SADI or SASI bariatric surgery, which is better for long-term weight loss?

Rim Suha and the team conducted a systematic literature search of electronic databases focused on weight loss outcomes, improvement of type 2 diabetes and other obesity-related comorbidities, and rate of remission and complications. The review comprised nine studies on SASI and seventeen studies on SADI.

The authors reported the following findings:

• Both procedures are similar in surgical technique and have demonstrated fewer complications than other bariatric procedures.
• Mean preoperative BMI was similar in both study groups: 46.4 kg/m2 in SADI and 48.8 kg/m2 in SASI.
• The mean %EWL at 12 months in the SADI group was 74.1% compared to 77.4% in the SASI group.
• Preoperative severity of T2DM appeared to be higher in the SASI patient group, with higher preoperative HbA1c and fasting blood glucose levels.
• T2DM resolution was achieved in a significant proportion of SADI and SASI patient populations (78.5% in SADI and 89.0% in SASI).
• Complication rates were comparable for both procedures.

"The findings revealed that both SASI and SADI effectively induce weight loss at 12 months, with a low mortality rate and major complications," the researchers wrote. "From the studies included in this review, the SASI procedure had a higher impact on type 2 diabetes resolution than SADI."

Reference:

Hye Rim Suh, Jasmine Mui, Ernest Cheng, Daniel Liu, Si Louise Sun, Ken Loi, Mark Magdy & Michel Gagner (2023) Outcomes of single anastomosis duodeno ileal bypass and single anastomosis stomach ileal bypass for type II diabetes: a systematic review, Expert Review of Endocrinology & Metabolism, DOI: 10.1080/17446651.2023.2218919