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Single-anastomosis Sleeve Jejunal: a Mid-term Follow-up Report of a New Surgical Technique

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Abstract

Introduction

Single anastomosis sleeve ileal bypass (SASI) is a combined bariatric metabolic technique, in which few studies have shown its outcomes efficacy. However, this technique has a high risk of malnutrition due to long biliopancreatic limb. Single anastomosis sleeve jejunal bypass (SASJ) has a shorter limb. Therefore, it seems to have a lower risk of nutrient deficiency. Furthermore, this technique is relatively new, and little is known about the efficacy and safety of SASJ. We aim to report our mid-term follow-up of SASJ from a high-volume center for bariatric metabolic surgery in the Middle East region.

Methods

For the current study, the 18-month follow-up data of 43 patients with severe obesity who underwent SASJ was collected. The primary outcome measures were demographic data, weight change variables according to ideal body mass index (BMI) of 25 kg/m2 at 6, 12, and 18 months, laboratory assessments, remission of obesity-associated medical problems, and other potential bariatric metabolic complications after the surgery.

Results

No patient was lost due to follow-up. After 18 months, patients lost 43.4 ± 11 kg of their weight and 68 ± 14% of their excess weight, and their BMI decreased from 44.9 ± 4.7 to 28.6 ± 3.8 kg/m2 (p < 0.001). The percentage of total weight loss till 18 months was 36.3%. The T2D remission rate at 18 months was 100%. Patients neither faced deficiency in significant markers for nutrition state nor represented major bariatric metabolic surgery complications.

Conclusion

SASJ bypass achieved satisfactory weight loss and remissions in obesity-associated medical problems within 18 months after surgery without major complications and malnutrition.

Graphical Abstract

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Data Availability

The data will be available for secondary analysis upon reasonable request from the corresponding author through email address.

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Acknowledgements

We express our gratitude toward Mr. Pouyan Tabesh and Danial Gramian for their kind help throughout this research.

Author information

Authors and Affiliations

  1. Department of Surgery, Division of Minimally Invasive and Bariatric Operations, Mehrad Hospital, Tehran, Iran

    Mohammad Taghi Rezaei

  2. Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

    Erfan Sheikhbahaei, Hamidreza Zefreh & Mostafa Allami

  3. Isfahan Minimally Invasive Surgery and Obesity Research Center, Alzahra University Hospital, Isfahan University of Medical Sciences, Sofe Blvd, Isfahan, Iran

    Erfan Sheikhbahaei, Hamidreza Zefreh & Masoud Sayadi Shahraki

  4. Minimally Invasive Surgery Research Center, Rasool-E Akram University Hospital, Iran University of Medical Sciences, Tehran, Iran

    Shahab Shahabi

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  1. Mohammad Taghi Rezaei
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Corresponding author

Correspondence to Masoud Sayadi Shahraki.

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A Statement of Human Rights

The study has been approved by the Isfahan University of Medical Sciences Ethics Committee according to registered code “IR.MUI.MED.REC.1397.089” and has been performed in accordance with the ethical standards presented in the Declaration of Helsinki and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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Key Points

SASJ procedure has acceptable excessive weight loss, similar to other procedures.

SASJ helps remission of obesity-related medical problems especially diabetes.

We found no major complications associated with the SASJ procedure.

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Supplementary file1 (M4V 6680 KB)

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Rezaei, M.T., Sheikhbahaei, E., Zefreh, H. et al. Single-anastomosis Sleeve Jejunal: a Mid-term Follow-up Report of a New Surgical Technique. OBES SURG 33, 1245–1252 (2023). https://doi.org/10.1007/s11695-023-06520-7

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