat Mahdy T, Gado W, Alwahidi A, et al. Sleeve gastrectomy, one-anastomosis gastric bypass (OAGB), and single anastomosis sleeve ileal (SASI) bypass in treatment of morbid obesity: a retrospective cohort study. Obes Surg. 2021;31(4):1579–89.CrossRefPubMed Mahdy T, Gado W, Alwahidi A, et al. Sleeve gastrectomy, one-anastomosis gastric bypass (OAGB), and single anastomosis sleeve ileal (SASI) bypass in treatment of morbid obesity: a retrospective cohort study. Obes Surg. 2021;31(4):1579–89.CrossRefPubMed
25.
Zurück zum Zitat Madyan A, Emile SH, Abdel-Razik MA, et al. Laparoscopic single anastomosis sleeve ileal (SASI) bypass for patients with morbid obesity: technical description and short-term outcomes. Surg Laparosc Endosc Percutan Tech. 2020;30(2):e13–7.CrossRefPubMed Madyan A, Emile SH, Abdel-Razik MA, et al. Laparoscopic single anastomosis sleeve ileal (SASI) bypass for patients with morbid obesity: technical description and short-term outcomes. Surg Laparosc Endosc Percutan Tech. 2020;30(2):e13–7.CrossRefPubMed
27.
Zurück zum Zitat Sala PC, Torrinhas RS, Giannella-Neto D, et al. Relationship between gut hormones and glucose homeostasis after bariatric surgery. Diabetol Metab Syndr. 2014;6(1):87.CrossRefPubMedPubMedCentral Sala PC, Torrinhas RS, Giannella-Neto D, et al. Relationship between gut hormones and glucose homeostasis after bariatric surgery. Diabetol Metab Syndr. 2014;6(1):87.CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Mahdy T, Emile SH, Madyan A, et al. Evaluation of the efficacy of single ileal (SASI) bypass for patients with morbid obesity: a multicenter study. Obes Surg. 2020;30(3):837–45.CrossRefPubMed Mahdy T, Emile SH, Madyan A, et al. Evaluation of the efficacy of single ileal (SASI) bypass for patients with morbid obesity: a multicenter study. Obes Surg. 2020;30(3):837–45.CrossRefPubMed
29.
Zurück zum Zitat Anderson B, Gill RS, de Gara CJ, et al. Biliopancreatic diversion: the effectiveness of duodenal switch and its limitations. Gastroenterol Res Pract. 2013;2013:974762.CrossRefPubMedPubMedCentral Anderson B, Gill RS, de Gara CJ, et al. Biliopancreatic diversion: the effectiveness of duodenal switch and its limitations. Gastroenterol Res Pract. 2013;2013:974762.CrossRefPubMedPubMedCentral
Metadaten
Titel
Comparison of the Effectiveness of Single Anastomosis Sleeve Ileal Bypass and Roux-en-Y Gastric Bypass in Obese Patients with Type 2 Diabetes
verfasst von
Mehmet Fatih Erol
Huseyin Ayhan Kayaoglu
Publikationsdatum
20.08.2024
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 10/2024
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-024-07472-2

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