Single- Versus Double-Anastomosis Duodenal Switch: Outcomes Stratified by Preoperative BMI.

Autor: Lind RP; Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando Health, 89 W Copeland Dr, 1st Floor, Orlando, FL, USA. Romulo.lind@orlandohealth.com., Ghanem M; Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando Health, 89 W Copeland Dr, 1st Floor, Orlando, FL, USA., Teixeira AF; Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando Health, 89 W Copeland Dr, 1st Floor, Orlando, FL, USA., Jawad MA; Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando Health, 89 W Copeland Dr, 1st Floor, Orlando, FL, USA., Osorio J; Bariatric and Metabolic Surgery Unit, Department of General and Digestive Surgery, Bellvitge University Hospital, Feixa Llarga S/N L'Hospitalet de Llobregat, 08907, Barcelona, Spain., Lazzara C; Bariatric and Metabolic Surgery Unit, Department of General and Digestive Surgery, Bellvitge University Hospital, Feixa Llarga S/N L'Hospitalet de Llobregat, 08907, Barcelona, Spain., Sobrino L; Bariatric and Metabolic Surgery Unit, Department of General and Digestive Surgery, Bellvitge University Hospital, Feixa Llarga S/N L'Hospitalet de Llobregat, 08907, Barcelona, Spain., Ortiz-Ciruela D; Bariatric and Metabolic Surgery Unit, Department of General and Digestive Surgery, Bellvitge University Hospital, Feixa Llarga S/N L'Hospitalet de Llobregat, 08907, Barcelona, Spain., de Gordejuela AGR; General Surgery Department, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Passeig de la Vall d'Hebron, 119, 08035, Barcelona, Spain.
Jazyk: angličtina
Zdroj: Obesity surgery [Obes Surg] 2022 Dec; Vol. 32 (12), pp. 3869-3878. Date of Electronic Publication: 2022 Oct 24.
DOI: 10.1007/s11695-022-06315-2
Abstrakt: Purpose: Describe and analyze the safety and weight loss performance of biliopancreatic diversion and duodenal switch (BPD-DS) and single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S), verifying any possible superiority according to preoperative BMI.
Methods: Retrospective review of patients who underwent primary SADI-S or BPD-DS in three bariatric centers. Study groups were further stratified according to preoperative BMI (subgroup 1: BMI < 50; subgroup 2: 50 ≤ BMI < 55; subgroup 3: BMI ≥ 55).
Results: Four hundred and sixty patients underwent BPD-DS (n = 220) or SADI-S (n = 240). The mean LOS was 3.48 ± 3.7 and 3.13 ± 2.3 days for BPD-DS and SADI-S respectively (p = 0.235). The mean operative time was shorter in the SADI-S group (167.25 ± 33.6 vs 140.85 ± 56.7 min) (p < 0.00). The mean %EWL was 44.2, 62.4, and 69.4 for the BPD-DS group and 48.4, 64.5, and 67.1 for the SADI-S group at 6, 12, and 24 months respectively. The mean %TBWL was 25, 35.9, and 40.3 for the BPD-DS group, and 26.2, 35, and 36.9 for the SADI-S group at 6, 12, and 24 months respectively. Overall complication rates were comparable between BPD-DS and SADI-S groups (14% vs 18%) (p = 0.219). SADI-S showed greater emergency department visits (17% vs 7%) (p = 0.005); similar readmission rates (6% vs 7%) (p = 0.80); similar reoperation rates (3% vs 7%) (p = 0.102); and similar mortality rate (0.9% vs 0.4%), after BPD-DS and SADI-S respectively.
Conclusion: BPD-DS achieved greater %TBWL at 2 years, but no superiority was perceived among study subgroups. SADI-S and BPD-DS showed similar overall complication rates.
(© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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