Department of Bariatric Surgery, University of Montreal, Montreal, H3C 3J7, Canada.
General Surgery, Government Medical College Surat, Surat, 395001, India.
Obes Surg. 2024 Sep;34(9):3285-3297. doi: 10.1007/s11695-024-07366-3. Epub 2024 Jul 26.
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.
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。
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