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Background <p>The single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) can be performed as a primary or (planned) secondary metabolic bariatric procedure. The aims of this study were to compare mid-term outcomes up to 5&#xa0;years after primary vs secondary SADI-S and between different common channel (CC) lengths.</p> Methods <p>Multicenter retrospective cohort study including 103 patients who underwent SADI-S between 06–2015 and 02–2019. Outcomes on weight loss, nutrient status, health-related quality of life (HRQoL) and gastro-intestinal symptoms until 5&#xa0;years postoperatively were evaluated and compared between primary (<i>n</i> = 19) vs secondary SADI-S (<i>n</i> = 84), and CC length ≤ 250&#xa0;cm (<i>n</i> = 66,) vs &gt; 250&#xa0;cm (<i>n</i> = 33).</p> Results <p>Mean total weight loss (TWL) at 5&#xa0;years of follow-up was higher for patients who underwent primary SADI-S compared to secondary SADI-S (34.8 (29.8–39.9)% vs 15.9 (13.0–18.9)%, <i>p</i> &lt; 0.001) and for CC length ≤ 250&#xa0;cm compared to &gt; 250&#xa0;cm (25.3 (21.8–28.9)% vs 21.3 (17.2–25.4)%, <i>p</i> = 0.12). Patients who underwent primary SADI-S also had significantly higher scores on the domains of the BODY-Q HRQoL questionnaire (<i>p</i> &lt; 0.05 for all), with the exception of sexual well-being. Nutrient status and gastro-intestinal symptoms were comparable between the indication groups, but CC length ≤ 250&#xa0;cm tended to result in more nutrient deficiencies and higher defecation frequency.</p> Conclusion <p>Both primary and secondary SADI-S result in durable weight loss outcomes up to 5&#xa0;years postoperatively. It is imperative that CC length should be at least 250&#xa0;cm to prevent malnutrition and&#xa0;gastro-intestinal complaints. Furthermore, focus on HRQoL is essential in future research into SADI-S.</p> Graphical Abstract <p></p>

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Five year outcomes of primary and secondary Single-Anastomosis Duodeno-Ileal bypass with Sleeve gastrectomy (SADI-S)

  • 期刊论文

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  • 发表日期：

    2025年5月9日

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  • Mitchell J. R. Harker,
  • Laura Heusschen,
  • Valerie M. Monpellier,
  • Ronald S.L. Liem,
  • Magaly J.J. Van himbeeck,
  • Simon W. Nienhuijs,
  • May Al Nawas,
  • Rene J. Wiezer,
  • Guusje Vugts,
  • Eric J. Hazebroek

摘要

Background

The single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) can be performed as a primary or (planned) secondary metabolic bariatric procedure. The aims of this study were to compare mid-term outcomes up to 5 years after primary vs secondary SADI-S and between different common channel (CC) lengths.

Methods

Multicenter retrospective cohort study including 103 patients who underwent SADI-S between 06–2015 and 02–2019. Outcomes on weight loss, nutrient status, health-related quality of life (HRQoL) and gastro-intestinal symptoms until 5 years postoperatively were evaluated and compared between primary (n = 19) vs secondary SADI-S (n = 84), and CC length ≤ 250 cm (n = 66,) vs > 250 cm (n = 33).

Results

Mean total weight loss (TWL) at 5 years of follow-up was higher for patients who underwent primary SADI-S compared to secondary SADI-S (34.8 (29.8–39.9)% vs 15.9 (13.0–18.9)%, p < 0.001) and for CC length ≤ 250 cm compared to > 250 cm (25.3 (21.8–28.9)% vs 21.3 (17.2–25.4)%, p = 0.12). Patients who underwent primary SADI-S also had significantly higher scores on the domains of the BODY-Q HRQoL questionnaire (p < 0.05 for all), with the exception of sexual well-being. Nutrient status and gastro-intestinal symptoms were comparable between the indication groups, but CC length ≤ 250 cm tended to result in more nutrient deficiencies and higher defecation frequency.

Conclusion

Both primary and secondary SADI-S result in durable weight loss outcomes up to 5 years postoperatively. It is imperative that CC length should be at least 250 cm to prevent malnutrition and gastro-intestinal complaints. Furthermore, focus on HRQoL is essential in future research into SADI-S.

Graphical Abstract