# Long-Term Results of Single-Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S)

## TL;DR

This study shows that the SADI-S surgery provides effective long-term weight loss and improvement in health conditions like diabetes.

## Contribution

The study presents long-term outcomes of SADI-S surgery, demonstrating its effectiveness over a 10-year period.

## Key findings

- SADI-S achieved 87% excess weight loss at 5 years and 80% at 10 years.
- Most patients experienced resolution or improvement in type 2 diabetes and other comorbidities.
- Only 25% of patients were lost to follow-up after 10 years, indicating reasonable long-term tracking.

## Abstract

Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is a simplification of the duodenal switch (DS) in which the alimentary limb is eliminated, and the common channel is lengthened from 200 to 300 cm. Short-term results have demonstrated that SADI-S is safe and reproducible and that weight loss and comorbidities resolution are comparable to biliopancreatic diversion or DS.

To analyze the long-term outcomes of SADI-S.

From May 2007 to December 2015, 164 patients were consecutively submitted to a one-step SADI-S. The mean age was 47 years, and the mean body mass index (BMI) was 45.8 kg/m2. A total of 101 patients had type 2 diabetes, 91 arterial hypertension, 81 obstructive apnea, and 118 dyslipidemia. Limb length was 200 cm in 50 cases, 250 cm in 99, and 300 cm in 15.

There was no mortality. One patient had a gastric leak, and 2 patients had an anastomotic leak. A total of 25% of the patients were lost to follow-up at 10 years. Excess weight loss and total weight loss were 87% and 38% at 5 years and 80% and 34% at 10 years. A total of 12 patients were submitted to revisional surgery for hypoproteinemia. Preoperatively 41 diabetics were under insulin treatment; at 5 years, 7 remained with insulin and 12 at 10 years. Mean glycemia was 104 mg/dL at 5 years and 118 mg/dL at 10 years. Mean HbA1c was 5.51% at 5 years and 5.86 at 10 years.

In the long term, SADI-S offers satisfactory weight loss and comorbidities resolution.