Center of Endosurgery and Lithotripsy (CELT), Moscow, Russian Federation.
Institute of Plastic Surgery and Cosmetology, Moscow, Russian Federation.
Obes Surg. 2021 Feb;31(2):570-579. doi: 10.1007/s11695-020-05031-z. Epub 2020 Oct 12.
There are only a small number of studies providing a comparison between SADI-S and Hess-Marceau's BPD/Duodenal Switch (RY-DS) operations. We aimed to compare 5-year results of SADI-S 250 (common limb 250 cm) with RY-DS.
Data of patients who underwent open SADI-S (n 226) and RY-DS (n 528) were retrospectively studied. EWL(%), EBMIL(%), TWL(%), antidiabetic effect, complications, and revision rate were compared between the two groups.
After the first 12 months, EWL% (77.0% vs 73.3%) and TWL% (39.4% vs 38.9%) were statistically significantly better after SADI-S (p < 0.01, and p < 0.05 respectively), but not EBMIL% (p > 0.05). At nadir to 24-36 months, EWL, TBWL, and EBMIL after SADI-S was comparable to the RY-DS group. Up to the fourth and fifth year, better weight loss (TBWL, EBMIL, EWL) was observed after RY-DS than after SADI-S. Early complication rate was less (2.65%) in the SADI-S group vs 5.1% in the RY-DS. Protein deficiency and small bowel obstruction rates were also lower after SADI-S. 93.4% of patients achieved total remission of their diabetes. 7.5% of patients in the SADI-S group had symptoms of bile reflux, which was a main indication for revisions.
SADI-S has many advantages over RY-DS. However, weight loss and antidiabetic effects after the third year were marginally lower after SADI-S compared to RY-DS. SADI-S is less dangerous in terms of malabsorption and looks to be a reasonable alternative to RY-DS as a metabolic operation. RY-DS could be implemented for weight regain and/or bile reflux after SADI-S.
仅有少数研究对 SADI-S 和 Hess-Marceau 的 BPD/十二指肠转流术（RY-DS）进行了比较。本研究旨在比较 SADI-S 250（共同肠段 250cm）与 RY-DS 的 5 年结果。
回顾性分析接受开放 SADI-S（n=226）和 RY-DS（n=528）治疗的患者数据。比较两组之间的体重减轻百分比（EWL%）、体质量指数（BMI）降低百分比（EBMIL%）、总体重减轻百分比（TWL%）、降糖效果、并发症和翻修率。
在最初的 12 个月后，SADI-S 组的 EWL%（77.0% vs 73.3%）和 TWL%（39.4% vs 38.9%）显著优于 RY-DS 组（p<0.01 和 p<0.05），但 EBMIL% 无统计学差异（p>0.05）。在最低随访 24-36 个月时，SADI-S 组的 EWL、TBWL 和 EBMIL 与 RY-DS 组相当。截至第 4 年和第 5 年，RY-DS 组的体重减轻（TBWL、EBMIL、EWL）优于 SADI-S 组。SADI-S 组的早期并发症发生率（2.65%）低于 RY-DS 组（5.1%）。SADI-S 组的蛋白质缺乏和小肠梗阻发生率也较低。93.4%的患者糖尿病完全缓解。SADI-S 组有 7.5%的患者出现胆汁反流症状，这是翻修的主要指征。
SADI-S 优于 RY-DS，但与 RY-DS 相比，SADI-S 组在第 3 年后的体重减轻和降糖效果略差。在吸收不良方面，SADI-S 的风险较低，似乎是 RY-DS 的一种合理代谢手术替代方案。RY-DS 可用于治疗 SADI-S 后体重增加和/或胆汁反流。
