Long Alimentary Limb Duodenal Switch (LADS): an Exploratory Randomized Trial, Results at 2 Years.
Bariatric surgery
Biliopancreatic diversion
Duodenal switch
Long alimentary limb
Obesity
Journal
Obesity surgery
ISSN: 1708-0428
Titre abrégé: Obes Surg
Pays: United States
ID NLM: 9106714
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
26
07
2020
accepted:
04
09
2020
revised:
03
09
2020
pubmed:
18
9
2020
medline:
15
4
2021
entrez:
17
9
2020
Statut:
ppublish
Résumé
The effectiveness of the standard biliopancreatic diversion with duodenal switch (BPD/DS) in terms of weight loss has been demonstrated. Increasing the strict alimentary limb length while maintaining the length of the common channel could lead to similar weight loss while reducing side effects. The objective was to evaluate the effect of increasing the strict alimentary limb length on weight loss, comorbidities, nutritional deficiencies, and quality of life 2 years after surgery, compared with standard BPD/DS. An exploratory randomized, double-blind study evaluated the results of LADS at 2 years in comparison with the standard BPD/DS. Common channel was kept at 100 cm in both groups while alimentary limb was created at 100 cm from Treitz angle in the LADS group and at 150 cm total in the BPD/DS group. Twenty patients were recruited from May 2013 to June 2015. Mean percentage of excess weight loss was statistically significantly lower in the LADS group at 24 months (81.6 ± 6.6% in the LADS group and 97.1 ± 11.1% in the BPD/DS group (p = 0.001). No significant difference regarding the rate of remission of comorbidities was noted. Mean calcium, vitamin D, hemoglobin, zinc, and copper levels were statistically lower in the BPD/DS group. Quality of life was significantly improved in both groups, with no statistically significant difference between the two groups. At 24 months, weight loss was lower in the LADS group. However, no difference was observed in the improvement in quality of life. LADS technique was discontinued following this study. ClinicalTrial.gov Ref. NCT03097926.
Identifiants
pubmed: 32940866
doi: 10.1007/s11695-020-04968-5
pii: 10.1007/s11695-020-04968-5
doi:
Banques de données
ClinicalTrials.gov
['NCT03097926']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
5047-5058Références
Obesity in Canada - a joint report from the Public Health Agency of Canada and the Canadian Institute for Health Information. 2011.
Gastrointestinal surgery for severe obesity: National Institutes of Health Consensus Development Conference Statement. Am J Clin Nutr 1992;55(2 Suppl):615S–9S. https://doi.org/10.1093/ajcn/55.2.615s .
Marceau P, Biron S, Fau-Hould F-S, et al. Duodenal switch: long-term results. Obes Surg. 2007;17(11):1421–30.
doi: 10.1007/s11695-008-9435-9
Anderson B, Gill RS, de Gara CJ, et al. Biliopancreatic diversion: the effectiveness of duodenal switch and its limitations. Gastroenterol Res Pract. 2013;2013:974762. https://doi.org/10.1155/2013/974762 .
doi: 10.1155/2013/974762
pubmed: 24639868
pmcid: 3929999
Homan J, Betzel B, Fau-Aarts EO, et al. Vitamin and mineral deficiencies after biliopancreatic diversion and biliopancreatic diversion with duodenal switch—the rule rather than the exception. Obes Surg. 2015;25(9):1626–32.
doi: 10.1007/s11695-015-1570-5
Cloutier A, Lebel S, Hould F, et al. Long alimentary limb duodenal switch (LADS): a short-term prospective randomized trial. Surg Obes Relat Dis. 2018;14(1):30–7.
doi: 10.1016/j.soard.2017.08.028
Therrien F, Marceau P, Turgeon N, et al. The Laval questionnaire: a new instrument to measure quality of life in morbid obesity. Health Qual Life Outcomes. 2011;9:66.
doi: 10.1186/1477-7525-9-66
Biertho L, Lebel S, Marceau S, et al. Biliopancreatic diversion with duodenal switch: surgical technique and perioperative care. Surg Clin North Am. 2016;96(4):815–26.
doi: 10.1016/j.suc.2016.03.012
Brethauer SA, Kim J, el Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Obes Surg. 2015;25(4):587–606.
doi: 10.1007/s11695-015-1645-3
Hamoui N, Anthone Gj Fau-Kaufman HS, Kaufman Hs Fau-Crookes PF, et al. Maintenance of weight loss in patients with body mass index >60 kg/m2: importance of length of small bowel bypassed. Surg Obes Relat Dis. 2008;4(3):404–6.
doi: 10.1016/j.soard.2007.08.020
McConnell DB, O’Rourke Rw Fau- Deveney CW, Deveney CW. Common channel length predicts outcomes of biliopancreatic diversion alone and with the duodenal switch surgery. Am J Surg 2005;189(5):536–540.
Cottam A, Cottam D, Portenier D, et al. A matched cohort analysis of stomach intestinal pylorus saving (SIPS) surgery versus biliopancreatic diversion with duodenal switch with two-year follow-up. Obes Surg. 2017;27(2):454–61.
doi: 10.1007/s11695-016-2341-7
Surve A, Zaveri H, Cottam D, et al. A retrospective comparison of biliopancreatic diversion with duodenal switch with single anastomosis duodenal switch (SIPS-stomach intestinal pylorus sparing surgery) at a single institution with two year follow-up. Surg Obes Relat Dis. 2017;13(3):415–22.
doi: 10.1016/j.soard.2016.11.020
Sanchez-Pernaute A, Rubio MA, Conde M, et al. Single-anastomosis duodenoileal bypass as a second step after sleeve gastrectomy. Surg Obes Relat Dis. 2015;11(2):351–5.
doi: 10.1016/j.soard.2014.06.016
Shoar S, Poliakin L, Rubenstein R, et al. Single anastomosis duodeno-Ileal switch (SADIS): a systematic review of efficacy and safety. Obes Surg. 2018;28(1):104–13.
doi: 10.1007/s11695-017-2838-8
Moon RC, Gaskins L, Teixeira AF, et al. Safety and effectiveness of single-anastomosis duodenal switch procedure: 2-year result from a single US institution. Obes Surg. 2018;28(6):1571–7.
doi: 10.1007/s11695-017-3066-y
Brown WA, Ooi G, Higa K, et al. IFSO-appointed task force reviewing the literature on SADI-S/OADS. Single anastomosis duodenal-Ileal bypass with sleeve gastrectomy/one anastomosis duodenal switch (SADI-S/OADS) IFSO position statement. Obes Surg. 2018;28(5):1207–16.
doi: 10.1007/s11695-018-3201-4
Moon RC, Kirkpatrick V, Gaskins L, et al. Safety and effectiveness of single- versus double-anastomosis duodenal switch at a single institution. Surg Obes Relat Dis févr. 2019;15(2):245–52.
doi: 10.1016/j.soard.2018.11.004
Finno P, Osorio J, García-Ruiz-de-Gordejuela A, et al. Single versus double-anastomosis duodenal switch: single-site comparative cohort study in 440 consecutive patients. Obes Surg. 2020;30(9):3309–16.
doi: 10.1007/s11695-020-04566-5