Department of Surgery, Klinikum Vest GmbH, Knappschaftskrankenhaus Recklinghausen, Recklinghausen, Germany.
Department of Surgery, Hospital Clinico San Carlos, Universidad Complutense de Madrid, Madrid, Spain.
Surg Obes Relat Dis. 2020 Aug;16(8):1060-1066. doi: 10.1016/j.soard.2020.04.014. Epub 2020 Apr 21.
Single-anastomosis duodeno-ileal bypass (SADI) and the one-anastomosis gastric bypass (OAGB) are 2 revisional procedures to address the problem of weight recidivism after laparoscopic sleeve gastrectomy (LSG).
To evaluate the efficacy and safety of SADI and OAGB as revisional bariatric surgery (RBS) in initially super-obese patients (body mass index [BMI] >50 kg/m).
Academic hospital, bariatric center of excellence, Germany.
Observational study of outcomes in 84 initially super-obese patients who had undergone RBS after LSG (SADI n = 42, OAGB n = 42) between July 2013 and April 2018. Follow-up examinations were performed at 1, 6, 12, 24, and 36 months after RBS. The variables analyzed included time between LSG and RBS, BMI, excess weight loss, total weight loss, operation time, and complications.
The time interval between LSG and RBS was 45.5 ± 22.8 and 43.5 ± 24.2 months for SADI and OAGB, respectively. At the time of RBS, the mean BMI was 42.8 ± 7.9 kg/m for SADI and 43.4 ± 9.2 kg/m for OAGB. The follow-up examinations rates (%) after SADI were 97.6, 92.8, 90.5, 78.6, 57.1, and 100, 97.6, 95.2, 85.7, and 59.5 after OAGB. The BMI at the follow-up examinations were 39.1 ± 7.2, 34.2 ± 6.9, 31.2 ± 5.8, 30.2 ± 5.3, 29.3 ± 5.1 for SADI, and 39.5 ± 8.1, 36.6 ± 7.4, 34.7 ± 7.9, 32.9 ± 6.3, and 31.6 ± 5.9 for OAGB. The mean operating times for SADI and OAGB were 138 ± 40 and 123 ± 39 minutes, respectively. Three patients in the SADI group and 1 patient in the OAGB group developed a major complication within the first 30 postoperative days.
SADI and OAGB were effective second-step procedures for further weight reduction after LSG in initially super-obese patients after short to medium follow-up. There was a trend toward higher weight loss for SADI though this did not reach statistical significance. Substantial differences concerning surgery time and complications between the 2 procedures were not observed.
单吻合口十二指肠空肠旁路术（SADI）和单吻合口胃旁路术（OAGB）是两种针对腹腔镜袖状胃切除术（LSG）后体重复发问题的修正手术。
评估 SADI 和 OAGB 作为修正性减重手术（RBS）在最初超肥胖患者（BMI>50kg/m）中的疗效和安全性。
德国，学术医院，减重卓越中心。
对 2013 年 7 月至 2018 年 4 月间 LSG 后接受 RBS（SADI n=42，OAGB n=42）的 84 例最初超肥胖患者的结局进行观察性研究。RBS 后 1、6、12、24 和 36 个月进行随访检查。分析的变量包括 LSG 和 RBS 之间的时间间隔、BMI、超重减轻量、总体重减轻量、手术时间和并发症。
LSG 和 RBS 之间的时间间隔分别为 SADI 的 45.5±22.8 个月和 OAGB 的 43.5±24.2 个月。在 RBS 时，SADI 的平均 BMI 为 42.8±7.9kg/m，OAGB 的平均 BMI 为 43.4±9.2kg/m。SADI 随访检查率（%）分别为 97.6、92.8、90.5、78.6、57.1 和 100，OAGB 分别为 97.6、95.2、85.7、59.5 和 31.6。SADI 随访检查的 BMI 分别为 39.1±7.2、34.2±6.9、31.2±5.8、30.2±5.3、29.3±5.1，OAGB 分别为 39.5±8.1、36.6±7.4、34.7±7.9、32.9±6.3 和 31.6±5.9。SADI 和 OAGB 的平均手术时间分别为 138±40 分钟和 123±39 分钟。SADI 组有 3 例患者和 OAGB 组有 1 例患者在术后 30 天内发生重大并发症。
在短至中等随访期间，SADI 和 OAGB 是 LSG 后最初超肥胖患者进一步减重的有效第二步手术。SADI 的减重效果呈上升趋势，但未达到统计学意义。两种手术在手术时间和并发症方面没有显著差异。
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