Single Anastomosis Duodeno-Ileal Bypass (SADI) as a Second Step After Failed Sleeve Gastrectomy:Systematic Review and Meta-analysis
10.17476/jmbs.2023.12.2.35
- Author:
Karim ATAYA
1
;
Ayman BSAT
;
Abdul Hafiz AL TANNIR
;
Al Moutuz Al JAAFAREH
;
Amir Rabih AL
;
George Abi SAAD
Author Information
1. Department of Bariatric Surgery, Kings College Hospital London, London, UK
- Publication Type:Original Article
- From:Journal of Metabolic and Bariatric Surgery
2023;12(2):35-43
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:Our aim in this study is to assess single anastomosis duodeno-ileal bypass (SADI) as a salvage procedure following sleeve gastrectomy (SG), examining its technical feasibility, outcomes, and potential complications.
Materials and Methods:A systematic review and meta-analysis were conducted, drawing data from PubMed, Medline, and the Cochrane library. The analysis encompassed 14 studies, involving 1,066 patients. We evaluated operative time, comorbidity resolution (hypertension, dyslipidemia, diabetes), post-operative diarrhea incidence, excess weight loss (EWL) at six, twelve, and twenty-four months, and post-operative leak rates.
Results:SADI as a salvage procedure following SG yielded positive outcomes. Mean operative time was 125.98 minutes (95% CI 102.50–149.46, I 2 =99%). Importantly, SADI led to comorbidity resolution in a notable proportion of cases: hypertension in 48% (95% CI 38–57%, I 2 =44%), dyslipidemia in 55% (95% CI 40–69%, I 2 =30%), and diabetes in 63% (95% CI 53–72%, I 2 =30%) of patients. Post-operative diarrhea incidence was relatively low at 2% (95% CI 1–9%, I 2 =75%).In terms of weight loss, SADI patients exhibited substantial EWL: 47.73% (95% CI 37.86–57.61, I 2 =95%) at six months, 59.39% (95% CI 51.18–67.61, I 2 =95%) at twelve months, and 23.84% (95% CI 5.76–41.92, I 2 =100%). At twenty-four months. Furthermore, post-operative leak rate was relatively low, reported in only 1% (95% CI 0–5%, I 2 =80%) of cases.
Conclusion:SADI as a salvage procedure post-SG demonstrates technical feasibility and marked effectiveness. It offers substantial comorbidity resolution, significant weight loss, and low post-operative complication rates, notably post-operative leaks. Further research should investigate the long-term impact of SADI on patient nutritional status to facilitate its broader adoption.
