International Federation for Surgery of Obesity and Metabolic Disorders, Naples, Italy.
Obes Surg. 2024 Oct;34(10):3639-3685. doi: 10.1007/s11695-024-07490-0. Epub 2024 Sep 12.
The single anastomosis duodeno-ileostomy with sleeve gastrectomy/single anastomosis duodenal switch (SADI-S/SADS) has gained attention as an alternative to the traditional biliopancreatic diversion with duodenal switch (BPD-DS). In 2021, IFSO endorsed SADI-S/SADS as a safe and effective procedure, underscoring the necessity for long-term multidisciplinary care and randomized controlled trials (RCTs). A task force was established to conduct a systematic review of current evidence on SADI-S/SADS to guide clinical practice. A systematic review was conducted across three databases, focusing on studies examining SADI-S/SADS and its outcomes. A total of 93 studies were analyzed. SADI-S/SADS demonstrated efficacy in weight loss and medium-to-long-term control of type 2 diabetes mellitus (T2DM), along with positive outcomes regarding hypertension and hyperlipidemia. However, its impact on other comorbidities remains inconclusive. Frequent nutritional deficiencies were identified, particularly in fat-soluble vitamins, anemia, and hypoalbuminemia. Despite significant efforts, high-quality evidence on SADI-S/SADS remains scarce, prompting IFSO to advocate for increased registry participation, publication of long-term studies, and more RCTs. Lifelong supplementation and monitoring for nutritional deficiencies are recommended. The current position statement will be reviewed in 2 years.
单吻合口十二指肠空肠旁路术联合袖状胃切除术/单吻合口十二指肠转位术（SADI-S/SADS）作为传统胆胰分流联合十二指肠转位术（BPD-DS）的替代方案引起了关注。2021 年，国际肥胖与代谢外科学会（IFSO）认可 SADI-S/SADS 是一种安全有效的手术，并强调需要长期的多学科护理和随机对照试验（RCT）。为此成立了一个工作组，对 SADI-S/SADS 的现有证据进行系统评价，以指导临床实践。该系统评价横跨三个数据库进行，重点研究了 SADI-S/SADS 及其结果。共分析了 93 项研究。SADI-S/SADS 在减肥和 2 型糖尿病（T2DM）的中长期控制方面显示出疗效，同时在高血压和高血脂方面也有积极的结果。然而，其对其他合并症的影响仍不确定。频繁发生营养缺乏，特别是脂溶性维生素、贫血和低白蛋白血症。尽管做出了巨大努力，但 SADI-S/SADS 的高质量证据仍然稀缺，IFSO 倡导增加登记参与、发表长期研究和更多 RCT。建议终身补充和监测营养缺乏。本立场声明将在 2 年后进行审查。
