Wityk Mateusz, Bobowicz Maciej, Pryt Mateusz, Dowgiałło-Gornowicz Natalia
Department of General and Oncological Surgery, Regional Health Centre, Lubin, Poland.
Department of Radiology, Medical University of Gdansk, Gdańsk, Poland.
Wideochir Inne Tech Maloinwazyjne. 2024 Nov 19;19(4):460-464. doi: 10.20452/wiitm.2024.17912. eCollection 2024 Dec 27.
The obesity epidemic has led to an increased prevalence of related conditions, such as type 2 diabetes (T2D) and hypertension. While laparoscopic sleeve gastrectomy is the most common metabolic bariatric surgery, up to 50% of patients may require revisional procedures due to weight regain or comorbidity recurrence. Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is emerging as an effective treatment option with promising short-term outcomes.
This study aimed to present the outcomes of patients who underwent SADI-S or revisional SADI.
This retrospective, single-center cohort study included 12 patients who underwent SADI-S or SADI between February 2023 and March 2024. The patients were assessed for percentage of total weight loss (%TWL), remission of T2D and hypertension, length of hospital stay, operative time, and complications. All outcomes were reported according to the American Society for Metabolic and Bariatric Surgery standards.
A total of 9 patients underwent primary SADI-S and 3 underwent revisional SADI. The mean (SD) %TWL was 27.9% (4.3%) at 6 months and 31.1% (5.9%) at 12 months after SADI and 21.2% (15.2%) and 14% (7.5%), respectively, after SADI-S. The mean (SD) preoperative body mass index was 42 (5.5) kg/m2 in the primary SADI-S group and 42.4 (9.3) kg/m2 in the revisional SADI group, and the mean (SD) follow-up was 10.1 (3.4) months. Full remission of T2D and hypertension was achieved in all patients within 6 months of surgery. There were no major complications, except for 1 case of intraoperative conversion to one-anastomosis gastric bypass.
SADI-S is associated with significant weight loss and comorbidity resolution with a low complication rate, though larger studies are needed for further validation of these results.
肥胖流行导致2型糖尿病（T2D）和高血压等相关疾病的患病率上升。虽然腹腔镜袖状胃切除术是最常见的代谢性减肥手术，但高达50%的患者可能因体重反弹或合并症复发而需要进行修正手术。单吻合口十二指肠回肠旁路术联合袖状胃切除术（SADI-S）正逐渐成为一种有效的治疗选择，短期疗效良好。
本研究旨在介绍接受SADI-S或修正性SADI手术患者的治疗结果。
这项回顾性单中心队列研究纳入了2023年2月至2024年3月期间接受SADI-S或SADI手术的12例患者。评估患者的总体重减轻百分比（%TWL）、T2D和高血压的缓解情况、住院时间、手术时间及并发症。所有结果均按照美国代谢与减肥外科学会的标准报告。
共有9例患者接受了初次SADI-S手术，3例接受了修正性SADI手术。SADI术后6个月和12个月时，平均（标准差）%TWL分别为27.9%（4.3%）和31.1%（5.9%）；SADI-S术后分别为21.2%（15.2%）和14%（7.5%）。初次SADI-S组术前平均（标准差）体重指数为42（5.5）kg/m²，修正性SADI组为42.4（9.3）kg/m²，平均（标准差）随访时间为10.1（3.4）个月。所有患者在术后6个月内实现了T2D和高血压的完全缓解。除1例术中转为单吻合口胃旁路术外，无重大并发症发生。
SADI-S与显著的体重减轻和合并症缓解相关，并发症发生率低，不过需要更大规模的研究来进一步验证这些结果。
