Immediate and long-term outcomes of the SADI-Sleeve procedure with a narrow gastric sleeve and a common loop length of 350 cm

Objective. To analyze treatment outcomes in patients who underwent SADI-Sleeve (SADI-S) with different common loop lengths in both the immediate an d long-term postoperative periods. Material and methods. A study was carried out on 203 cases (head group) of SADI-S with a 36 Fr gastric sleeve diameter and a common loop length of 350 cm, and 73 cases (control group) of SADI-S with a 54 Fr gastric sleeve diameter and a common loop length of 250 cm. The head group included 38 men and 165 women, ages 31 to 60. The control group consisted of 16 men and 57 women, aged 23 to 60. The average BMI was 47. 26.1% of patients had a history of either type 2 diabetes or impaired glucose tolerance. Results. The duration of the operation in the head group was significantly shorter compared to the control group. The overall complication rate decreased from 4.2% to 0.98% in the head group. In the long-term postoperative period, both groups demonstrated a clear trend of BMI/weight reduction. No significant differences between the groups regarding remission of comorbidities. The incidence of malabsorption symptoms was lower in the head group. The quality of life, evaluated using the GSRS questionnaire, was significantly lower in the control group than in the main group. The rate of revision surgeries in the long-term postoperative period was 11% in the control group and 0.98% in the head group. Conclusions. The proposed technique reduces the malabsorptive component of the surgery while enhancing its restrictive effect. It also decreases the average operation duration by 37 minutes and reduces early postoperative complications from 4.2% to 0.98%. The technique leads to a weight reduction comparable to the classical method, lowers long-term postoperative complications by 9.9%, and significantly improves quality of life indicators.