Aljazeera International Hospital, Misurata University School of Medicine, Misurata, Libya.
Gastrointestinal Bariatric and Metabolic Surgery Center (GBMC), Jordan Hospital, Amman, Jordan.
Obes Surg. 2024 May;34(5):1742-1747. doi: 10.1007/s11695-024-07192-7. Epub 2024 Mar 27.
Single anastomosis sleeve ileal (SASI) bypass is a modification of sleeve gastrectomy with transit bipartition (SG + TB). This study aims to assess the safety and efficacy of SASI as a primary metabolic and bariatric surgery (MBS).
This is a retrospective case series of 30 patients who underwent SASI bypass from January to December 2021. All patients completed at least 12 months of follow-up.
Among the 30 patients, 93.3% were women, the mean age was 37.4 years, and the mean body mass index (BMI) was 45.6 kg/m. The percentage of total body weight loss (TWL%) was 42.7%, the percent excess body weight loss (EWL%) was 92.7%, and the mean BMI at 12 months went from 45.6(35.2-58.4) to 25.8 kg/m (19.2-33.4). The obesity-associated complications remission rate was 87.5% for type 2 diabetes (T2D), 71.4% for hypertension (HTN) and 100% for obstructive sleep apnea (OSA). Thirteen patients (43.3%) had diarrhea, 7 (23.3%) had hypoalbuminemia, defined as serum albumin < 3 g/dl, and 6 (20%) underwent reversal of their index SASI. As for other nutritional issues, iron deficiency anemia was present in 21 patients (70%), while 19 patients (63.3%) had vitamin D, and 2(6.6%) had vitamin B12 deficiency.
Despite good short-term weight loss and improvement of obesity-associated complications, SASI is accompanied by high alarming malnutrition, even in short-term follow-up. Novel MBS should be judged for their long-term effects and compared to well-tested standard operations before they are used in routine clinical practice.
单吻合口袖状空肠旁路术（SASI）是袖状胃切除术加转位二分术（SG+TB）的改良术式。本研究旨在评估 SASI 作为一种主要代谢和减重手术（MBS）的安全性和有效性。
这是一项回顾性病例系列研究，纳入了 2021 年 1 月至 12 月期间接受 SASI 旁路手术的 30 例患者。所有患者均完成了至少 12 个月的随访。
30 例患者中，93.3%为女性，平均年龄为 37.4 岁，平均体重指数（BMI）为 45.6kg/m。总体重减轻百分比（TWL%）为 42.7%，多余体重减轻百分比（EWL%）为 92.7%，12 个月时 BMI 从 45.6（35.2-58.4）降至 25.8kg/m（19.2-33.4）。2 型糖尿病（T2D）缓解率为 87.5%，高血压（HTN）缓解率为 71.4%，阻塞性睡眠呼吸暂停（OSA）缓解率为 100%，肥胖相关并发症缓解率为 87.5%。13 例（43.3%）患者出现腹泻，7 例（23.3%）患者出现低白蛋白血症，定义为血清白蛋白<3g/dl，6 例（20%）患者行原 SASI 逆转。其他营养问题方面，21 例（70%）患者出现缺铁性贫血，19 例（63.3%）患者维生素 D 缺乏，2 例（6.6%）患者维生素 B12 缺乏。
尽管 SASI 术后短期内体重减轻效果良好，肥胖相关并发症得到改善，但即使在短期随访中，也存在较高的营养不良风险。新型 MBS 应根据其长期效果进行评估，并在常规临床实践中使用之前与经过充分验证的标准手术进行比较。
