Single Anastomosis Duodeno-Ileal Bypass (SADI) as a Second Step After Failed Sleeve Gastrectomy: Systematic Review and Meta-analysis.

Autor:	Ataya K; Department of Bariatric Surgery, Kings College Hospital London, London, UK., Bsat A; Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon., Al Tannir AH; Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon., Al Jaafareh AM; Department of Bariatric Surgery, Kings College Hospital London, London, UK., Rabih Al A; Lebanese University Faculty of Medical Sciences, Beirut, Lebanon., Abi Saad G; Department of General Surgery, American University of Beirut, Beirut, Lebanon.
Jazyk:	angličtina
Zdroj:	Journal of metabolic and bariatric surgery [J Metab Bariatr Surg] 2023 Dec; Vol. 12 (2), pp. 35-43. Date of Electronic Publication: 2023 Nov 08.
DOI:	10.17476/jmbs.2023.12.2.35
Abstrakt:	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. Competing Interests: Conflict of Interest: None of the authors have any conflict of interest. (Copyright © 2023, The Korean Society for Metabolic and Bariatric Surgery.)
Databáze:	MEDLINE
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