The outcomes of single anastomosis sleeve jejunal bypass as a treatment for morbid obesity (Two-year follow-up)
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and Other Interventional Techniques
2020 SAGES ORAL
The outcomes of single anastomosis sleeve jejunal bypass as a treatment for morbid obesity (Two‑year follow‑up) Alaa M. Sewefy1 · Abdelfattah Saleh1 Received: 3 April 2020 / Accepted: 16 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction Santoro’s operation is a sleeve gastrectomy with transit bipartition. The aim of the procedure is to keep pass to the duodenum to decrease nutritional deficiency and to allow endoscopic management of obstructive jaundice. To be easier, this procedure was rapidly altered to a single anastomosis sleeve ileal bypass (SASI). In this study, we shifted the anastomosis up to the jejunum to evaluate the effect of laparoscopic single anastomosis sleeve jejunal (SASJ) bypass as a treatment for morbid obesity and related comorbidities. In addition, the effect of the SASJ procedure on nutritional deficiency was examined. Methods In this study, 150 morbidly obese patients underwent SASJ bypass with a biliary limb length of 200–250 cm. All patients were followed up at 1, 3, 6, 12, 18, and 24 months. We evaluated all cases by assessing BMI, complications, nutritional status, and obesity-related comorbidities. Results The mean age of participants was 30.6 years, and the mean body mass index (BMI) was 44.6 kg/m 2. Of the patients, 35 (23.2%) had type two diabetes and 47 (31.3%) were hypertensive. Postoperative bleeding occurred in two cases (1.3%). One patient developed a gastric leak (0.7%), and five patients developed biliary gastritis (3.3%). One patient (0.7%) developed a pulmonary embolism. The %EWL reached 85% in 1 year. Normalization of blood glucose occurred within 2 months after surgery in all diabetic patients. Hypertension underwent remittance in 89% of hypertensive patients. All patients were gradually weaned from four types of multivitamin regimens to only one multivitamin regimen without apparent nutritional deficiency. Conclusions Laparoscopic SASJ bypass is an effective, safe, and simple procedure for treating morbid obesity and comorbid conditions with least nutritional deficiency. However, long-term studies are needed. Keywords SASI · Loop bipatition · Single anastomosids sleeve jejunal bypass · Sleeve jejunal bypass · Sleeve loop bipartition Obesity is a critical health problem associated with an increased risk of cardiovascular disease, diabetes, and cancers, affecting both the quality of life and life expectancy [1]. The increasing prevalence of obesity and comorbid conditions requires effective treatment and prevention [2]. Previous evidence has demonstrated that bariatric surgery Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00464-020-08029-x) contains supplementary material, which is available to authorized users. * Alaa M. Sewefy [email protected] 1
Department of Surgery, Minia University Hospital, Minia, Egypt
is associated with greater and longer-term weight loss than non-surgical management [3]. Th
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