Magnetic duodenoileal anastomosis with sleeve gastrectomy: a prospective multicenter study

IF 3.5 3区医学 Q1 SURGERY

Surgery for Obesity and Related Diseases Pub Date : 2025-02-01 DOI:10.1016/j.soard.2024.10.020

Laurent Biertho M.D. , Simon Marceau M.D. , Mélanie Nadeau M.Sc. , Stéfane Lebel M.D. , François Julien M.D. , André Tchernof Ph.D. , Thomas Ransom M.D. , Richard T. Spence M.D. , James Ellesmere M.D.

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引用次数: 0

Abstract

Background

Magnetic digestive anastomosis has the potential to reduce anastomotic complications and complexity. We report the 1-year results of a new surgical technique using Self-forming Neodymium magnet Anastomosis Procedure with Sleeve gastrectomy (SNAP-S; GI Windows).

Methods

This was a prospective, nonrandomized multicenter trial. Participants with type 2 diabetes (T2D) who met criteria for metabolic surgery were recruited. A dual-path duodenoileal anastomosis was created at 300 cm from the ileocecal valve using circular magnetic anastomosis. The proximal magnet was deployed by endoscopy and the distal one by laparoscopy. Sleeve gastrectomy was performed at the same time. Data are reported as mean ± standard deviation or percentage.

Results

Nineteen subjects with T2D were recruited (age 45 ± 9 years, body mass index 43 ± 5 kg/m², hemoglobin A1C 7.3 ± 1.3%). There was no conversion, mortality, or adverse event related to the magnetic anastomosis. Mean time for anastomosis creation was 32 ± 10 minutes. One patient was not implanted because of an inability to bring the ileum to the duodenum. Follow-up rate at 12 months was 95%. A total of 41 procedure-related adverse events were recorded during follow-up. Seven events in 4 subjects were considered serious. Total weight loss at 3, 6, and 12 months was 22 ± 19%, 28 ± 19%, and 31 ± 11%, respectively. Excess weight loss was 45 ± 14%, 59 ± 21%, and 78 ± 33%, respectively. All patients had an hemoglobin A1C ≤6.0% at 12 months with complete T2D remission in 78%.

Conclusion

The SNAP-S procedure is feasible with a low complication rate related to the anastomotic technique itself. The SNAP-S procedure provides significant weight loss and improvement of comorbidities. Additional prospective data are needed to better define the place of SNAP-S procedure.

查看原文本刊更多论文

袖带胃切除术的十二指肠磁吻合术：一项前瞻性多中心研究。

背景：磁性消化道吻合术具有减少吻合并发症和复杂性的潜力。我们报告了自成型钕磁铁吻合术与袖状胃切除术（SNAP-S；GI Windows）这一新手术技术的 1 年结果：这是一项前瞻性、非随机多中心试验。方法：这是一项前瞻性非随机多中心试验，招募符合代谢手术标准的 2 型糖尿病（T2D）患者。使用环形磁性吻合器在距回盲瓣 300 厘米处进行双路径十二指肠吻合术。近端磁体通过内窥镜展开，远端磁体通过腹腔镜展开。袖带胃切除术同时进行。数据以均数±标准差或百分比表示：共招募了 19 名患有 T2D 的受试者（年龄 45 ± 9 岁，体重指数 43 ± 5 kg/m2，血红蛋白 A1C 7.3 ± 1.3%）。没有发生与磁性吻合有关的转换、死亡或不良事件。吻合术的平均时间为 32 ± 10 分钟。一名患者因无法将回肠移至十二指肠而未植入。12 个月的随访率为 95%。随访期间共记录了41起与手术相关的不良事件。4名受试者中的7起事件被视为严重事件。3、6和12个月的总体重减轻率分别为22±19%、28±19%和31±11%。超重率分别为 45 ± 14%、59 ± 21% 和 78 ± 33%。所有患者在 12 个月时的血红蛋白 A1C 均低于 6.0%，78% 的患者 T2D 完全缓解：结论：SNAP-S 手术是可行的，与吻合技术本身相关的并发症发生率较低。SNAP-S手术能显著减轻体重，改善合并症。需要更多的前瞻性数据来更好地确定 SNAP-S 手术的位置。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery for Obesity and Related Diseases 医学-外科

CiteScore

6.70

自引率

12.90%

发文量

570

审稿时长

56 days

期刊介绍： Surgery for Obesity and Related Diseases (SOARD), The Official Journal of the American Society for Metabolic and Bariatric Surgery (ASMBS) and the Brazilian Society for Bariatric Surgery, is an international journal devoted to the publication of peer-reviewed manuscripts of the highest quality with objective data regarding techniques for the treatment of severe obesity. Articles document the effects of surgically induced weight loss on obesity physiological, psychiatric and social co-morbidities.