Single-anastomosis duodenal ileostomy with sleeve is a safe and effective option for patients in an ambulatory surgical center.


Journal

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
ISSN: 1878-7533
Titre abrégé: Surg Obes Relat Dis
Pays: United States
ID NLM: 101233161

Informations de publication

Date de publication:
Nov 2019
Historique:
received: 30 05 2019
revised: 23 07 2019
accepted: 11 09 2019
pubmed: 28 10 2019
medline: 26 8 2020
entrez: 27 10 2019
Statut: ppublish

Résumé

The single-anastomosis duodenal ileostomy with sleeve gastrectomy (SADI-S) is gaining popularity in the United States as an alternative to the gastric bypass for patients with a high body mass index (BMI) or who are less likely to succeed with a sleeve. While SADI-S has similar weight loss to the gastric bypass, the complication rate is significantly lower, allowing surgeons to perform SADI-S in an ambulatory surgical center with a 23-hour stay. To determine if SADI-S can be safely performed in an ambulatory surgical setting. Private practice. All SADI-S procedures performed from August 2015 to March 2019 at 2 bariatric centers were included in this study. Patients selection for SADI-S in the ambulatory surgical center required no end organ damage, no evidence of severe sleep apnea, and BMI <55 for males and BMI <60 for females. All data were gathered retrospectively from prospectively kept databases. Thirty-day complication rates were analyzed using the Clavien-Dindo scale to assess the safety of performing SADI-S in an ambulatory surgical center. Eighty-two patients were included in this study. The sample was 72% female with an average age of 46 and BMI of 45. All patients received planned intravenous fluid within 3 days after the procedure. There were 2 (2.4%) grade IIIb to V complications. There were no mortalities in this series. SADI-S can be performed safely in an ambulatory surgery 23-hour setting with appropriate patient selection, perioperative support, and enhanced recovery after surgery protocols.

Sections du résumé

BACKGROUND BACKGROUND
The single-anastomosis duodenal ileostomy with sleeve gastrectomy (SADI-S) is gaining popularity in the United States as an alternative to the gastric bypass for patients with a high body mass index (BMI) or who are less likely to succeed with a sleeve. While SADI-S has similar weight loss to the gastric bypass, the complication rate is significantly lower, allowing surgeons to perform SADI-S in an ambulatory surgical center with a 23-hour stay.
OBJECTIVES OBJECTIVE
To determine if SADI-S can be safely performed in an ambulatory surgical setting.
SETTING METHODS
Private practice.
METHODS METHODS
All SADI-S procedures performed from August 2015 to March 2019 at 2 bariatric centers were included in this study. Patients selection for SADI-S in the ambulatory surgical center required no end organ damage, no evidence of severe sleep apnea, and BMI <55 for males and BMI <60 for females. All data were gathered retrospectively from prospectively kept databases. Thirty-day complication rates were analyzed using the Clavien-Dindo scale to assess the safety of performing SADI-S in an ambulatory surgical center.
RESULTS RESULTS
Eighty-two patients were included in this study. The sample was 72% female with an average age of 46 and BMI of 45. All patients received planned intravenous fluid within 3 days after the procedure. There were 2 (2.4%) grade IIIb to V complications. There were no mortalities in this series.
CONCLUSION CONCLUSIONS
SADI-S can be performed safely in an ambulatory surgery 23-hour setting with appropriate patient selection, perioperative support, and enhanced recovery after surgery protocols.

Identifiants

pubmed: 31653570
pii: S1550-7289(19)30999-2
doi: 10.1016/j.soard.2019.09.062
pii:
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1990-1993

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2019 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Auteurs

Samuel Cottam (S)

Bariatric Medicine Institute, Salt Lake City, Utah.

Peter Ng (P)

REX Bariatric Specialists, Raleigh, North Carolina.

Lindsey Sharp (L)

REX Bariatric Specialists, Raleigh, North Carolina.

Walter Medlin (W)

Bariatric Medicine Institute, Salt Lake City, Utah.

Daniel Rhead Cottam (DR)

Bariatric Medicine Institute, Salt Lake City, Utah. Electronic address: drdanielcottam@yahoo.com.

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