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Retrospective Comparison of SADI-S Versus RYGB in Chinese with Diabetes and BMI< 35kg/m2: a Propensity Score Adjustment Analysis

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Abstract

Background

As a modification of the duodenal switch (DS), single-anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) has recently become very popular and is successful for weight loss and T2DM remission. However, current studies have been mostly aimed at patients with severe obesity.

Objectives

In this study, we firstly compare primary SADI-S to the Roux-en-Y gastric bypass (RYGB) in Chinese with diabetes and BMI< 35 kg/m2.

Methods

Using a propensity score (PS) matching analysis, we analyzed all patients with diabetes and BMI< 35 kg/m2 who underwent primary SADI-S or RYGB. All surgeries were conducted by a single surgeon at a Chinese center from June 2017 to January 2019.

Results

Twenty-six patients who underwent SADI-S and 65 patients who underwent RYGB were included in our analysis. Of these, 26 (100%) of patients in the SADI-S group and 43 (66%) of patients in the RYGB group completed the 24-month follow-up. No severe perioperative complication was observed in either group. There was a statistically higher percentage of total weight loss with SADI-S at the 2-year follow-up when compared to RYGB (p = 0.017 after PS correction). After PS adjustment, 76.5% of patients in the SADI-S group and 82.4% of patients in the RYGB group achieved complete remission of T2DM (p = 1.000). Nutritional outcomes were similar in the two groups.

Conclusion

In Chinese with diabetes and BMI< 35 kg/m2, with comparable T2DM remission and nutritional outcomes, primary SADI-S allows for better weight loss than RYGB. Compared with RYGB, SADI-S is also a safe, effective, and feasible treatment for these patients.

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Funding

This article was funded by the Beijing Municipal Science and Technology Commission (Grant No. Z191100006619043) and the Project of Science and Technology Research and Development of China Railway Corporation (Gant No. 2018F006).

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Authors and Affiliations

  1. Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, 100038, China

    Qing Sang, Liang Wang, Xuejing Zheng, Nengwei Zhang & Dexiao Du

  2. Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, China

    Qiqige Wuyun

  3. Department of General Surgery, Aerospace Center Hospital, Beijing, 100049, China

    Dezhong Wang

Authors
  1. Qing Sang
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  2. Liang Wang
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  3. Qiqige Wuyun
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  4. Xuejing Zheng
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  5. Dezhong Wang
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  6. Nengwei Zhang
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  7. Dexiao Du
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Correspondence to Nengwei Zhang or Dexiao Du.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Key Points

1. Primary SADI-S has comparable T2DM remission with RYGB in Chinese with diabetes and BMI < 35kg/m2.

2. Primary SADI-S allows for better weight loss with RYGB in Chinese with T2DM and BMI < 35kg/m2.

3. Nutritional outcomes between the two groups are similar. Surgeons must take full account of that.

4. Compared with RYGB, SADI-S is also a safe, effective, and feasible treatment for these patients.

Qing Sang, Liang Wang, and Qiqige Wuyun are co-first authors of this manuscript.

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Sang, Q., Wang, L., Wuyun, Q. et al. Retrospective Comparison of SADI-S Versus RYGB in Chinese with Diabetes and BMI< 35kg/m2: a Propensity Score Adjustment Analysis. OBES SURG 31, 5166–5175 (2021). https://doi.org/10.1007/s11695-021-05708-z

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  • DOI: https://doi.org/10.1007/s11695-021-05708-z

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