Faculty of Medicine, University of Porto - Alameda Prof.Hernâni Monteiro, Porto, 4200-319, Portugal.
Obesity Integrated Responsibility Unit (CRI-O), São João University Medical Center, Alameda Prof. Hernâni Monteiro, Porto, 4200- 319, Portugal.
Langenbecks Arch Surg. 2024 Jul 18;409(1):221. doi: 10.1007/s00423-024-03413-w.
The Single Anastomosis Sleeve Ileal (SASI) bypass is a new bariatric surgery corresponding to an adaptation of the Santoro approach, consisting of a sleeve gastrectomy (SG) followed by loop gastroileostomy. Therefore, we aimed to systematically assess all the current literature on SASI bypass in terms of safety, weight loss, improvement in associated comorbidities, and complications.
Following the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) recommendations, we conducted a systematic review and meta-analysis by searching three databases (PubMed, Scopus, and Web of Science). We performed a meta-analysis of risk ratios and mean differences to compare surgical approaches for excessive weight loss, improvement/remission in type 2 diabetes mellitus (T2DM), hypertension (HT), dyslipidemia (DL), obstructive sleep apnea (OSA), and complications. Heterogeneity was assessed using the I statistic.
Eighteen studies were included in the qualitative analysis and four in the quantitative analysis, comparing SASI bypass with SG and One-Anastomosis Gastric Bypass (OAGB). A comparison between Roux-en-Y Gastric Bypass (RYGB) and SASI bypass could not be performed. Compared to SG, the SASI bypass was associated with improved weight loss (MD = 11.32; 95% confidence interval (95%CI) [7.89;14.76]; p < 0.0001), and improvement or remission in T2DM (RR = 1.35; 95%CI [1.07;1.69]; p = 0.011), DL (RR = 1.41; 95%CI [1.00;1.99]; p = 0.048) and OSA (RR = 1.50; 95%CI [1.01;2.22]; p = 0.042). No statistically significant differences in any of the assessed outcomes were observed when compared with OAGB. When compared to both SG and OAGB, the complication rate of SASI was similar.
Although studies with longer follow-up periods are needed, this systematic review and meta-analysis showed that SASI bypass has a significant effect on weight loss and metabolic variables. Variations in outcomes between studies reinforce the need for standardization.
单吻合口袖状空肠旁路术（SASI）是一种新的减重手术，对应于 Santoro 方法的一种适应，包括袖状胃切除术（SG）和套叠式胃肠吻合术。因此，我们旨在从安全性、减重效果、改善相关合并症以及并发症的角度，系统评估所有关于 SASI 旁路的现有文献。
根据首选报告项目的系统审查和荟萃分析（PRISMA）建议，我们通过搜索三个数据库（PubMed、Scopus 和 Web of Science）进行了系统评价和荟萃分析。我们进行了风险比和平均差异的荟萃分析，以比较过多体重减轻的手术方法、2 型糖尿病（T2DM）、高血压（HT）、血脂异常（DL）、阻塞性睡眠呼吸暂停（OSA）的改善/缓解和并发症。使用 I 统计量评估异质性。
定性分析纳入了 18 项研究，定量分析纳入了 4 项研究，比较了 SASI 旁路与 SG 和单吻合口胃旁路术（OAGB）。无法进行 Roux-en-Y 胃旁路术（RYGB）与 SASI 旁路的比较。与 SG 相比，SASI 旁路与体重减轻改善相关（MD=11.32；95%置信区间[95%CI]为[7.89；14.76]；p<0.0001），2 型糖尿病（RR=1.35；95%CI [1.07；1.69]；p=0.011）、血脂异常（RR=1.41；95%CI [1.00；1.99]；p=0.048）和 OSA（RR=1.50；95%CI [1.01；2.22]；p=0.042）的改善或缓解。与 OAGB 相比，在任何评估结果中均未观察到统计学上的显著差异。与 SG 和 OAGB 相比，SASI 的并发症发生率相似。
尽管需要更长随访期的研究，但本系统评价和荟萃分析表明，SASI 旁路对体重减轻和代谢变量有显著影响。研究之间结果的差异加强了标准化的必要性。
