Skip to main content
Erschienen in: Obesity Surgery 12/2020

17.09.2020 | Original Contributions

Long Alimentary Limb Duodenal Switch (LADS): an Exploratory Randomized Trial, Results at 2 Years

verfasst von: François-Charles Malo, Andréanne Marion, Antoine Rioux, Stéfane Lebel, Frédéric Hould, François Julien, Simon Marceau, Odette Lescelleur, Annie Lafortune, Léonie Bouvet-Bouchard, Laurent Biertho

Erschienen in: Obesity Surgery | Ausgabe 12/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The effectiveness of the standard biliopancreatic diversion with duodenal switch (BPD/DS) in terms of weight loss has been demonstrated. Increasing the strict alimentary limb length while maintaining the length of the common channel could lead to similar weight loss while reducing side effects.

Materials and Methods

The objective was to evaluate the effect of increasing the strict alimentary limb length on weight loss, comorbidities, nutritional deficiencies, and quality of life 2 years after surgery, compared with standard BPD/DS. An exploratory randomized, double-blind study evaluated the results of LADS at 2 years in comparison with the standard BPD/DS. Common channel was kept at 100 cm in both groups while alimentary limb was created at 100 cm from Treitz angle in the LADS group and at 150 cm total in the BPD/DS group.

Results

Twenty patients were recruited from May 2013 to June 2015. Mean percentage of excess weight loss was statistically significantly lower in the LADS group at 24 months (81.6 ± 6.6% in the LADS group and 97.1 ± 11.1% in the BPD/DS group (p = 0.001). No significant difference regarding the rate of remission of comorbidities was noted. Mean calcium, vitamin D, hemoglobin, zinc, and copper levels were statistically lower in the BPD/DS group. Quality of life was significantly improved in both groups, with no statistically significant difference between the two groups.

Conclusions

At 24 months, weight loss was lower in the LADS group. However, no difference was observed in the improvement in quality of life. LADS technique was discontinued following this study.

Trial registration

ClinicalTrial.​gov Ref. NCT03097926
Literatur
1.
Zurück zum Zitat Obesity in Canada - a joint report from the Public Health Agency of Canada and the Canadian Institute for Health Information. 2011. Obesity in Canada - a joint report from the Public Health Agency of Canada and the Canadian Institute for Health Information. 2011.
3.
Zurück zum Zitat Marceau P, Biron S, Fau-Hould F-S, et al. Duodenal switch: long-term results. Obes Surg. 2007;17(11):1421–30.CrossRef Marceau P, Biron S, Fau-Hould F-S, et al. Duodenal switch: long-term results. Obes Surg. 2007;17(11):1421–30.CrossRef
5.
Zurück zum Zitat Homan J, Betzel B, Fau-Aarts EO, et al. Vitamin and mineral deficiencies after biliopancreatic diversion and biliopancreatic diversion with duodenal switch—the rule rather than the exception. Obes Surg. 2015;25(9):1626–32.CrossRef Homan J, Betzel B, Fau-Aarts EO, et al. Vitamin and mineral deficiencies after biliopancreatic diversion and biliopancreatic diversion with duodenal switch—the rule rather than the exception. Obes Surg. 2015;25(9):1626–32.CrossRef
6.
Zurück zum Zitat Cloutier A, Lebel S, Hould F, et al. Long alimentary limb duodenal switch (LADS): a short-term prospective randomized trial. Surg Obes Relat Dis. 2018;14(1):30–7.CrossRef Cloutier A, Lebel S, Hould F, et al. Long alimentary limb duodenal switch (LADS): a short-term prospective randomized trial. Surg Obes Relat Dis. 2018;14(1):30–7.CrossRef
7.
Zurück zum Zitat Therrien F, Marceau P, Turgeon N, et al. The Laval questionnaire: a new instrument to measure quality of life in morbid obesity. Health Qual Life Outcomes. 2011;9:66.CrossRef Therrien F, Marceau P, Turgeon N, et al. The Laval questionnaire: a new instrument to measure quality of life in morbid obesity. Health Qual Life Outcomes. 2011;9:66.CrossRef
8.
Zurück zum Zitat Biertho L, Lebel S, Marceau S, et al. Biliopancreatic diversion with duodenal switch: surgical technique and perioperative care. Surg Clin North Am. 2016;96(4):815–26.CrossRef Biertho L, Lebel S, Marceau S, et al. Biliopancreatic diversion with duodenal switch: surgical technique and perioperative care. Surg Clin North Am. 2016;96(4):815–26.CrossRef
9.
Zurück zum Zitat Brethauer SA, Kim J, el Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Obes Surg. 2015;25(4):587–606.CrossRef Brethauer SA, Kim J, el Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Obes Surg. 2015;25(4):587–606.CrossRef
10.
Zurück zum Zitat Hamoui N, Anthone Gj Fau-Kaufman HS, Kaufman Hs Fau-Crookes PF, et al. Maintenance of weight loss in patients with body mass index >60 kg/m2: importance of length of small bowel bypassed. Surg Obes Relat Dis. 2008;4(3):404–6.CrossRef Hamoui N, Anthone Gj Fau-Kaufman HS, Kaufman Hs Fau-Crookes PF, et al. Maintenance of weight loss in patients with body mass index >60 kg/m2: importance of length of small bowel bypassed. Surg Obes Relat Dis. 2008;4(3):404–6.CrossRef
11.
Zurück zum Zitat McConnell DB, O’Rourke Rw Fau- Deveney CW, Deveney CW. Common channel length predicts outcomes of biliopancreatic diversion alone and with the duodenal switch surgery. Am J Surg 2005;189(5):536–540. McConnell DB, O’Rourke Rw Fau- Deveney CW, Deveney CW. Common channel length predicts outcomes of biliopancreatic diversion alone and with the duodenal switch surgery. Am J Surg 2005;189(5):536–540.
12.
Zurück zum Zitat 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. 2017;27(2):454–61.CrossRef 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. 2017;27(2):454–61.CrossRef
13.
Zurück zum Zitat Surve A, Zaveri H, Cottam D, et al. A retrospective comparison of biliopancreatic diversion with duodenal switch with single anastomosis duodenal switch (SIPS-stomach intestinal pylorus sparing surgery) at a single institution with two year follow-up. Surg Obes Relat Dis. 2017;13(3):415–22.CrossRef Surve A, Zaveri H, Cottam D, et al. A retrospective comparison of biliopancreatic diversion with duodenal switch with single anastomosis duodenal switch (SIPS-stomach intestinal pylorus sparing surgery) at a single institution with two year follow-up. Surg Obes Relat Dis. 2017;13(3):415–22.CrossRef
14.
Zurück zum Zitat Sanchez-Pernaute A, Rubio MA, Conde M, et al. Single-anastomosis duodenoileal bypass as a second step after sleeve gastrectomy. Surg Obes Relat Dis. 2015;11(2):351–5.CrossRef Sanchez-Pernaute A, Rubio MA, Conde M, et al. Single-anastomosis duodenoileal bypass as a second step after sleeve gastrectomy. Surg Obes Relat Dis. 2015;11(2):351–5.CrossRef
15.
Zurück zum Zitat 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.CrossRef 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.CrossRef
16.
Zurück zum Zitat Moon RC, Gaskins L, Teixeira AF, et al. Safety and effectiveness of single-anastomosis duodenal switch procedure: 2-year result from a single US institution. Obes Surg. 2018;28(6):1571–7.CrossRef Moon RC, Gaskins L, Teixeira AF, et al. Safety and effectiveness of single-anastomosis duodenal switch procedure: 2-year result from a single US institution. Obes Surg. 2018;28(6):1571–7.CrossRef
17.
Zurück zum Zitat Brown WA, Ooi G, Higa K, et al. IFSO-appointed task force reviewing the literature on SADI-S/OADS. Single anastomosis duodenal-Ileal bypass with sleeve gastrectomy/one anastomosis duodenal switch (SADI-S/OADS) IFSO position statement. Obes Surg. 2018;28(5):1207–16.CrossRef Brown WA, Ooi G, Higa K, et al. IFSO-appointed task force reviewing the literature on SADI-S/OADS. Single anastomosis duodenal-Ileal bypass with sleeve gastrectomy/one anastomosis duodenal switch (SADI-S/OADS) IFSO position statement. Obes Surg. 2018;28(5):1207–16.CrossRef
18.
Zurück zum Zitat Moon RC, Kirkpatrick V, Gaskins L, et al. Safety and effectiveness of single- versus double-anastomosis duodenal switch at a single institution. Surg Obes Relat Dis févr. 2019;15(2):245–52.CrossRef Moon RC, Kirkpatrick V, Gaskins L, et al. Safety and effectiveness of single- versus double-anastomosis duodenal switch at a single institution. Surg Obes Relat Dis févr. 2019;15(2):245–52.CrossRef
19.
Zurück zum Zitat Finno P, Osorio J, García-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(9):3309–16.CrossRef Finno P, Osorio J, García-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(9):3309–16.CrossRef
Metadaten
Titel
Long Alimentary Limb Duodenal Switch (LADS): an Exploratory Randomized Trial, Results at 2 Years
verfasst von
François-Charles Malo
Andréanne Marion
Antoine Rioux
Stéfane Lebel
Frédéric Hould
François Julien
Simon Marceau
Odette Lescelleur
Annie Lafortune
Léonie Bouvet-Bouchard
Laurent Biertho
Publikationsdatum
17.09.2020
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 12/2020
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-04968-5

Weitere Artikel der Ausgabe 12/2020

Obesity Surgery 12/2020 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.