Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug-Sep;99(7):514-520.
doi: 10.1016/j.cireng.2021.06.017. Epub 2021 Jul 1.

Direct and two-step single anastomosis duodenal switch (SADI-S): Unicentric comparative analysis of 232 cases

Víctor Admella  1 , Javier Osorio  2 , Maria Sorribas  1 , Lucía Sobrino  1 , Anna Casajoana  1 , Jordi Pujol-Gebellí  1
Affiliations

Direct and two-step single anastomosis duodenal switch (SADI-S): Unicentric comparative analysis of 232 cases

Víctor Admella et al. Cir Esp (Engl Ed). 2021 Aug-Sep.

Abstract

Introduction: The "Single Anastomosis Duodeno-Ileal bypass with Sleeve gastrectomy" (SADI-S) is a bariatric surgery conceived to simplify the duodenal switch in order to reduce its postoperative complications. The objective of this study is to assess the safety and efficacy of SADI-S, comparing its results in both direct and two-step procedure.

Methods: Unicentric cohort study that includes patients submitted to SADI-S, both direct or in two-step, between 2014 and 2019.

Results: Two hundred thirty-two patients were included, 192 were submitted to direct SADI-S and 40 had previously undergone a sleeve gastrectomy. The severe complications rate (Clavien-Dindo ≥ IIIA) was 7.8%, being hemoperitoneum and duodenal stump leak the most frequent ones. One patient was exitus between the first 90 days after surgery (0.4%). Patients submitted to direct SADI-S had an initial body mass index (BMI) of 49.6 kg/m2 in comparison of 56.2 kg/m2 in the two-step SADI-S (P < .001). The mean excess weight loss (EWL) at two years was higher in direct SADI-S (77.3 vs. 59.3%, P < .05). Rate of comorbidities resolution was 88.5% for diabetes, 73.0% for hypertension, 77.0% for dyslipidemia and 85.7% for sleep apnea, with no differences between both techniques.

Conclusion: In medium term, SADI-S is a safe and effective technique that offers a satisfactory weight loss and remission of comorbidities. Patients submitted to two-step SADI-S had a higher initial BMI and presented a lower EWL than direct SADI-S.

Keywords: Bariatric surgery; Cirugía bariátrica; Cirugía hipoabsortiva; Cruce duodenal; Duodenal switch; Hypoabsorption surgery; SADI-S; SADS; SIPS.

PubMed Disclaimer