1-Year Follow-up of Single Anastomosis Sleeve Ileal (SASI) Bypass in Morbid Obese Patients: Efficacy and Concerns
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ORIGINAL CONTRIBUTIONS
1-Year Follow-up of Single Anastomosis Sleeve Ileal (SASI) Bypass in Morbid Obese Patients: Efficacy and Concerns Mohammad Kermansaravi 1,2,3,4 & Ali Kabir 4
&
Abdolreza Pazouki 1,2,3
Received: 11 April 2020 / Revised: 10 June 2020 / Accepted: 11 June 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Single anastomosis sleeve ileal (SASI) bypass is a new bariatric and metabolic procedure that has both restrictive and malabsorptive effects. This study was conducted to assess both the efficacy and safety of this procedure in a short-term follow-up. Methods This retrospective cohort study examined weight loss- and obesity-related comorbidities and complications in patients who had undergone SASI bypass from October 2017 to March 2018 at a center of excellence for bariatric/metabolic surgery. Results Twenty-four patients had undergone SASI bypass due to some existing risk factors of gastric cancer or premalignant lesions in the esophagogastroduodenoscopy. The mean BMI of the patients was 44.2 (median 43.7, range 37.0–54.8) kg/m2. Six and 12 months after surgery, the mean (median) excessive weight loss (EWL) was 67.8% (63.3) and 86.2% (82.9) and total weight loss (TWL) was 28.5% (27.6) and 36.46% (35.8), respectively. Most patients had complete remission in type 2 diabetes mellitus (89%), arterial hypertension (86%), dyslipidemia (100%), obstructive sleep apnea (100%), and non-alcoholic fatty liver disease (73%) during the 1 year after surgery. One case of extra-luminal bleeding and one case of trocar site hernia occurred after surgery. Moreover, two patients converted to sleeve gastrectomy because of hypoalbuminemia and EWL about 1 year after SASI. Conclusion SASI bypass is a newly introduced investigational procedure for improving weight loss and comorbidities; however, it may result in EWL and protein malnutrition and should only be performed for select patients and by well-experienced bariatric surgeons. Keywords SASI . Single anastomosis . Sleeve ileal . Morbid obesity . Hypoalbuminemia
Introduction * Mohammad Kermansaravi [email protected]; [email protected] * Ali Kabir [email protected]; [email protected] Abdolreza Pazouki [email protected] 1
Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
2
Iran National Center of Excellence for Minimally Invasive Surgery Education, Iran University of Medical Sciences, Tehran, Iran
3
Center of Excellence of European Branch of International Federation for Surgery of Obesity, Tehran, Iran
4
Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Mansoury Alley, Niyayesh St., Sattarkhan St, Tehran, Iran
With the increase in the worldwide prevalence of morbid obesity, bariatric and metabolic surgery remain the best and most efficient way for the treatment of obesity and its related morbidities [1]. Bariatric surgery is
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