Single-Anastomosis Sleeve Ileal (SASI) Bypass: Hopes and Concerns after a Two-Year Follow-up

Khalaf, Mohamed; Hamed, Hosam

doi:10.1007/s11695-020-04945-y

Cited by 31 publications

(31 citation statements)

References 22 publications

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“…Our study reported the safety of the SASJ procedure regarding the early post-operative course, as no cases with leakage, peritonitis or bleeding were encountered. In another study, bleeding was encountered in 3.7% of cases while staple line leakage occurred in 0.3% of cases [24].…”

Section: Discussionmentioning

confidence: 87%

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Comparative Study between Single Anastomosis Sleeve Jejunal Bypass, Sleeve Gastrectomy and One Anastomosis Gastric Bypass: A Prospective Randomized trial

Elrefai

Ibrahim

Zeid

et al. 2022

Preprint

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Background: A variety of bariatric procedures are being practiced nowadays. Laparoscopic sleeve gastrectomy (LSG) and one anastomosis gastric bypass (OAGB) are two commonly practiced bariatric procedures. Recently, single anastomosis sleeve jejunal bypass (SASJ) has emerged as a novel effective procedure with a decreased risk of malnutrition due to the presence of two pathways for food. Herein, we compared outcomes of these three procedures regarding short-term weight loss, complications, comorbidity resolution and quality of life.Patients and methods: We included a total of 60 cases in this prospective randomized study, and they were divided into three equal groups; SASJ, LSG and OAGB groups. The three procedures were performed by the same surgical team adapting standardized techniques. Weight loss parameters were our primary objectives, while secondary outcomes included post-operative complications, nutritional status, improvement/resolution of comorbidities and quality of life.Results: Operative time was significantly prolonged in the SASJ group, compared to the other two groups. Nevertheless, the incidence of post-operative complications did not significantly differ between the three groups, apart from GERD, that was more encountered in LSG group (20% of cases). Percentage of total weight loss (%TWL) were comparable among the 3 procedures; (SASJ 39.4 and 56.85%), (LSG 46.05 and 65.6%) and (OAGB 43 and 61.4%) at 6 and 12 months respectively. Comorbidity improvement, quality of life and nutritional status didn’t differ among the three study groups.Conclusion: SASJ bypass is an effective bariatric procedure regarding weight loss and comorbidity resolution, with a safe perioperative outcome comparable to OAGB and LSG.

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Section: Discussionmentioning

confidence: 87%

“…However, our results are within the normal limits reported in the literature. Khalaf and Hamed reported that the mean operative time of the SASI procedure was 98.8 minutes [24].…”

Section: Discussionmentioning

confidence: 99%

Comparative Study between Single Anastomosis Sleeve Jejunal Bypass, Sleeve Gastrectomy and One Anastomosis Gastric Bypass: A Prospective Randomized trial

Elrefai

Ibrahim

Zeid

et al. 2022

Preprint

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“…There was unanimous agreement among the studies investigating the SASI bypass procedure about its effect on T2DM remission. The improvement and remission rates ranged from 85% to 100% [6], [15], [17], [18], [20], [22], [23], [24].…”

Section: Discussionmentioning

confidence: 99%

“…Accordingly, Mahdy et al [20] reported that lower pre-operative BMI was predictors for higher %EBWL following the SASI bypass procedure. Likewise, it was stated that higher pre-operative BMIs have been associated with lower %EWL after SG [22].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Single Anastomosis Sleeve Ileal Bypass with Follow-up of Weight Loss and Metabolic Impact

Abdalaziz

Sarhan²,

Abou-Eisha³

et al. 2022

Open Access Maced J Med Sci

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Background: Bariatric surgery has been an effective safe management for severe obesity. The newly developed single-anastomosis sleeve ileal (SASI) bypass has shown efficacy as a functional as well as mechanical restrictive bariatric procedure, with a neuroendocrine modulation effect. SASI bypass is still an investigational procedure, hence, more evidence is needed till it is declared as a standard bariatric procedure by the IFSO. Aim of the study: The current work aimed to describe our experience regarding the technical steps, the efficacy and the short-term outcome of SASI bypass procedure in patients with severe obesity. Patients and methods: Forty seven patients with severe obesity underwent SASI bypass procedure. They were followed till 1 year postoperatively. The weight loss, comorbidities and laboratory changes were assessed. Results: Patients evaluation at the 1-year postoperative follow up revealed a mean %TWL of 37.55 ± 6.17 and a mean %EBWL of 76.21 ± 9.8. The remission rates of T2DM, hyperlipidemia and hypertension were 85.7%, 94.7% and 89.66%, respectively, with statistically high significant differences between the preoperative and 1-year postoperative comorbidities rate. Stepwise regression analysis demonstrated that only the preoperative HbA1C remained in the model predicting the %TWL, and the preoperative BMI was the remaining factor in the model predicting the %EBWL in the study patients. Conclusion: The present study adds a new evidence to the promising outcome of the newly introduced SASI bypass procedure. After one year, the study patients showed excellent weight loss and comorbidities remission together with acceptable major complication rates.

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“…3 27 Therefore, endoscopic SEMS treatment could have a crucial impact on the management of anastomotic complications after SG. 28 Standard treatments are time-consuming and can lead to substantial morbidity, including patient discomfort and decreased quality of life. 29 Therefore, it is almost acceptable by surgeons that SEMS might shorten hospital stays and reduce complications of specialized feeding.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Self-Expanding Metallic Stent Placement in the Management of Post Laparoscopic Sleeve Gastrectomy Complications

Goudarzi¹,

Obney

Hemmatizadeh³

et al. 2022

Journal of Digestive Endoscopy

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Introduction Endoscopic treatments have become popular by providing the best solution for healing complications while allowing oral nutrition. In this study, we aim to evaluate outcomes of the endoscopic-covered stents for staple line complications following bariatric surgery. Methods A prospective evaluation was performed for all patients treated for staple line complications after bariatric surgery. Bariatric patients with acute leaks, chronic gastrocutaneous fistulas, and anastomotic strictures refractory to endoscopic dilation after sleeve gastrectomy were included in this survey. Results From January 2019 to June 2020, 41 patients (12 with acute leaks, 16 with chronic fistulas, and 13 with strictures) were treated with endoscopic silicone-covered stents (polyester or nitinol). The mean follow-up was 3.5 months. Immediate symptomatic improvement occurred in 95.2% (91.7% of acute leaks, 81.2% of fistulas, and 92.3% of strictures). In addition, 87.8% of patients initiated oral feeding immediately after stenting. There was no mortality case in this population. Conclusion Although stent migration rarely occurs in subjects, the endoscopic silicone-covered stents strategy is one of the best treatments for anastomotic complications after bariatric surgery, providing rapid healing while simultaneously allowing for oral nutrition.

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Single-Anastomosis Sleeve Ileal (SASI) Bypass: Hopes and Concerns after a Two-Year Follow-up

Cited by 31 publications

References 22 publications

Comparative Study between Single Anastomosis Sleeve Jejunal Bypass, Sleeve Gastrectomy and One Anastomosis Gastric Bypass: A Prospective Randomized trial

Comparative Study between Single Anastomosis Sleeve Jejunal Bypass, Sleeve Gastrectomy and One Anastomosis Gastric Bypass: A Prospective Randomized trial

Laparoscopic Single Anastomosis Sleeve Ileal Bypass with Follow-up of Weight Loss and Metabolic Impact

Endoscopic Self-Expanding Metallic Stent Placement in the Management of Post Laparoscopic Sleeve Gastrectomy Complications

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