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Surgical Treatment of Superobesity, Results of the Two-Stage Strategy of SADI-S

Revista de la Sociedad Española de Cirugía de Obesidad y Metabólica y de la Sociedad Española para el Estudio de la Obesidad2025

Diogo Paula, Joana Oliveira, José Carlos Campos, André Lázaro, José Guilherme Tralhão

Abstract

SADI-S is a simplified version of the Duodenal Switch, combining a single anastomosis between the duodenum and ileum with a sleeve gastrectomy.For patients with a body mass index (BMI) over 50 kg/m 2 , a two-stage approach can be used, starting with the sleeve followed by the SADI procedure.This retrospective, observational study aims to evaluate how the time between the two surgical procedures affects the patient's outcome at the end of the firstyear follow-up, after the last surgery.25 patients, with a mean age of 43.04 years and a mean initial BMI of 56.83 Kg/m 2 , were included in this study.The time between surgical interventions varied from 212 to 872 days.The percentage of excess weight loss (%EWL) was, on average, 72.29% in the first year of follow-up and was inversely correlated with the time elapsed between interventions (Spearman's =-0,596, p=0,007).In terms of controlling metabolic comorbidities, 56% of patients achieved total remission.In conclusion, dividing SADI-S into two stages, first performing the sleeve, induces weight loss and metabolic health, making the later bypass safer.A shorter time between surgeries may lead to greater weight loss, but more research is needed to determine the best timing.