Efficacy of single anastomosis sleeve ileal (SASI) bypass for type-2 diabetic morbid obese patients: Gastric bipartition, a novel metabolic surgery procedure: A retrospective cohort study.
TL;DR: SASI bypass is a promising operation that offers excellent weight loss and diabetic resolution and is a therapeutic option for obese T2DM patients.
Abstract: Introduction The single anastomosis sleeve ileal (SASI) bypass is a Novel Metabolic/Bariatric Surgery operation based on mini gastric bypass operation and Santoro's operation in which a sleeve gastrectomy is followed by a side to side gastro-ileal anastomosis. The purpose of this Study is to report the clinical results of the outcomes of SASI bypass as a therapeutic option for obese T2DM patients. Methods We conducted a retrospective cohort study of type 2 diabetic obese patients who underwent SASI bypass at one hospital from March 1, 2013 to December 31, 2014. Patients with previous bariatric surgery, history of upper laparotomy, and with less than one year follow up, were excluded. Sleeve gastrectomy was performed over a 36-Fr bougie, 6 cm from the pylorus, and 250 cm from the ileocecal valve the ileum brought to be anastomosis side to side with the antrum. Data collected included comorbidity resolution, percent excess weight loss (% EWL), and one-year morbidity and mortality. Results During the study period, 61 underwent laparoscopic SASI bypass. Ultimately, 50 patients with a mean BMI of 48.7 ± 7.6 kg/m2 met inclusion criteria and were evaluated. %EWL reached 90% at one year and all patients have normal glucose level in the first 3 months after surgery. Hypertension remitted in 86%, hypercholesterolemia in 100% and hypertriglyceridemia in 97% of patients. There were 6 postoperative complications. One pulmonary embolism, one postoperative bleeding, one leak from biliary limb and one complete obstruction at the gastro-ileal anastomosis. Six months postoperative, one patient was diagnosed with marginal ulcer, 12 months after surgery, another patient was re-operated for fear of more excessive weight loss. Conclusion SASI bypass is a promising operation that offers excellent weight loss and diabetic resolution.
Cites background or methods from "Efficacy of single anastomosis slee..."
...Origin, Advantages The SASI bypass is a modification of the SG-TB of Santoro  popularized byMahdy and colleagues ....
...Patency of the anastomosis and ulceration are potential long-term concerns ....
...benefits without the nutrient deficiencies and protein caloric malnutrition ....
...0% of patients at 3 months, and all were off insulin and hypoglycemic drugs ....
"Efficacy of single anastomosis slee..." refers background in this paper
...Obesity and type 2 diabetes mellitus (T2DM) has become a major public health problem , and medical treatment fails to provide adequate control in a significant number of obese diabetics....
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