{"title":"单吻合器袖式回肠（SASI）旁路术作为治疗肥胖症的替代手术的效果：最新系统回顾与元分析》。","authors":"Karim Ataya, Neha Patel, Almoutuz Aljaafreh, Samah Sofyan Melebari, Wah Yang, Camilo Guillen, Hussein El Bourji, Lubna Al-Sharif","doi":"10.1007/s11695-024-07366-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The Single Anastomosis Sleeve Ileal (SASI) bypass is a novel bariatric procedure that simplifies Santoro's procedure, balancing functional restriction and neuroendocrine modulation while preserving anatomy. We aim to conduct a single-arm meta-analysis of the SASI bypass to explore its moderate-term efficacy, as this might expand the available choices for surgeons to choose the best bariatric surgery that suits the patient's condition.</p><p><strong>Materials and methods: </strong>We conducted a comprehensive search on PubMed, Scopus, EMBASE, and Cochrane to identify studies for the SASI bypass surgery focusing on outcomes such as %EWL, %TWL, remission rate of comorbidities, and complications. The statistical analysis was carried out using RStudio version 4.3.2. Heterogeneity was assessed using the Cochrane Q test and I<sup>2</sup> statistics.</p><p><strong>Results: </strong>Our findings illuminate SASI's potency by undertaking a single-arm meta-analysis involving 1873 patients across 26 studies. At 12 months, we report a noteworthy % Excess Weight Loss (%EWL) (Mean 84.13; 95% CI 78.41-89.85; I<sup>2</sup> = 95%), and % Total Weight Loss (%TWL) (Mean 35.17; 95% CI 32.30-38.04; I<sup>2</sup> = 97%), highlighting SASI's efficacy on weight loss. Cumulative meta-analyses supported these findings. More weight loss was observed with a 250 cm common limb and a greater than 3 cm anastomosis. An 88.28% remission rate in type 2 diabetes mellitus (95% CI 79.74-95.03; I<sup>2</sup> = 84%) at 12 months was observed. Beyond weight outcomes, SASI impacts comorbidities with a good safety profile.</p><p><strong>Conclusion: </strong>Our study positions the SASI bypass as a good alternative option. 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At 12 months, we report a noteworthy % Excess Weight Loss (%EWL) (Mean 84.13; 95% CI 78.41-89.85; I<sup>2</sup> = 95%), and % Total Weight Loss (%TWL) (Mean 35.17; 95% CI 32.30-38.04; I<sup>2</sup> = 97%), highlighting SASI's efficacy on weight loss. Cumulative meta-analyses supported these findings. More weight loss was observed with a 250 cm common limb and a greater than 3 cm anastomosis. An 88.28% remission rate in type 2 diabetes mellitus (95% CI 79.74-95.03; I<sup>2</sup> = 84%) at 12 months was observed. Beyond weight outcomes, SASI impacts comorbidities with a good safety profile.</p><p><strong>Conclusion: </strong>Our study positions the SASI bypass as a good alternative option. 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引用次数: 0
摘要
目的：单吻合器袖带回肠（SASI）分流术是一种新型减肥手术，它简化了桑托罗手术，在保留解剖结构的同时兼顾了功能限制和神经内分泌调节。我们旨在对 SASI 分流术进行单臂荟萃分析，以探讨其中期疗效，因为这可能会扩大外科医生的选择范围，从而选择最适合患者病情的减肥手术：我们在PubMed、Scopus、EMBASE和Cochrane上进行了全面搜索，以确定SASI分流术的相关研究，重点关注EWL%、TWL%、合并症缓解率和并发症等结果。统计分析使用 RStudio 4.3.2 版本进行。使用 Cochrane Q 检验和 I2 统计量评估了异质性：通过对26项研究中的1873名患者进行单臂荟萃分析，我们的研究结果阐明了SASI的有效性。12 个月后，我们报告了值得注意的超重百分比（%EWL）（平均值 84.13；95% CI 78.41-89.85；I2 = 95%）和总重量百分比（%TWL）（平均值 35.17；95% CI 32.30-38.04；I2 = 97%），突出了 SASI 在减轻体重方面的功效。累积荟萃分析支持这些发现。250 厘米的共同肢体和大于 3 厘米的吻合口可观察到更多的体重减轻。12 个月后，2 型糖尿病的缓解率为 88.28%（95% CI 79.74-95.03；I2 = 84%）。除体重结果外，SASI 还对合并症产生了影响，安全性良好：我们的研究将 SASI 旁路定位为一种很好的替代选择。结论：我们的研究将 SASI 分流术定位为一种很好的替代选择，但其长期疗效还有待进一步探索。
Outcomes of Single Anastomosis Sleeve Ileal (SASI) Bypass as an Alternative Procedure in Treating Obesity: An Updated Systematic Review and Meta-Analysis.
Purpose: The Single Anastomosis Sleeve Ileal (SASI) bypass is a novel bariatric procedure that simplifies Santoro's procedure, balancing functional restriction and neuroendocrine modulation while preserving anatomy. We aim to conduct a single-arm meta-analysis of the SASI bypass to explore its moderate-term efficacy, as this might expand the available choices for surgeons to choose the best bariatric surgery that suits the patient's condition.
Materials and methods: We conducted a comprehensive search on PubMed, Scopus, EMBASE, and Cochrane to identify studies for the SASI bypass surgery focusing on outcomes such as %EWL, %TWL, remission rate of comorbidities, and complications. The statistical analysis was carried out using RStudio version 4.3.2. Heterogeneity was assessed using the Cochrane Q test and I2 statistics.
Results: Our findings illuminate SASI's potency by undertaking a single-arm meta-analysis involving 1873 patients across 26 studies. At 12 months, we report a noteworthy % Excess Weight Loss (%EWL) (Mean 84.13; 95% CI 78.41-89.85; I2 = 95%), and % Total Weight Loss (%TWL) (Mean 35.17; 95% CI 32.30-38.04; I2 = 97%), highlighting SASI's efficacy on weight loss. Cumulative meta-analyses supported these findings. More weight loss was observed with a 250 cm common limb and a greater than 3 cm anastomosis. An 88.28% remission rate in type 2 diabetes mellitus (95% CI 79.74-95.03; I2 = 84%) at 12 months was observed. Beyond weight outcomes, SASI impacts comorbidities with a good safety profile.
Conclusion: Our study positions the SASI bypass as a good alternative option. However, long-term efficacy is yet to be explored in the future.
期刊介绍：
Obesity Surgery is the official journal of the International Federation for the Surgery of Obesity and metabolic disorders (IFSO). A journal for bariatric/metabolic surgeons, Obesity Surgery provides an international, interdisciplinary forum for communicating the latest research, surgical and laparoscopic techniques, for treatment of massive obesity and metabolic disorders. Topics covered include original research, clinical reports, current status, guidelines, historical notes, invited commentaries, letters to the editor, medicolegal issues, meeting abstracts, modern surgery/technical innovations, new concepts, reviews, scholarly presentations and opinions.
Obesity Surgery benefits surgeons performing obesity/metabolic surgery, general surgeons and surgical residents, endoscopists, anesthetists, support staff, nurses, dietitians, psychiatrists, psychologists, plastic surgeons, internists including endocrinologists and diabetologists, nutritional scientists, and those dealing with eating disorders.
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