Long-term results of Roux-en-Y gastric bypass (RYGB) versus single anastomosis duodeno-ileal bypass (SADI) as revisional procedures after failed sleeve gastrectomy: a systematic literature review and pooled analysis.

IF 2.1 3区医学 Q2 SURGERY Langenbeck's Archives of Surgery Pub Date : 2024-11-23 DOI:10.1007/s00423-024-03557-9

Theodoros Thomopoulos, Styliani Mantziari, Gaëtan-Romain Joliat

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Abstract

Purpose: Revisional bariatric surgery (RBS) has flourished during the last decades in many countries, due to suboptimal weight loss or long-term complications of primary bariatric surgery. Restrictive procedures, and in particular sleeve gastrectomy (SG), although widely performed as primary bariatric surgery, seems particularly prone to need surgical revision for the above-mentioned reasons during long-term follow-up. The aim of this systematic review was to compare the long-term (5-year) safety and efficacy between Roux-en-Y gastric bypass (RYGB) and single anastomosis duodeno-ileal bypass (SADI) after 'failed' SG.

Methods: A systematic review was performed from 2007 to September 2024. Articles were included if SADI or RYGB were performed as RBS after 'failed SG' with follow-up at least 5 years. Pooled analysis was performed to summarize the data.

Results: Among the seven studies eligible and included in this review, the SADI procedure showed comparable results to RYGB in terms of weight loss, nutritional deficiencies, and resolution of comorbidities during the long-term follow-up. However, RYGB proved superior in terms of remission of reflux disease and other functional problems after SG.

Conclusions: The present review found that SADI seems to be a promising and suitable method for suboptimal weight loss after SG, with comparable or even better results to RYGB after 5-year follow-up.

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作为袖状胃切除术失败后的翻修手术，Roux-en-Y 胃旁路术（RYGB）与单吻合十二指肠-回肠旁路术（SADI）的长期效果：系统性文献综述和汇总分析。

目的：在过去的几十年中，由于减肥效果不理想或初次减肥手术的长期并发症，减肥手术翻修（RBS）在许多国家蓬勃发展。限制性手术，尤其是袖带胃切除术（SG），虽然作为初级减肥手术被广泛实施，但在长期随访中似乎特别容易因上述原因而需要进行手术翻修。本系统综述旨在比较袖带胃切除术（SG）"失败 "后Roux-en-Y胃旁路术（RYGB）和单吻合十二指肠-回肠旁路术（SADI）的长期（5年）安全性和有效性：方法：从 2007 年至 2024 年 9 月进行了一次系统性回顾。方法：2007 年至 2024 年 9 月期间进行了一项系统性综述，如果 SADI 或 RYGB 是在 SG "失败 "后作为 RBS 进行的，且随访至少 5 年，则纳入相关文章。对数据进行汇总分析：结果：在符合条件并纳入本综述的七项研究中，SADI 手术在长期随访期间的体重减轻、营养缺乏和合并症缓解方面显示出与 RYGB 相当的效果。然而，事实证明，RYGB 在缓解反流病和 SG 后的其他功能问题方面更胜一筹：本综述发现，SADI 似乎是一种很有前景且适用于 SG 术后亚理想体重减轻的方法，5 年随访后的效果与 RYGB 相当甚至更好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Langenbeck's Archives of Surgery 医学-外科

CiteScore

3.30

自引率

8.70%

发文量

342

审稿时长

4-8 weeks

期刊介绍： Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.