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.
About: This article is published in International Journal of Surgery.The article was published on 2016-10-01 and is currently open access. It has received 71 citations till now. The article focuses on the topics: Sleeve gastrectomy & Anastomosis.
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TL;DR: SASI bypass is an effective and safe bariatric surgical procedure that achieves satisfactory weight loss with significantly improvement in obesity-related complications, such as T2DM and GERD, and minimal postoperative nutritional complications.
4 citations
TL;DR: The incidence of Gallstone (GS) formation in patients underwent bariatric surgery and the influence of weight loss on GS formation was high and routine US is recommended every 3, 6, 9 and 12 months during the first year after BS.
4 citations
TL;DR: In this paper , a comprehensive review of 1986 patients who underwent SAS-J bypass over 6 years is presented. But the authors only evaluated the perioperative data and did not evaluate the follow-up of more than 5 years.
4 citations
TL;DR: In this paper , the outcomes of the first group of patients that underwent the SASI bypass in their clinic and assess the safety and efficiency of the procedure were presented, and the mean excess weight loss after 3, 6, 9 and 12 months of follow-up was 43, 56, 72.5%, 88.83% respectively.
Abstract: Introduction Single anastomosis sleeve ileal (SASI) bypass is a recently introduced bariatric procedure that combines the advantages of restrictive and malabsorptive operations, at the same time reducing the risk of nutrient deficiencies by maintaining passage through all the alimentary tract. Aim To present the outcomes of the first group of patients that underwent the SASI bypass in our clinic and assess the safety and efficiency of the procedure. Material and methods We analyzed patients qualified for SASI bypass between January 2020 and February 2021. Retrospective analysis was performed and outpatient treatment results were evaluated. Results A group of nineteen patients (18 women) underwent SASI bypass. The mean preoperative body mass index was 40.3 ±3.74 kg/m2, mean age: 43.3 ±7.83. The mean excess weight loss (% EWL) after 3, 6, 9 and 12 months of follow-up was 43%, 56%, 72.5%, 88.83% respectively. Remission of obesity related diseases was as followed: hypertension in 8 patients (80%, p < 0.05), type II diabetes in 6 patients (100%, p < 0.05), pre-diabetes in 4 patients (50%, p = 0.13). Complications occurred in 4 cases: hematemesis, dysphagia, diarrhea, short bowel syndrome. A patient who developed symptoms of short bowel syndrome was reoperated on and gastrointestinal anastomosis was disconnected. Postoperatively, unwanted symptoms resolved and a good bariatric effect was preserved. Conclusions Our first experience is consistent with that reported in previous studies: very good EWL and a rapid resolution of obesity related diseases after SASI bypass as well as safety of the procedure.
3 citations
TL;DR: The SASI procedure may be a better alternative as it has excellent bariatric and metabolic results with lower risk for hypoalbuminemia and iron deficiency and can be easily converted into either SADI-S or SG procedures.
3 citations
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TL;DR: Effective weight loss was achieved in morbidly obese patients after undergoing bariatric surgery, and a substantial majority of patients with diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea experienced complete resolution or improvement.
Abstract: ContextAbout 5% of the US population is morbidly obese. This disease remains
largely refractory to diet and drug therapy, but generally responds well to
bariatric surgery.ObjectiveTo determine the impact of bariatric surgery on weight loss, operative
mortality outcome, and 4 obesity comorbidities (diabetes, hyperlipidemia,
hypertension, and obstructive sleep apnea).Data Sources and Study SelectionElectronic literature search of MEDLINE, Current Contents, and the Cochrane
Library databases plus manual reference checks of all articles on bariatric
surgery published in the English language between 1990 and 2003. Two levels
of screening were used on 2738 citations.Data ExtractionA total of 136 fully extracted studies, which included 91 overlapping
patient populations (kin studies), were included for a total of 22 094
patients. Nineteen percent of the patients were men and 72.6% were women,
with a mean age of 39 years (range, 16-64 years). Sex was not reported for
1537 patients (8%). The baseline mean body mass index for 16 944 patients
was 46.9 (range, 32.3-68.8).Data SynthesisA random effects model was used in the meta-analysis. The mean (95%
confidence interval) percentage of excess weight loss was 61.2% (58.1%-64.4%)
for all patients; 47.5% (40.7%-54.2%) for patients who underwent gastric banding;
61.6% (56.7%-66.5%), gastric bypass; 68.2% (61.5%-74.8%), gastroplasty; and
70.1% (66.3%-73.9%), biliopancreatic diversion or duodenal switch. Operative
mortality (≤30 days) in the extracted studies was 0.1% for the purely restrictive
procedures, 0.5% for gastric bypass, and 1.1% for biliopancreatic diversion
or duodenal switch. Diabetes was completely resolved in 76.8% of patients
and resolved or improved in 86.0%. Hyperlipidemia improved in 70% or more
of patients. Hypertension was resolved in 61.7% of patients and resolved or
improved in 78.5%. Obstructive sleep apnea was resolved in 85.7% of patients
and was resolved or improved in 83.6% of patients.ConclusionsEffective weight loss was achieved in morbidly obese patients after
undergoing bariatric surgery. A substantial majority of patients with diabetes,
hyperlipidemia, hypertension, and obstructive sleep apnea experienced complete
resolution or improvement.
6,373 citations
TL;DR: The observation of greatly increased postprandial plasma GLP-1 7-36 levels in patients with postgastrectomy dumping syndrome suggests that it may mediate the hyperinsulinaemia and reactive hypoglycaemia of this disorder.
1,897 citations
TL;DR: The causes of Type 2 diabetes mellitus and prediabetes are embedded in a very complex group of genetic and epigenetic systems interacting within an equally complex societal framework that determines behavior and environmental influences as mentioned in this paper.
Abstract: Over the past three decades, the number of people with diabetes mellitus has more than doubled globally, making it one of the most important public health challenges to all nations. Type 2 diabetes mellitus (T2DM) and prediabetes are increasingly observed among children, adolescents and younger adults. The causes of the epidemic of T2DM are embedded in a very complex group of genetic and epigenetic systems interacting within an equally complex societal framework that determines behavior and environmental influences. This complexity is reflected in the diverse topics discussed in this Review. In the past few years considerable emphasis has been placed on the effect of the intrauterine environment in the epidemic of T2DM, particularly in the early onset of T2DM and obesity. Prevention of T2DM is a 'whole-of-life' task and requires an integrated approach operating from the origin of the disease. Future research is necessary to better understand the potential role of remaining factors, such as genetic predisposition and maternal environment, to help shape prevention programs. The potential effect on global diabetes surveillance of using HbA(1c) rather than glucose values in the diagnosis of T2DM is also discussed.
1,818 citations
"Efficacy of single anastomosis slee..." refers background in this paper
...Obesity and type 2 diabetes mellitus (T2DM) has become a major public health problem [1], and medical treatment fails to provide adequate control in a significant number of obese diabetics....
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TL;DR: In obese patients with uncontrolled type 2 diabetes, 12 months of medical therapy plus bariatric surgery achieved glycemic control in significantly more patients than medical therapy alone.
Abstract: Of the 150 patients, 93% completed 12 months of follow-up. The proportion of patients with the primary end point was 12% (5 of 41 patients) in the medicaltherapy group versus 42% (21 of 50 patients) in the gastric-bypass group (P = 0.002) and 37% (18 of 49 patients) in the sleeve-gastrectomy group (P = 0.008). Glycemic control improved in all three groups, with a mean glycated hemoglobin level of 7.5±1.8% in the medical-therapy group, 6.4±0.9% in the gastric-bypass group (P<0.001), and 6.6±1.0% in the sleeve-gastrectomy group (P = 0.003). Weight loss was greater in the gastric-bypass group and sleeve-gastrectomy group (−29.4±9.0 kg and −25.1±8.5 kg, respectively) than in the medical-therapy group (−5.4±8.0 kg) (P<0.001 for both com parisons). The use of drugs to lower glucose, lipid, and blood-pressure levels decreased significantly after both surgical procedures but increased in patients receiving medical therapy only. The index for homeostasis model assessment of insulin resistance (HOMA-IR) improved significantly after bariatric surgery. Four patients underwent reoperation. There were no deaths or life-threatening complications. Conclusions In obese patients with uncontrolled type 2 diabetes, 12 months of medical therapy plus bariatric surgery achieved glycemic control in significantly more patients than medical therapy alone. Further study will be necessary to assess the durability of these results. (Funded by Ethicon Endo-Surgery and others; ClinicalTrials.gov number, NCT00432809.)
1,542 citations
TL;DR: In this paper, the authors showed that the use of drugs to lower glucose, lipid, and blood-pressure levels decreased significantly after both surgical procedures but increased in patients receiving medical therapy only.
Abstract: Of the 150 patients, 93% completed 12 months of follow-up. The proportion of patients with the primary end point was 12% (5 of 41 patients) in the medicaltherapy group versus 42% (21 of 50 patients) in the gastric-bypass group (P = 0.002) and 37% (18 of 49 patients) in the sleeve-gastrectomy group (P = 0.008). Glycemic control improved in all three groups, with a mean glycated hemoglobin level of 7.5±1.8% in the medical-therapy group, 6.4±0.9% in the gastric-bypass group (P<0.001), and 6.6±1.0% in the sleeve-gastrectomy group (P = 0.003). Weight loss was greater in the gastric-bypass group and sleeve-gastrectomy group (−29.4±9.0 kg and −25.1±8.5 kg, respectively) than in the medical-therapy group (−5.4±8.0 kg) (P<0.001 for both com parisons). The use of drugs to lower glucose, lipid, and blood-pressure levels decreased significantly after both surgical procedures but increased in patients receiving medical therapy only. The index for homeostasis model assessment of insulin resistance (HOMA-IR) improved significantly after bariatric surgery. Four patients underwent reoperation. There were no deaths or life-threatening complications. Conclusions In obese patients with uncontrolled type 2 diabetes, 12 months of medical therapy plus bariatric surgery achieved glycemic control in significantly more patients than medical therapy alone. Further study will be necessary to assess the durability of these results. (Funded by Ethicon Endo-Surgery and others; ClinicalTrials.gov number, NCT00432809.)
797 citations