Study Finds Single-Anastomosis Sleeve Ileal Bypass Surgery Is Safe, Effective

Single-anastomosis sleeve ileal (SASI) bypass surgery was safe and effective for producing weight loss and reducing obesity-related health conditions, according to recent findings published in Surgical Endoscopy.

Researchers studied outcomes related to SASI bypass, a bariatric procedure, over a period of up to 4 years. Previous short-term studies have suggested SASI bypass can provide comparable weight loss to Roux-en-Y Gastric Bypass while having fewer complications and better reduction/resolution of obesity-related health conditions. However, long-term data on SASI bypass has been limited, researchers said.

The retrospective cohort analysis involved 366 patients with morbid obesity who underwent primary SASI bypass between January 2018 and February 2022. The average age of the patients was 41 years, and the preoperative body mass index (BMI) averaged 43.9 kg/m².

Follow-up data was available for different time periods: 1-year (229 patients), 2-year (112 patients), 3-year (61 patients), and 4-year (35 patients). The rates of intraoperative complications were 0%, short-term complications were 2.5%, and long-term complications were 4.6%, according to the findings.

After 4 years, the mean percentage of excess weight loss was 93.3%, indicating significant weight reduction, researchers said. The total weight loss averaged 41.2%. Remission rates for comorbidities associated with obesity were also notable: 93% for type 2 diabetes mellitus, 73% for hypertension, 83% for hyperlipidemia, 79% for sleep apnea, and 25% for gastroesophageal reflux disease (GERD).

The incidence of biliary gastritis and ulcers was rare; however, 8 patients developed new-onset GERD symptoms, which required treatment with proton pump inhibitors, researchers reported. None of the patients experienced hypoalbuminemia or malabsorption that did not respond to increased protein intake and vitamin or mineral supplementation.

SASI bypass is a safe and highly effective bariatric procedure for weight loss and the resolution of obesity-related comorbidities, researchers concluded, adding that the creation of a double outlet in this procedure appears to minimize nutritional complications. 

The long-term data provided by this study adds to the existing evidence supporting the use of SASI bypass as a viable option for patients with morbid obesity. However, further research and longer-term studies are still warranted to confirm these findings and evaluate the durability of outcomes, researchers said.

Reference: 
Aghajani E, Schou C, Gislason H, Nergaard BJ. Mid-term outcomes after single anastomosis sleeve ileal (SASI) bypass in treatment of morbid obesity. Surg Endosc. Published online May 12, 2023. 2023;10.1007/s00464-023-10112-y. doi:10.1007/s00464-023-10112-y