Single and dual anastomosis duodenal switch for obesity treatment: a single-center experience

• Type: Article in International Scientific Journal
• Date: 2021

Authors

Pereira, AM (Author) Other; Guimaraes, M (Author) Other; Pereira, SS (Author) ICBAS; de Almeida, RF (Author) Other; Monteiro, M (Author) ICBAS; Nora, M (Author) Other

Journal

Title: Surgery for Obesity and Related Diseases

Vol. 17

Pages: 12-22

ISSN: 1550-7289

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 13 Citations

Scopus - 17 Citations

Other information

Authenticus ID: P-00T-0TS

DOI: 10.1016/j.soard.2020.09.029

Abstract (EN): Background: Biliopancreatic diversion with duodenal switch (BPD/DS) is the most effective bariatric surgery in super-obese patients, although technically complex and time consuming. As a primary surgery, single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is similar to BPD/DS in terms of short-term outcomes, but long-term and comparative data are lacking. Objectives: The aim of this study was to compare the outcomes of patients submitted to SADI-S and BPD/DS. Setting: Public hospital. Methods: Obese patients (n = 112) submitted to SADI-S (n = 83) and BPD/DS (n = 29) for obesity treatment were prospectively compared. Results: The mean preoperative body mass indexes (BMIs) were 53.41 +/- .93 for BPD/DS and 50.61 +/- .52 kg/m(2) for SADI-S. Follow-up of 48 months was achieved in 18% (n 5 21) of patients, with a nonsignificant difference in the percentage of excess BMI loss (%EBMIL; 81.20 +/- 3.71 for BPD/DS; 74.82 +/- 3.45 for SADI-S). Operative time (164.30 +/- 7.78 minutes for BPD/DS; 132.70 +/- 7.19 minutes for SADI-S; P = .006) and hospital stay (4.90 +/- 1.10 days for BPD/DS; 4.35 6.70 days for SADI-S; P = .006) were significantly shorter for SADI-S. There was no significant difference in the 30-day postoperative complication rate. No mortality was reported. After surgery, significant improvements were observed in glucose and lipid profiles for both groups. The type 2 diabetes remission rate was 100% for BPD/DS and ranged from 60 to 80% for SADI-S across follow-up times. Dyslipidemia remission followed a similar pattern. Protein deficiency was observed in up to 50% of patients after BPD/DS and 20% after SADI-S, without statistically significances. Conclusion: SADI-S and BPD/DS as primary surgery for obesity treatment result in no significant differences in %EBMIL, improvement in obesity-related diseases, nutritional deficiencies, and post-operative morbidity. Nevertheless, there was greater total weight loss after BPD/DS. SADI-S, being less time consuming and technically simpler, can represent an advantage over BPD/DS.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 13