单吻合袖空肠（SAS-J）旁路与单吻合袖回肠（SASI）旁路，前瞻性随机对照临床试验。

IF 12.5 2区医学 Q1 SURGERY

International journal of surgery Pub Date : 2025-05-26 DOI:10.1097/JS9.0000000000002551

Alaa Mostafa Sewefy, Mohmed A AbdElzaher, Karim Sabry, Amr Madyan, Ramy Helmy, Mina Makram Hendy, Taha Hassan Kayed

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引用次数: 0

摘要

背景：单吻合袖回肠旁路术是对Santoro手术的一种改进。其目的是保持正常的食物通道，并允许内窥镜检查。为减少营养缺乏，手术方法改为单套空肠搭桥（SAS-J）。该研究旨在比较SASI和SAS-J旁路。材料和方法：这是一项前瞻性随机对照试验，包括180例患者。将患者随机分为2组，1组行SASI旁路，2组行SAS-J旁路。所有患者均完成至少一年的随访。结果：患者中女性占63%，男性占37%。平均体重指数（BMI）为47.6。平均年龄为37岁。1组营养不良总发生率为58%，2组为27.6% （p = 0.000）。蛋白质营养不良发生率1组为15.9%，2组为4.6% （p = 0.014）。1组贫血发生率为14.8%，2组为5.7% （p = 0.049）。1年EWL组为94.8 VS 90.6 （p = 0.005）。第1组腹泻发生率为21.6%，第2组为8% （p = 0.012）。过度体重减轻（EXWL）的发生率1组为11.4%，2组为2.3% （p = 0.0031）。再手术率1组为11.4%，2组为2.3% （p = 0.018）。结论：SASI和SAS-J搭桥术作为代谢和减肥手术都是有效的，但是与SASI搭桥术相比，SAS-J搭桥术的营养缺乏和并发症发生率更低。

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Single Anastomosis Sleeve Jejunal (SAS-J) Bypass Vs Single Anastomosis Sleeve Ileal (SASI) bypass, prospective randomized controlled clinical trial.

Background: Single anastomosis sleeve ileal (SASI) bypass is a modification of Santoro's operation. Which aimed to keep normal food pathway and allow endoscopic examination. The procedure was modified to single anastomosis sleeve jejunal (SAS-J) bypass to minimize the nutritional deficiency. The study aimed to compare SASI to SAS-J bypass.

Material and methods: This was a prospective randomized controlled trial that included 180 patients. Patients were randomly assigned to 2 equal groups: Group 1, was operated with SASI bypass while Group 2 was operated with SAS-J bypass. All patients complete at least one year follow up.

Results: 63% of patients were female and 37 % were male. The mean body mass index (BMI) was 47.6. The mean age was 37 years. The total incidence of malnutrition was 58% in Group 1 VS 27.6% in Group 2 (p = .000). Protein malnutrition occurred in 15.9% Group 1 VS 4.6% in Group 2 (p = .014). Anemia occurred in 14.8% in Group 1 VS 5.7% in Group 2 (p = .049). %EWL at one year was 94.8 in Group 1 VS 90.6 in Group 2 (p = .005). Diarrhea occurred in 21.6% in Group 1 VS 8% in Group 2 (p = .012). The incidence of excessive weight loss (EXWL) was 11.4% in Group 1 VS 2.3% in Group 2 (p = .0031). The rat of reoperation was 11.4% in group 1 VS 2.3% in Group 2 (p = .018).

Conclusions: Both SASI and SAS-J bypass are effective as a metabolic and a weight loss surgery, but, SAS-J bypass is associated with less nutritional deficiency and less complications rate compared to SASI bypass.

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来源期刊

International journal of surgery SURGERY-

CiteScore

17.70

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The International Journal of Surgery (IJS) has a broad scope, encompassing all surgical specialties. Its primary objective is to facilitate the exchange of crucial ideas and lines of thought between and across these specialties.By doing so, the journal aims to counter the growing trend of increasing sub-specialization, which can result in "tunnel-vision" and the isolation of significant surgical advancements within specific specialties.