A Matched Cohort Comparison of Long-term Outcomes of Roux-en-Y Gastric Bypass (RYGB) Versus Single-Anastomosis Duodeno-i
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ORIGINAL CONTRIBUTIONS
A Matched Cohort Comparison of Long-term Outcomes of Roux-en-Y Gastric Bypass (RYGB) Versus Single-Anastomosis Duodeno-ileostomy with Sleeve Gastrectomy (SADI-S) Amit Surve 1 & Daniel Cottam 1
&
Christina Richards 1 & Walter Medlin 1 & Legrand Belnap 1
Received: 2 October 2020 / Revised: 11 November 2020 / Accepted: 11 November 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background The long-term effectiveness of Roux-en-Y gastric bypass (RYGB) and single-anastomosis duodeno-ileostomy with sleeve gastrectomy (SADI-S) is unknown. Purpose Compare the long-term outcomes. Setting Single private institute, USA. Materials and Methods Data from 1254 patients who underwent primary RYGB or SADI-S were used for a retrospective matched cohort. Data were obtained by matching every RYGB patient to a SADI-S patient of the same sex, body mass index (BMI), and weight. Only patients out 5 years and had at least one > 5-year follow-up visit were included. Results The matched cohort included 61 RYGB and 61 SADI-S patients. There was no statistical, demographic difference between the two groups. At 5 years, a 100% follow-up was available in each group. The intraoperative outcomes were significantly better with SADI-S. The 30-day readmission, reoperation, emergency department (ED) visits, and complication rates were statistically similar between the two groups. The long-term complication rates, Clavien-Dindo grade IIIb complications, and number of patients with more than one complication were significantly lower with SADI-S. Weight loss was significantly greater in the SADI-S group at 5 years. The long-term weight-loss failure rate was significantly higher in the RYGB group. The SADI-S procedure was associated with fewer reintervention through 6 years (14.7% patients vs. 39.3% patients, p = 0.001). Conversion or reversal of the procedure was required only in the RYGB group. There also was no significant difference in nutritional outcomes between the two procedures. Conclusions This study showed that problems, including long-term complications, reinterventions, weight-loss failure, and conversion, were more often associated with RYGB than with SADI-S. The SADI-S may be considered one of the viable alternatives to RYGB. Keywords Long term . Matched cohort . RYGB . SADI-S . Versus . Bariatrics
* Daniel Cottam [email protected] Amit Surve [email protected] Christina Richards [email protected] Walter Medlin [email protected] Legrand Belnap [email protected] 1
Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT 84102, USA
Bariatric surgery procedures can treat morbid obesity and associated comorbid conditions. There are two mechanisms, restriction and malabsorption of food, by which a bariatric procedure can induce significant weight loss. A mixed type of bariatric procedure is a combination of a degree of restriction and malabsorption. Such procedures are usually used to treat patients with a higher body mass index (BMI). In this category of bar
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