Long-term outcomes of primary single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S)

Background: The long-term outcomes of primary single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) have never been reported in the literature. Objectives: The study aimed to evaluate the long-term outcomes after primary laparoscopic SADI-S (LSADI-S). Setting: Single, private institute, United States. Methods: Data from 750 patients who underwent a primary LSADI-S from June 2013 through November 2019 by 3 surgeons were retrospectively analyzed. Results: Seven hundred fifty patients were included in the study. The mean age and preoperative body mass index were 49.3 +/- 13.1 years and 50 +/- 12.6 kg/m 2 , respectively. Follow-up was available on 109 patients (61%) at 5 years and on 87 patients (53%) at 6 years. Six patients did not have any follow-up. The average operative time and length of stay were 67.6 +/- 27.4 minutes and 1.5 +/- .8 days, respectively. The intraoperative, short-term, and long-term complication rates were 0%, 7.8%, 11.7%, respectively. The 30-day emergency room visit, readmission, and reoperation rates were .4%, 1.1%, and 1.1%, respectively. In total, there were 15 (2%) grade IIlb long-term complications unique to LSADI-S. Complete remission of type 2 diabetes was seen in 77% of the diabetic population. At 5 and 6 years, the mean change in body mass index was 17.5 +/- 6.9 and 17.6 +/- 6.4 kg/m(2), respectively. The mortality rate was .5%. Conclusions: LSADI-S is effective in this retrospective review in achieving good initial weight loss and weight maintenance. Although our data show acceptable nutritional complications, questions still remain because of the retrospective nature of the study. (C) 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.