Short term weight-loss and metabolic results after revisional and primary SADI-S: a single center study

Abstract

Background: The number of obese people has tripled since 1975, reaching 650 million obese, while 1,9 billion people were overweight. Bariatric surgery has been a useful treatment for overweight and obese patients, demonstrating better results than non-surgical treatment, lowering overall mortality and morbidity. Sleeve gastrectomy (SG) rose to prominence in the medical community as an effective technique with good weight loss and reduced complications. This technique presents re-intervention rates of 32%-36%%; weight regain, and gastroesophageal reflux disease are not uncommon after SG. Single anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) is a modified technique which aims to improve weight loss and metabolic outcomes with an acceptable rate of complications. Objectives: To report our single-center SADI-S short-term weight-loss, metabolic outcomes, and nutritional deficiencies. Methods: Retrospective analysis of 29 obese patients submitted to primary SADI-S (n=7) and revisional SADI-S (n=22), regarding weight loss, metabolic profile, and nutritional status. Results: Patients' body mass index (BMI) mean was 51.5±7.0 kg/m2. Surgery duration mean was 177.0±34.2 minutes and hospital stays lasted 2.0±0.0 days. There were no complications and no mortality during follow-up period. At 12 months follow-up, mean BMI was 33.8±4.4 kg/m2 and the mean excess weight loss was 66.3±16.4%. Lipidic profile and glucose metabolism parameters were improved. Regarding nutritional deficiencies, protein deficits were present in 31.3% of patients, and vitamin D deficits were present in 43.8% of patients at 12 months. Conclusion: SADI-S resulted in acceptable weight loss outcomes and improved metabolic profile. Minimal and manageable nutritional deficits were detected.