Single Anastomosis Duodeno-Ileal Switch (SADIS): A Systematic Review of Efficacy and Safety

Shoar, Saeed; Poliakin, Lauren; Rubenstein, Rebecca; Saber, Alan A.

doi:10.1007/s11695-017-2838-8

Cited by 100 publications

(41 citation statements)

References 26 publications

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“…It is recognized that there is a growing interest in OAGB/MGB and SADIs and that, as yet, these are not covered robustly by clinical practice guidelines. Until such data emerge, it may be hypothesized that requirements for nutritional supplements in people undergoing OAGB/MGB with BP limb of 150 cm would be at least that of people undergoing RYGB, if not more, and that nutritional requirements for people undergoing OAGB/MGB with BP limb greater than 150 cm and SADIS would be at least that of people undergoing the traditional BPD/DS 163–166 . We therefore recommend that healthcare professionals follow RYGB nutritional recommendations for postoperative care after OAGB/MGB with BP limb length of 150 cm and BPD/DS recommendations for people after OAGB/MGB with BP limb length of greater than 150 cm or SADIs.…”

Section: Abnormal Test Results and Clinical Problemsmentioning

confidence: 99%

British Obesity and Metabolic Surgery Society Guidelines on perioperative and postoperative biochemical monitoring and micronutrient replacement for patients undergoing bariatric surgery—2020 update

et al. 2020

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Bariatric surgery is recognized as the most clinically and cost-effective treatment for people with severe and complex obesity. Many people presenting for surgery have pre-existing low vitamin and mineral concentrations. The incidence of these may increase after bariatric surgery as all procedures potentially cause clinically significant micronutrient deficiencies. Therefore, preparation for surgery and long-term nutritional monitoring and follow-up are essential components of bariatric surgical care. These guidelines update the 2014 British Obesity and Metabolic Surgery Society nutritional guidelines. Since the 2014 guidelines, the working group has been expanded to include healthcare professionals working in specialist and non-specialist care as well as patient representatives. In addition, in these updated guidelines, the current evidence has been systematically reviewed for adults and adolescents undergoing the following procedures: adjustable gastric band, sleeve gastrectomy, Rouxen-Y gastric bypass and biliopancreatic diversion/duodenal switch. Using methods based on Scottish Intercollegiate Guidelines Network methodology, the levels of evidence and recommendations have been graded. These guidelines are comprehensive,

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Section: Abnormal Test Results and Clinical Problemsmentioning

confidence: 99%

British Obesity and Metabolic Surgery Society Guidelines on perioperative and postoperative biochemical monitoring and micronutrient replacement for patients undergoing bariatric surgery—2020 update

et al. 2020

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“…This weight regain could be reduced by diet modification, increasing the length of bypassed jejunum, or reducing the size of gastric pouch in intractable cases [30][31][32]. SADI-S procedure has been developed mainly to simplify the technique for biliopancreatic diversion (BPD) and many of the postoperative complications post-SADI-S procedure such as anastomotic leak or stricture were attributed to the learning curve and technical difficulties in the early phase of starting the SADI-S surgery as per previous studies [15,33]. We did not encounter such complications in our patients postoperatively or during follow-up; however, one of our patients developed intraabdominal collection postoperatively which was treated by aspiration and conservative treatment.…”

Section: Discussionmentioning

confidence: 99%

Single Anastomosis Duodeno-ileostomy (SADI-S) Versus One Anastomosis Gastric Bypass (OAGB-MGB) as Revisional Procedures for Patients with Weight Recidivism After Sleeve Gastrectomy: a Comparative Analysis of Efficacy and Outcomes

et al. 2020

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Purpose Many revisional procedures are available for unsuccessful laparoscopic sleeve gastrectomy (LSG) in patients with complications or weight recidivism. Single anastomosis duodeno-ileal bypass (SADI-S) and one anastomosis gastric bypass (OAGB-MGB) are two revisional procedures to address the problem of weight recidivism. We aimed to evaluate the efficacy and outcomes of the 2 revisional approaches (SADI-S vs. OAGB-MGB). Materials and Methods A retrospective analysis of prospectively collected database of patients who underwent SADI-S or OAGB-MGB as a revisional procedure for weight recidivism after primary LSG with a minimum 1-year follow-up. Weight loss, comorbidities, nutritional deficiencies, complications, and outcomes were compared in the 2 procedures. Results Ninety-one patients were included in the study (42 SADI-S and 49 OAGB-MGB). There was a significant weight loss (total weight loss percentage, TWL%) at 1-year follow-up observed for SADI-S when compared to OAGB-MGB (23.7 ± 5.7 vs. 18.7 ± 8.5, p = 0.02). However, this difference was not statistically significant at 18 months (26.4 ± 7.3 vs. 21.2 ± 11.0, p = 0.25). Remission of comorbidities (diabetes mellitus and hypertension) was comparable. Although OAGB-MGB had higher complication rate than SADI-S, the difference was not statistically significant (p = 0.39). No mortality was reported in the study groups. Conclusion Both SADI-S and OAGB-MGB are effective and safe revisional procedures for weight regain after LSG. The shortterm outcomes are comparable; however, SADI-S is associated with less upper gastrointestinal complications and could be a better option for patients suffering from GERD post-LSG. Moreover, the underlying bile reflux may get worse with OAGB-MGB. However, further prospective larger studies are needed. Keywords Revisional surgery. Sleeve gastrectomy. Single anastomosis duodeno-ileostomy. One anastomosis gastric bypass Abbreviations BMI Body mass index LSG Laparoscopic sleeve gastrectomy SADI-S Single anastomosis duodeno-ileostomy OAGB-MGB One anastomosis gastric bypass/mini gastric bypass EWL% Excess weight loss percentage TWL% Total weight loss percentage GERD Gastroesophageal reflux disease T2D Type 2 diabetes mellitus A1C Glycated hemoglobin A1C Electronic supplementary material The online version of this article (

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“…In another study, selenium intake and markers of deficiency were most evident at 3 months after RYGB, but not LAGB, prompting recommendations for routine increases in high selenium foods and use of routine multivitamin supplements with more than 55 μg/d of selenium . In a more recent report, Shoar et al found about 50% of patients undergoing SADI‐S had a selenium deficiency.…”

Section: Executive Summarymentioning

confidence: 96%

Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures – 2019 Update: Cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic and Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists

Mechanick

Apovian

Brethauer

et al. 2020

Obesity

340

464

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Objective The development of these updated clinical practice guidelines (CPGs) was commissioned by the American Association of Clinical Endocrinologists (AACE), The Obesity Society (TOS), American Society for Metabolic and Bariatric Surgery (ASMBS), Obesity Medicine Association (OMA), and American Society of Anesthesiologists (ASA) Boards of Directors in adherence with the AACE 2017 protocol for standardized production of CPGs, algorithms, and checklists. Methods Each recommendation was evaluated and updated based on new evidence from 2013 to the present and subjective factors provided by experts. Results New or updated topics in this CPG include: contextualization in an adiposity‐based chronic disease complications‐centric model, nuance‐based and algorithm/checklist‐assisted clinical decision‐making about procedure selection, novel bariatric procedures, enhanced recovery after bariatric surgery protocols, and logistical concerns (including cost factors) in the current health care arena. There are 85 numbered recommendations that have updated supporting evidence, of which 61 are revised and 12 are new. Noting that there can be multiple recommendation statements within a single numbered recommendation, there are 31 (13%) Grade A, 42 (17%) Grade B, 72 (29%) Grade C, and 101 (41%) Grade D recommendations. There are 858 citations, of which 81 (9.4%) are evidence level (EL) 1 (highest), 562 (65.5%) are EL 2, 72 (8.4%) are EL 3, and 143 (16.7%) are EL 4 (lowest). Conclusions Bariatric procedures remain a safe and effective intervention for higher‐risk patients with obesity. Clinical decision‐making should be evidence based within the context of a chronic disease. A team approach to perioperative care is mandatory, with special attention to nutritional and metabolic issues.

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Single Anastomosis Duodeno-Ileal Switch (SADIS): A Systematic Review of Efficacy and Safety

Cited by 100 publications

References 26 publications

British Obesity and Metabolic Surgery Society Guidelines on perioperative and postoperative biochemical monitoring and micronutrient replacement for patients undergoing bariatric surgery—2020 update

British Obesity and Metabolic Surgery Society Guidelines on perioperative and postoperative biochemical monitoring and micronutrient replacement for patients undergoing bariatric surgery—2020 update

Single Anastomosis Duodeno-ileostomy (SADI-S) Versus One Anastomosis Gastric Bypass (OAGB-MGB) as Revisional Procedures for Patients with Weight Recidivism After Sleeve Gastrectomy: a Comparative Analysis of Efficacy and Outcomes

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