Evaluation of Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S) as a New Operation for Morbid Obesity

Abstract
Background: Obesity is a serious worldwide health prob-lem; it has been shown to predispose to various diseases particularly cardiovascular diseases, diabetes disease, sleep apnea and osteoarthritis. There are non-surgical methods for weight loss as behavior modification, dietary control, exercise and drug therapy, but there are many surgical techniques that has less recurrence rate.
Aim of the Study: Is to evaluate Single anastomosis duodeno-ileal bypass with sleeve gastrectomy as a suitable operation for the morbidly obese patient and for those with significant metabolic disorders.
Patients and Methods: A prospective study was held in Al-Azhar University Hospitals and Ain Sham University Hospitals between January 2016 and January 2018. A total of 30 patients with fulfilled the criteria for bariatric surgery e.g., BMI >40kg/m2 or >35kg/m2 with associated comorbidity with failed diet for more than two years.
Results: Male to female ratio was 40% (12 male patients) to 60% (18 female patients). Mean age was 32 years ranging from 20 years to 56 years. The mean preoperative weight was 142.53kg ranging from 100kg to 210kg, the maximum weight was for a 28 years old male with BMI 77.13kg/m2 and the minimum weight was for a 25 years old female with BM 43.28kg/m2. The mean operative time was 216.6 minutes ranging from 150 to 360 minutes. The mean postoperative hospital stay was 6 days ranging from 3 days to 13 days. The table shows weight loss through the follow-up period; mean weight decreased from 142.53kg±32.174kg preoperatively to 131.697kg±29.0021 kg at one month, 111.200kg±23.1774 kg at six months, 97.713kg±19.5476 kg at one year and 81.753 kg±14.8329kg at two years.
Conclusion: Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy is a novel bariatric operation based on the principles of biliopancreatic diversion (BPD). SADI-S can be done either laparoscopically or through an open access. In this study, we have found that the Laparoscopic Single-anastomosis duodeno-ileal bypass with sleeve gastrec-tomy provides an innovative approach to one of our major health problems.