IBC Oxford University Oral Abstract 27 - Single anastomosis sleeve ileal (SASI) bypass <i>versus</i> single anastomosis sleeve jejunal (SAS-J) bypass: one year follow-up

Abstract Background Single anastomosis sleeve ileal (SASI) bypass is a modification of Santoro's operation (sleeve gastrectomy with transit bipartition) which is a bypass weight loss surgery but keeps the tnormal food pathway and allow endoscopic examination. The procedure is rapidly modified to single anastomosis sleeve jejunal (SAS-J) bypass to minimize the nutritional deficiency. The study aimed to compare SASI to SAS-J bypass. Material and Methods This was a randomized controlled trial that included 180 patients. Patients were randomly assigned to 2 equal groups: Group 1, was operated with SASI bypass while Group 2 was operated with SAS-J bypass. All cases were followed up for one year. Results In this study, 63% of patients were female and 37% were male. The mean body mass index (BMI) was 47.6 kg/m2. The mean age was 37 years. Regarding comorbidities, 23.3% of the patients had type 2 diabetes, 19% were hypertensive, 19% had obstructive sleep apnoea syndrome, 16% had gastroesophageal reflux disease (GERD), and 26% had hyperlipidaemia. %EWL at one year was 94.7 in Group 1 versus 91.3 in Group 2. Regarding late complications. Biliary gastritis occurred in 4.4% Group 1 versus 7.8% in Group 2. Diarrhoea occurred in 21.1% Group 1 versus 7.8% in Group 2. Protein malnutrition occurred in 15.6% Group 1 versus 4.4% Group 2. Vitamin D deficiency occurred in 14.4% in Group 1 versus 11.1% in Group 2. Hypocalcaemia occurred in 12.2% in Group 1 versus 5.6% in Group 2. Anaemia occurred in 14.4% in Group 1 versus 4.4% in group 2. The incidence of excessive weight loss (EWL) was 20% in Group 1 versus 7.8% in Group 2. The rate of reoperation was11.1% in group 1 versus 3.3% in Group 2. Conclusions Laparoscopic SAS-J bypass is an effective metabolic and weight loss surgery with less nutritional deficiency and late complications compared to SASI bypass.