Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2023; 11(21): 5035-5046
Published online Jul 26, 2023. doi: 10.12998/wjcc.v11.i21.5035
Clinical outcomes and complications of single anastomosis duodenal-ileal bypass with sleeve gastrectomy: A 2-year follow-up study in Bogotá, Colombia
Andres Ospina Jaramillo, Angie Carolina Riscanevo Bobadilla, Mariana Ospina Espinosa, Alvaro Valencia, Humberto Jiménez, Maria del Pilar Montilla Velásquez, Maria Bastidas
Andres Ospina Jaramillo, Alvaro Valencia, Humberto Jiménez, Maria Bastidas, Department of General Surgery, Clínica Reina Sofia, Colsanitas, Bogotá D.C 110151, Colombia
Angie Carolina Riscanevo Bobadilla, Department of General Surgery, Fundación Universitaria Sanitas, Bogotá D.C 11162, Colombia
Mariana Ospina Espinosa, Department of General Surgery, Universidad del Rosario, Bogotá 110151, Colombia
Maria del Pilar Montilla Velásquez, Department of Epidemiology, Fundación Universitaria Sanitas, Bogotá 110151, Colombia
Author contributions: Ospina Jaramillo A, Riscanevo Bobadilla AC, and Espinosa MO contributed equally to this work; Ospina Jaramillo A, Valencia A, and Jiménez H designed the research; Ospina Jaramillo A and Riscanevo Bobadilla AC performed the research; Montilla Velásquez MDP contributed new reagents/analytic tools; Riscanevo Bobadilla AC and Bastidas M analyzed the data; Ospina Jaramillo A, Riscanevo Bobadilla AC, and Espinosa MO wrote the paper.
Institutional review board statement: After approval by the research and ethics committees of the institution, the study was conducted following the 1964 Helsinki Declaration and subsequent revisions.
Informed consent statement: The surgical informed consent that patients signed for the surgery included the use of personal and surgical data, images, and videos for scientific purposes. Therefore, all study participants or their legal guardians possess prior written informed consent for the study.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Angie Carolina Riscanevo Bobadilla, PsyD, Surgeon, Department of General Surgery, Fundación Universitaria Sanitas, Av. C. 127 #20-78, Bogotá, Bogotá D.C 11162, Colombia. caroriscanevo@gmail.com
Received: March 20, 2023
Peer-review started: March 20, 2023
First decision: April 21, 2023
Revised: May 15, 2023
Accepted: June 26, 2023
Article in press: June 26, 2023
Published online: July 26, 2023
Abstract
BACKGROUND

The global prevalence of obesity has increased over the past 40 years, and bariatric surgery has proven to be the most effective therapy for long-term weight loss. Its principles are based on modifying the brain-gut axis by altering the gastrointestinal anatomy and affecting the function of gastrointestinal hormones, thereby modifying satiety signals. Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) combines both techniques and has become an alternative to gastric bypass and biliopancreatic diversion procedures for treating severe obesity and associated metabolic diseases in selected patients.

AIM

To describe the outcomes and complications of SADI-S.

METHODS

We retrospectively analyzed the data of patients who underwent SADI-S laparoscopically at the Clínica Reina Sofía in Bogotá, Colombia. This study assessed the therapeutic effectiveness of SADI-S in terms of short-term preoperative clinical characteristics, postoperative complications, comorbidities, nutritional defi-ciencies, and intraoperative complications during a 2-year follow-up.

RESULTS

Sixty-one patients with a mean body mass index (BMI) of 50 ± 7.1 kg/m2 underwent laparoscopic SADI-S. The mean operative time and hospital stays were 143.8 ± 42 min and 2.3 ± 0.8 d, respectively. The mean follow-up period was 18 mo, and the mean BMI decreased to 28.5 ± 12.2 kg/m2. The excess BMI loss was 41.8% ± 13.5%, and the weight loss percentage was 81.1% ± 17.0%. Resolution of obesity-related comorbidities, including type 2 diabetes mellitus, hypertension, dyslipidemia, and obstructive sleep apnea, was achieved and defined as complete or partial remission. No intraoperative complications were observed. Short-term complications were observed in four (6.8%) patients. However, larger studies with longer follow-up periods are required to draw definitive conclusions.

CONCLUSION

SADI-S has a low intraoperative and postoperative complication rate and is effective for weight loss and improving obesity-related comorbidities, including hypertension, type 2 diabetes mellitus, dyslipidemia, and sleep apnea syndrome.

Keywords: Extreme obesity, Bariatric surgery, Body mass index, Metabolic syndrome, Cardiovascular diseases, Complications

Core Tip: In this publication, we showcase our institution's experience with single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) in Colombia. We provide a comprehensive description of the patient journey, from preoperative to postoperative phases, demonstrating weight loss outcomes and resolution of obesity-related comorbidities. We present procedural complications, immediate postoperative care, and the evolution of patients with early initiation of oral intake, ambulation, and nutritional strategies. Our study emphasizes SADI-S as a viable surgical alternative for extreme obesity and metabolic diseases, highlighting its progressive weight reduction and promising lifestyle modifications for this patient population. Our findings support the effectiveness of SADI-S in the Colombian context.