Short-term Efficacy Analysis For The Treatment Of Obesity And Its Related Diseases:SADI-S Versus SG

Background and purpose:Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy(SADI-S)is one of the most effective bariatric procedures for the treatment of obesity and its related diseases,yet there are few studies in China and a lack of comparison with other procedures.The aim of this study was to retrospectively analyze the clinical data of patients who underwent SADI-S and sleeve gastrectomy(SG)at our center and to compare the short-term efficacy and safety of the two procedures.Methods:The clinical data of 55 patients who underwent SADI-S at the Department of Bariatric and Metabolic Surgery of China-Japan Union Hospital of Jilin university between November 2018 and September 2021were retrospectively analyzed,and a total of 55 patients who underwent SG at our center and had comparable preoperative basic information such as age,weight,body mass index and comorbid obesity-related metabolic diseases to those in the SADI-S group were also selected.The safety and efficacy of weight loss[weight,body mass index,percent of excess weight loss(%EWL)and percent of total weight loss(%TWL)],remission of obesity-related metabolic diseases(hyperuricemia,hypertriglyceridemia,hypercholesterolemia,hypertension and type 2diabetes)and nutritional deficiencies(hypoproteinemia,anemia,micronutrient deficiencies and vitamin deficiencies)at 12 months after surgery were compared between the two groups.Results:All the patients successfully underwent laparoscopic bariatric surgery without conversion to laparotomy or death.In the SADI-S group,the operative time was 180(105-290)min,the length of stay was 7(4-22)days,and the surgical complication rate was 7.27%(4/55),while in the SG group,the operative time was 110(70-354)min,the length of stay was 7(3-94)days,and the surgical complication rate was 3.64%(2/55).In the SG group,the time of surgery was significantly less than that in the SADI-S group,and the difference was statistically significant(P<0.05);the differences in the postoperative hospital stay and the incidence of surgical complications were not statistically significant.At 12 months postoperative,in SADI-S group the weight was 75(45-117)kg,BMI was(25.30±3.64)kg/m~2,%EWL was 101.2(51.3-214.7)%and%TWL was(41.0±6.5)%.In the SG group,the weight was 80(55-116)kg,BMI was(28.11±4.02)kg/m~2,%EWL was 101.2(51.3-214.7)%,and%TWL was(33.6±9.1)%.Comparing the above indicators between the two groups,the weight and BMI at 12 months postoperatively in the SADI-S group were significantly smaller than those in the SG group(P<0.05),and the%EWL and%TWL were significantly higher than those in the SG group(P<0.05).The complete remission rate of hypercholesterolemia(100%vs46.2%,P<0.05)and type 2 diabetes(100%vs 72.2%,P<0.05)were significantly higher in the SADI-S group than in the SG group,and there were no significant differences in the complete remission rate of the remaining obesity-related diseases.The incidence of anemia and zinc deficiency was significantly higher in the SADI-S group than in the SG group(14.8%vs 1.9%and 32.7%vs 4.2%,respectively,P<0.05);the incidence of vitamin B12 deficiency was significantly higher in the SG group than in the SADI-S group(0 vs 8.2%,P<0.05);the differences were not statistically significant when comparing the other nutritional outcomes of the two groups.Conclusion:Both SADI-S and SG are safe and effective in the treatment of obesity and its related diseases,but SADI-S performs better.The long-term efficacy of both needs further follow-up.