General Surgery Department, Mansoura Faculty of Medicine, Mansoura University Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, Dakahlia, 35516, Egypt.
AlQassimi Hospital, Sharjah, UAE.
Obes Surg. 2021 Apr;31(4):1579-1589. doi: 10.1007/s11695-020-05159-y. Epub 2021 Jan 6.
Bariatric surgery is the most effective treatment for morbid obesity. The present study aimed to assess three bariatric procedures with different mechanisms of actions; sleeve gastrectomy (SG), one-anastomosis gastric bypass (OAGB), and single anastomosis sleeve ileal (SASI) bypass, in terms of efficacy and safety.
This was a retrospective cohort study on patients with morbid obesity who underwent SG, OAGB, or SASI bypass. The main outcome measures were weight loss and improvement in comorbidities at 6 and 12 months postoperatively, and complications.
A total of 264 patients (186 female) with mean preoperative body mass index (BMI) of 43.6 ± 9.9 kg/mwere included to the study. Significant weight loss was recorded at 6 and 12 months after the three procedures. At 6 and 12 months postoperatively, body weight and BMI were significantly lower after SASI bypass than after SG and OAGB. The %total weight loss (%TWL) and %excess weight loss (%EWL) were significantly higher after SASI bypass than after SG and OAGB. SASI bypass was associated with a significantly higher rate of improvement in DM than SG and OAGB (97.7% vs 71.4% vs 86.7%; p = 0.04) whereas improvement in other comorbidities was similar. The short-term complication rate was similar between the three procedures, yet SASI bypass was followed by higher long-term complication rate.
Based on retrospective review of data, SASI bypass was associated with more reduction in body weight and BMI, higher %TWL and %EWL, better improvement in T2DM, and more long-term nutritional complications than SG and OAGB.
减重手术是治疗病态肥胖最有效的方法。本研究旨在评估三种作用机制不同的减重手术：袖状胃切除术（SG）、单吻合口胃旁路术（OAGB）和单吻合口袖状回肠旁路术（SASI），从疗效和安全性方面进行评估。
这是一项回顾性队列研究，纳入了接受 SG、OAGB 或 SASI 旁路手术的病态肥胖患者。主要观察指标为术后 6 个月和 12 个月的体重减轻和合并症改善情况，以及并发症。
共纳入 264 例（女性 186 例），术前平均体重指数（BMI）为 43.6±9.9kg/m。三种手术术后 6 个月和 12 个月均有显著的体重减轻。术后 6 个月和 12 个月，SASI 旁路术后体重和 BMI 明显低于 SG 和 OAGB。SASI 旁路术后的总体重减轻百分比（%TWL）和超重体重减轻百分比（%EWL）明显高于 SG 和 OAGB。SASI 旁路术与 SG 和 OAGB 相比，糖尿病（DM）改善率显著更高（97.7% vs 71.4% vs 86.7%；p=0.04），而其他合并症的改善情况相似。三种手术的短期并发症发生率相似，但 SASI 旁路术后的长期并发症发生率更高。
基于对数据的回顾性分析，SASI 旁路术与 SG 和 OAGB 相比，体重和 BMI 降低更多，%TWL 和 %EWL 更高，T2DM 改善更好，长期营养并发症更多。
