Single Anastomosis Sleeve Jejunal Bypass (SASJ) Versus Roux-en-Y Gastric Bypass in Patients with Obesity

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of General Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Fellowship of Advanced laparoscopy and Minimally Invasive Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Obesity and its related morbidities has become a great concern worldwide. Bariatric surgery, regardless of its type, is the most effective approach for morbid obesity treatment. Single anastomosis sleeve jejunal (SASJ) bypass is a novel technique of bariatric surgery that can be considered for patients with previous history of severe gastroesophageal symptoms. The current study aimed to compare outcomes of SASJ with classic gastric bypass in a six-month follow-up.Methods: This was a cohort study conducted on 50 patients underwent two types of bariatric surgeries (Classic Roux en-Y and SASJ), each contained 25 cases, during the years 2017 and 2018. Patients' information including age, gender, height, basal weight, body mass index (BMI), serum albumin, and glycated hemoglobin (HbA1C) were recorded and compared basically and within one, three and six months after surgery.Findings: Members of two groups were similar regarding age, gender distribution, height, basic BMI, HbA1C, albumin, and excess weight (P > 0.050 for all). Both the groups significantly lost weight within six months; while comparison of them showed no statistical difference regarding excess weight loss, BMI, HbA1C, and albumin (P > 0.050 for all). Within six months, the mean excess weight loss was 54.54 in SASJ and 50.54 in the other group.Conclusion: Trend of weight loss following SASJ bypass was similar to classic gastric bypass. Therefore, due to reversibility and easier gastric follow-up studies in SASJ approach, this technique can be considered for cases with particular indications. Further studies with longer follow-ups are strongly recommended.

Keywords

References

  1. Dixon JB. The global burden of obesity and diabetes. In: Brethauer SA, Schauer PR, Schirmer BD, editors. Minimally invasive bariatric surgery. New York, NY: Springer; 2015. p. 1-6.
  2. Nguyen NT, Varela JE. Bariatric surgery for obesity and metabolic disorders: State of the art. Nat Rev Gastroenterol Hepatol 2017; 14(3): 160-9.
  3. Picot J, Jones J, Colquitt JL, Gospodarevskaya E, Loveman E, Baxter L, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess 2009; 13(41): 1-357.
  4. Colquitt JL, Pickett K, Loveman E, Frampton GK. Surgery for weight loss in adults. Cochrane Database Syst Rev 2014; (8): CD003641.
  5. Angrisani L, Santonicola A, Iovino P, Formisano G, Buchwald H, Scopinaro N. Bariatric Surgery Worldwide 2013. Obes Surg 2015; 25(10): 1822-32.
  6. Santoro S, Milleo FQ, Malzoni CE, Klajner S, Borges PC, Santo MA, et al. Enterohormonal changes after digestive adaptation: Five-year results of a surgical proposal to treat obesity and associated diseases. Obes Surg 2008; 18(1): 17-26.
  7. Reames BN, Finks JF, Bacal D, Carlin AM, Dimick JB. Changes in bariatric surgery procedure use in Michigan, 2006-2013. JAMA 2014; 312(9): 959-61.
  8. Alamo M, Sepulveda M, Gellona J, Herrera M, Astorga C, Manterola C. Sleeve gastrectomy with jejunal bypass for the treatment of type 2 diabetes mellitus in patients with body mass index <35 kg/m2. A cohort study. Obes Surg 2012; 22(7): 1097-103.
  9. Fried M, Ribaric G, Buchwald JN, Svacina S, Dolezalova K, Scopinaro N. Metabolic surgery for the treatment of type 2 diabetes in patients with BMI <35 kg/m2: an integrative review of early studies. Obes Surg 2010; 20(6): 776-90.
  10. Mahdy T, Al WA, Schou C. Efficacy of single anastomosis sleeve ileal (SASI) bypass for type-2 diabetic morbid obese patients: Gastric bipartition, a novel metabolic surgery procedure: A retrospective cohort study. Int J Surg 2016; 34: 28-34.
  11. Melissas J, Peppe A, Askoxilakis J, Dimitriadis E, Grammatikakis J. Sleeve gastrectomy plus side-to-side jejunoileal anastomosis for the treatment of morbid obesity and metabolic diseases: A promising operation. Obes Surg 2012; 22(7): 1104-9.
  12. Zachariah PJ, Chen CY, Lee WJ, Chen SC, Ser KH, Chen JC, et al. Compared to sleeve gastrectomy, duodenal-jejunal bypass with sleeve gastrectomy gives better glycemic control in T2DM patients, with a lower beta-cell response and similar appetite sensations: mixed-meal study. Obes Surg 2016; 26(12): 2862-72.
  13. Sanchez-Pernaute A, Rubio MA, Cabrerizo L, Ramos-Levi A, Perez-Aguirre E, Torres A. Single-anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S) for obese diabetic patients. Surg Obes Relat Dis 2015; 11(5): 1092-8.
  14. Huang CK, Mahendra R, Hsin MC, Chang PC. Novel metabolic surgery: First Asia series and short-term results of laparoscopic proximal jejunal bypass with sleeve gastrectomy. Ann Laparosc Endosc Surg 2016; 1(7): 37.
Journal of Isfahan Medical School
Volume 38, Issue 563 - Serial Number 563
January and February 2020
Pages 49-54

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History

  • Receive Date: 05 May 2019
  • Revise Date: 02 November 2024
  • Accept Date: 06 April 2022

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