Short-term Outcome of Single-Anastomosis Plication Ileal Bypass (SAPI) in Treatment of Morbid Obesity
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ORIGINAL CONTRIBUTIONS
Short-term Outcome of Single-Anastomosis Plication Ileal Bypass (SAPI) in Treatment of Morbid Obesity Hosam Elbanna 1
&
Mohamed Anwar Abdel-Razik 1 & Sameh Hany Emile 1
Received: 31 May 2020 / Revised: 31 August 2020 / Accepted: 4 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose This prospective study aimed to report the short-term outcome of the single-anastomosis plication ileal (SAPI) bypass in the treatment of morbid obesity. Methods Adult patients with morbid obesity who underwent SAPI procedure were recruited to this prospective study. SAPI procedure involved plication of the greater curvature of the stomach in two rows then performing a stapled side-to-side anastomosis between an ileal loop and the gastric antrum. Body mass index (BMI), percentage excess weight loss (%EWL), percentage total weight loss (%TWL), and improvement in comorbidities were recorded at 6 and 12 months postoperatively. Results The present study included 56 patients (48 female) of a mean age of 37.3 years. There was a significant decrease in BMI at 6 months (37.2 ± 9.3) and 12 months (31.5 ± 7.8) as compared with the baseline BMI (47.9 ± 5.7). The %EWL at 12 months was 72.5 ± 16.2, significantly higher than its value at 6 months (50.1 ± 15.6). The %TWL at 12 months was 36.4 ± 6.4, significantly higher than its value at 6 months (24.9 ± 6.3). All patients with DM showed remission or improvement in their diabetic state. Improvement in hyperlipidemia and hypertension was recorded in 81.8% and 77.8% of patients, respectively. Postoperative complications were recorded in five (8.9%) patients. Conclusion SAPI procedure achieved significant reduction in body weight and BMI, significant %EWL, and satisfactory improvement in comorbidities at 12 months after surgery. Longer follow-up of patients is needed to reach more solid conclusions on the efficacy and safety of this new technique. Keywords Plication . Single-anastomosis . Ileal . Bypass . Morbid obesity
Introduction Bariatric surgery is considered the most effective treatment of morbid obesity. Restrictive bariatric procedures include sleeve gastrectomy (SG), greater curvature plication (GCP), and adjustable gastric banding. In addition to the mechanical restrictive effect, SG entails weight-independent metabolic effects that contribute to weight loss. The concept of GCP relies on
* Hosam Elbanna [email protected] Mohamed Anwar Abdel-Razik [email protected] Sameh Hany Emile [email protected] 1
General Surgery Department, Faculty of medicine, Mansoura University Hospitals, Mansoura University, Mansoura city, Egypt
the restriction the gastric volume by plication and invagination of the greater curvature into the gastric lumen [1]. A systematic review of GCP [2] concluded that excess weight loss (EWL) after the procedure can reach up to 54% at 6 months and up to 67% at 12 months postoperatively. As compared with SG, GCP has similar rates of improvement in comorbidities and complications, yet
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