Vol.:(0123456789) 1 3 Surgical Endoscopy https://doi.org/10.1007/s00464-020-07430-w Single anastomosis sleeve ileal (SASI) bypass versus sleeve gastrectomy: a case‑matched multicenter study Sameh Hany Emile 1  · Amr Madyan 1  · Tarek Mahdy 1,2  · Ayman Elshobaky 1  · Hosam Ghazy Elbanna 1  · Mohamed Anwar Abdel‑Razik 1 Received: 11 November 2019 / Accepted: 10 February 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020 Abstract Background The present study aimed to compare the outcome of single anastomosis sleeve ileal (SASI) bypass and sleeve gastrectomy (SG) in regards weight loss, improvement in comorbidities at 12 months of follow-up, and postoperative complications. Methods This was a case-matched, multicenter analysis of the outcome of patients who underwent SG or SASI bypass. Patients who underwent SASI bypass were matched with an equal number of patients who underwent SG in terms of age, sex, BMI, and comorbidities. The main outcome measures were excess weight loss (EWL) at 6 and 12 months after surgery, improvement in medical comorbidities, and complications. Results A total of 116 patients (97 female) of a mean age of 35.8 years were included. Fifty-eight patients underwent SASI bypass and an equal number underwent SG. %EWL at 6 months postoperatively was similar between the two groups. SASI bypass conferred signifcantly higher %EWL at 12 months than SG (72.6 Vs 60.4, p < 0.0001). Improvement in type 2 dia- betes mellitus (T2DM) and gastroesophageal refux disease (GERD) after SASI bypass was better than SG (95.8% Vs 70% and 85.7% Vs 18.2%, respectively). SASI bypass required longer operation time than SG (108.7 Vs 92.8 min, p < 0.0001). Complications occurred in 12 (20.7%) patients after SG and 4 (6.9%) patients after SASI bypass (p = 0.056). Conclusion The %EWL at 12 months after SASI bypass was signifcantly higher than after SG. SASI bypass conferred bet- ter improvement in T2DM and GERD than SG. Both procedures had similar weight loss at 6 months postoperatively and comparable complication rates. Keywords Single anastomosis · SASI · Sleeve gastrectomy · Case-matched · Bypass Bariatric surgery has been recognized as the most efective treatment of morbid obesity as compared to medical and conservative treatments [1]. Furthermore, bariatric surgery can achieve better resolution of type 2 diabetes mellitus (T2DM) than intensive medical therapy alone [2]. The ben- efcial efect of bariatric surgery extends to include improve- ment in or even resolution of several other obesity-related comorbidities such as hypertension, dyslipidemia, sleep apnea, and joint pain. Bariatric procedures can be classifed according to the mechanism of weight loss exerted. Whether employing restrictive, malabsorptive, or mixed weight loss mechanism, bariatric surgery continues to achieve satisfactory outcomes. While a recent meta-analysis [3] found roux-en-Y-gastric bypass (RYGB) and sleeve gastrectomy (SG) confer similar weight loss, both were superior to laparoscopic adjustable gastric banding. and Other Interventional Techniques * Sameh Hany Emile Sameh200@hotmail.com Amr Madyan profamoora@gmail.com Tarek Mahdy tmahdy@yahoo.com Ayman Elshobaky elshobakyayman@yahoo.com Hosam Ghazy Elbanna hosamelbanna@hotmail.com Mohamed Anwar Abdel-Razik drmohamedanwar1981@yahoo.com 1 General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt 2 General Surgery Department, Al Qassimi Hospital, Sharjah, United Arab Emirates