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作为治疗肥胖症的替代方法,单吻合口套叠式回肠旁路术(SASI)的疗效:更新的系统评价和荟萃分析。

Outcomes of Single Anastomosis Sleeve Ileal (SASI) Bypass as an Alternative Procedure in Treating Obesity: An Updated Systematic Review and Meta-Analysis.

机构信息

Department of Bariatric Surgery, University of Montreal, Montreal, H3C 3J7, Canada.

General Surgery, Government Medical College Surat, Surat, 395001, India.

出版信息

Obes Surg. 2024 Sep;34(9):3285-3297. doi: 10.1007/s11695-024-07366-3. Epub 2024 Jul 26.


DOI:10.1007/s11695-024-07366-3
PMID:39060638
Abstract

PURPOSE: The Single Anastomosis Sleeve Ileal (SASI) bypass is a novel bariatric procedure that simplifies Santoro's procedure, balancing functional restriction and neuroendocrine modulation while preserving anatomy. We aim to conduct a single-arm meta-analysis of the SASI bypass to explore its moderate-term efficacy, as this might expand the available choices for surgeons to choose the best bariatric surgery that suits the patient's condition. MATERIALS AND METHODS: We conducted a comprehensive search on PubMed, Scopus, EMBASE, and Cochrane to identify studies for the SASI bypass surgery focusing on outcomes such as %EWL, %TWL, remission rate of comorbidities, and complications. The statistical analysis was carried out using RStudio version 4.3.2. Heterogeneity was assessed using the Cochrane Q test and I statistics. RESULTS: Our findings illuminate SASI's potency by undertaking a single-arm meta-analysis involving 1873 patients across 26 studies. At 12 months, we report a noteworthy % Excess Weight Loss (%EWL) (Mean 84.13; 95% CI 78.41-89.85; I = 95%), and % Total Weight Loss (%TWL) (Mean 35.17; 95% CI 32.30-38.04; I = 97%), highlighting SASI's efficacy on weight loss. Cumulative meta-analyses supported these findings. More weight loss was observed with a 250 cm common limb and a greater than 3 cm anastomosis. An 88.28% remission rate in type 2 diabetes mellitus (95% CI 79.74-95.03; I = 84%) at 12 months was observed. Beyond weight outcomes, SASI impacts comorbidities with a good safety profile. CONCLUSION: Our study positions the SASI bypass as a good alternative option. However, long-term efficacy is yet to be explored in the future.

摘要

目的:单吻合口袖状空肠旁路术(SASI)是一种新型减重手术,简化了 Santoro 的手术操作,在保持解剖结构的同时平衡了功能限制和神经内分泌调节。我们旨在对 SASI 旁路术进行单臂荟萃分析,以探讨其中期疗效,因为这可能为外科医生提供更多选择,以选择最适合患者病情的最佳减重手术。

材料和方法:我们在 PubMed、Scopus、EMBASE 和 Cochrane 上进行了全面检索,以确定针对 SASI 旁路手术的研究,重点关注术后体重减轻百分比(%EWL)、总体重减轻百分比(%TWL)、合并症缓解率和并发症等结果。使用 RStudio 版本 4.3.2 进行统计分析。使用 Cochrane Q 检验和 I 统计量评估异质性。

结果:我们通过对 26 项研究中的 1873 名患者进行单臂荟萃分析,发现了 SASI 的疗效。在 12 个月时,我们报告了显著的术后体重减轻百分比(%EWL)(平均值 84.13%;95%CI 78.41-89.85;I=95%)和总体重减轻百分比(%TWL)(平均值 35.17%;95%CI 32.30-38.04;I=97%),表明 SASI 在减重方面的疗效。累积荟萃分析支持了这些发现。使用 250cm 长的共同空肠支和大于 3cm 的吻合口,可观察到更多的体重减轻。在 12 个月时,2 型糖尿病的缓解率为 88.28%(95%CI 79.74-95.03;I=84%)。除了体重结果外,SASI 还对合并症有影响,具有良好的安全性。

结论:我们的研究将 SASI 旁路术定位为一种良好的替代选择。然而,长期疗效仍有待未来探索。

相似文献

[1]
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[2]
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[3]
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[4]
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[5]
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[6]
Sleeve Gastrectomy, One-Anastomosis Gastric Bypass (OAGB), and Single Anastomosis Sleeve Ileal (SASI) Bypass in Treatment of Morbid Obesity: a Retrospective Cohort Study.

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[8]
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[9]
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[10]
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引用本文的文献

[1]
Laparoscopic Single Anastomosis Sleeve Ileal Bypass Versus Laparoscopic Roux-en-Y Gastric Bypass as Single Stage Procedure for Management of Patients with Class V Obesity (BMI ≥ 60 kg/m): Short-Term Follow-Up.

Obes Surg. 2025-5-28

本文引用的文献

[1]
One Anastomosis Transit Bipartition (OATB): Rational and Mid-term Outcomes.

Obes Surg. 2024-2

[2]
Single anastomosis sleeve ileal (SASI) bypass as a primary and revisional procedure: a single-centre experience.

Wideochir Inne Tech Maloinwazyjne. 2023-9

[3]
Update on the Obesity Epidemic: After the Sudden Rise, Is the Upward Trajectory Beginning to Flatten?

Curr Obes Rep. 2023-12

[4]
Short-term Results of Transit Bipartition to Promote Weight Loss After Laparoscopic Sleeve Gastrectomy.

Ann Surg Open. 2021-10-1

[5]
Adiponectin and leptin levels of patients after sleeve gastrectomy, Roux-en-Y gastric bypass, and single anastomosis sleeve ileal bypass surgeries.

J Res Med Sci. 2023-5-29

[6]
Laparoscopic Sleeve Gastrectomy With Transit Loop Bipartition and Transit Bipartition in Type 2 Diabetic Patients With Obesity: A Retrospective Analysis.

Surg Laparosc Endosc Percutan Tech. 2023-8-1

[7]
Mid-term outcomes after single anastomosis sleeve ileal (SASI) bypass in treatment of morbid obesity.

Surg Endosc. 2023-8

[8]
Comparison of Laparoscopic Sleeve Gastrectomy and Single Anastomosis Sleeve Ileal Bypass in Type 2 Diabetes Mellitus Remission Using International Criteria.

J Laparoendosc Adv Surg Tech A. 2023-8

[9]
From Our One Anastomosis Gastric Bypass (OAGB) Experience to Establishing Single Anastomosis Sleeve Ileal (SASI) Bypass Procedure: A Single-Center Report.

Obes Surg. 2023-4

[10]
Innovative Bariatric Procedures and Ethics in Bariatric Surgery: the IFSO Position Statement.

Obes Surg. 2022-10

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