Skip to main content
Top
Published in:

03-01-2024 | Bariatric Surgery | Original Contributions

Outcomes of SADI and OAGB Compared to RYGB from the Metabolic and Bariatric Surgery Quality Improvement Program: The North American Experience

Authors: Grace F. Chao, Joseph Canner, Safraz Hamid, Lee D. Ying, Saber Ghiassi, Jennifer S. Schwartz, Karen E. Gibbs

Published in: Obesity Surgery | Issue 2/2024

Login to get access

Abstract

Background

Rapid adoption of sleeve gastrectomy (SG) in the last decade aptly reflects the desire of patients and surgeons for alternatives to RYGB and DS. While SG provides good outcomes, other options that address specific patient needs are warranted. Recently approved by ASMBS, SADI, and OAGB have garnered increasing interest due to their single anastomosis technique.

Methods

Using the Metabolic and Bariatric Surgery Quality Improvement Program database, we examined laparoscopic and robotic cases from 2018 to 2021 to understand the percentage of primary bariatric surgery cases that are SADI and OAGB. We used coarsened exact matching to match patients who underwent SADI or OAGB to patients who underwent Roux-en-Y gastric bypass (RYGB). We examined outcomes of matched patients using logistic regression.

Results

Of the 667,979 patients that underwent bariatric-metabolic surgery, 1326 (0.2%) underwent SADI, and 2541 (0.4%) underwent OAGB. SADI was not identified in the database until 2020. In 2020, there were 487 SADI procedures compared to 839 in 2021. From 2018 to 2021, OAGBs went from 149 to 940. Compared with RYGB, SADI was associated with higher rates of anastomotic or staple line leak (OR 2.21 (95% CI 1.08–4.53)) and sepsis (OR 3.62 (95% CI 1.62–8.12)). Compared with RYGB, OAGB was associated with lower rates of gastrointestinal bleeding (OR 0.29 (95% CI 0.12–0.71)) and bowel obstruction (OR 0.10 (95% CI 0.02–0.39)). Of note, there were no differences between these procedures and RYGB for 30-day mortality.

Conclusion

More SADIs and OAGBs are being performed. However, there were higher complication rates associated with the SADI procedure. Further studies will be needed to better understand the key drivers for these outcomes.

Graphical Abstract

Appendix
Available only for authorised users
Literature
1.
go back to reference Al-Mazrou AM, Bellorin O, Dhar V, et al. Minimally invasive versus open duodenal switch: a nationwide retrospective analysis. Surg Endosc. 2022;36(9):7000–7.CrossRefPubMed Al-Mazrou AM, Bellorin O, Dhar V, et al. Minimally invasive versus open duodenal switch: a nationwide retrospective analysis. Surg Endosc. 2022;36(9):7000–7.CrossRefPubMed
2.
go back to reference Nguyen NT, Masoomi H, Magno CP, et al. Trends in use of bariatric surgery, 2003-2008. J Am Coll Surg. 2011;213(2):261–6.CrossRefPubMed Nguyen NT, Masoomi H, Magno CP, et al. Trends in use of bariatric surgery, 2003-2008. J Am Coll Surg. 2011;213(2):261–6.CrossRefPubMed
3.
go back to reference Khan S, Rock K, Baskara A, et al. Trends in bariatric surgery from 2008 to 2012. Am J Surg. 2016;211(6):1041–6.CrossRefPubMed Khan S, Rock K, Baskara A, et al. Trends in bariatric surgery from 2008 to 2012. Am J Surg. 2016;211(6):1041–6.CrossRefPubMed
4.
go back to reference English WJ, DeMaria EJ, Brethauer SA, et al. American Society for Metabolic and Bariatric Surgery estimation of metabolic and bariatric procedures performed in the United States in 2016. Surg Obes Relat Dis. 2018;14(3):259–63.CrossRefPubMed English WJ, DeMaria EJ, Brethauer SA, et al. American Society for Metabolic and Bariatric Surgery estimation of metabolic and bariatric procedures performed in the United States in 2016. Surg Obes Relat Dis. 2018;14(3):259–63.CrossRefPubMed
5.
go back to reference Ren CJ, Cabrera I, Rajaram K, et al. Factors influencing patient choice for bariatric operation. Obes Surg. 2005;15(2):202–6.CrossRefPubMed Ren CJ, Cabrera I, Rajaram K, et al. Factors influencing patient choice for bariatric operation. Obes Surg. 2005;15(2):202–6.CrossRefPubMed
6.
go back to reference Rozier MD, Ghaferi AA, Rose A, et al. Patient preferences for bariatric surgery: findings from a survey using discrete choice experiment methodology. JAMA Surg. 2019;154(1):e184375.CrossRefPubMed Rozier MD, Ghaferi AA, Rose A, et al. Patient preferences for bariatric surgery: findings from a survey using discrete choice experiment methodology. JAMA Surg. 2019;154(1):e184375.CrossRefPubMed
7.
go back to reference Weinstein AL, Marascalchi BJ, Spiegel MA, Saunders JK, Fagerlin A, Parikh M. Patient preferences and bariatric surgery procedure selection; the need for shared decision-making. Obes Surg. 2014;24(11):1933–9.CrossRefPubMed Weinstein AL, Marascalchi BJ, Spiegel MA, Saunders JK, Fagerlin A, Parikh M. Patient preferences and bariatric surgery procedure selection; the need for shared decision-making. Obes Surg. 2014;24(11):1933–9.CrossRefPubMed
8.
go back to reference Opozda M, Wittert G, Chur-Hansen A. Patients’ reasons for and against undergoing Roux-en-Y gastric bypass, adjustable gastric banding, and vertical sleeve gastrectomy. Surg Obes Relat Dis. 2017;13(11):1887–96.CrossRefPubMed Opozda M, Wittert G, Chur-Hansen A. Patients’ reasons for and against undergoing Roux-en-Y gastric bypass, adjustable gastric banding, and vertical sleeve gastrectomy. Surg Obes Relat Dis. 2017;13(11):1887–96.CrossRefPubMed
9.
go back to reference Samuels JM, Carmichael H, Beaty L, et al. Demographic factors as determinant of selection of sleeve gastrectomy or gastric bypass for surgical weight loss. Surg Endosc. 2022;36(11):8154–63.CrossRefPubMed Samuels JM, Carmichael H, Beaty L, et al. Demographic factors as determinant of selection of sleeve gastrectomy or gastric bypass for surgical weight loss. Surg Endosc. 2022;36(11):8154–63.CrossRefPubMed
10.
go back to reference Rozier MD, Ghaferi AA, Rose AM, et al. Preferences for bariatric surgery: comparing surgeons and patients using a discrete choice experiment. Surg Obes Relat Dis. 2020;16(6):738–44.CrossRefPubMed Rozier MD, Ghaferi AA, Rose AM, et al. Preferences for bariatric surgery: comparing surgeons and patients using a discrete choice experiment. Surg Obes Relat Dis. 2020;16(6):738–44.CrossRefPubMed
11.
go back to reference Kallies K, Rogers AM. American Society for M, bariatric surgery clinical issues C. American Society for Metabolic and Bariatric Surgery updated statement on single-anastomosis duodenal switch. Surg Obes Relat Dis. 2020;16(7):825–30.CrossRefPubMed Kallies K, Rogers AM. American Society for M, bariatric surgery clinical issues C. American Society for Metabolic and Bariatric Surgery updated statement on single-anastomosis duodenal switch. Surg Obes Relat Dis. 2020;16(7):825–30.CrossRefPubMed
12.
go back to reference Clapp B, Corbett J, Jordan M, et al. Single-anastomosis duodenoileal bypass with sleeve in the United States: a first comparative safety analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. Surg Obes Relat Dis. 2023;19(1):11–7.CrossRefPubMed Clapp B, Corbett J, Jordan M, et al. Single-anastomosis duodenoileal bypass with sleeve in the United States: a first comparative safety analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. Surg Obes Relat Dis. 2023;19(1):11–7.CrossRefPubMed
13.
go back to reference Verhoeff K, Mocanu V, Jogiat U, et al. Patient selection and 30-day outcomes of SADI-S compared to RYGB: a retrospective cohort study of 47,375 patients. Obes Surg. 2022;32(7):1–8.CrossRefPubMedPubMedCentral Verhoeff K, Mocanu V, Jogiat U, et al. Patient selection and 30-day outcomes of SADI-S compared to RYGB: a retrospective cohort study of 47,375 patients. Obes Surg. 2022;32(7):1–8.CrossRefPubMedPubMedCentral
14.
go back to reference Docimo S, Yang J, Zhang X, et al. One anastomosis gastric bypass versus Roux-en-Y gastric bypass: a 30-day follow-up review. Surg Endosc. 2022;36(1):498–503.CrossRefPubMed Docimo S, Yang J, Zhang X, et al. One anastomosis gastric bypass versus Roux-en-Y gastric bypass: a 30-day follow-up review. Surg Endosc. 2022;36(1):498–503.CrossRefPubMed
15.
go back to reference Jung JJ, Park AK, Hutter MM. The United States experience with one anastomosis gastric bypass at MBSAQIP-accredited centers. Obes Surg. 2022;32(10):3239–47.CrossRefPubMed Jung JJ, Park AK, Hutter MM. The United States experience with one anastomosis gastric bypass at MBSAQIP-accredited centers. Obes Surg. 2022;32(10):3239–47.CrossRefPubMed
16.
go back to reference Campos GM, Khoraki J, Browning MG, et al. Changes in utilization of bariatric surgery in the United States from 1993 to 2016. Ann Surg. 2020;271(2):201–9.CrossRefPubMed Campos GM, Khoraki J, Browning MG, et al. Changes in utilization of bariatric surgery in the United States from 1993 to 2016. Ann Surg. 2020;271(2):201–9.CrossRefPubMed
18.
go back to reference Torres A, Rubio MA, Ramos-Levi AM, et al. Cardiovascular risk factors after single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S): a new effective therapeutic approach? Curr Atheroscler Rep. 2017;19(12):58.CrossRefPubMed Torres A, Rubio MA, Ramos-Levi AM, et al. Cardiovascular risk factors after single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S): a new effective therapeutic approach? Curr Atheroscler Rep. 2017;19(12):58.CrossRefPubMed
19.
go back to reference Surve A, Cottam D, Richards C, et al. A matched cohort comparison of long-term outcomes of Roux-en-Y gastric bypass (RYGB) versus single-anastomosis duodeno-ileostomy with sleeve gastrectomy (SADI-S). Obes Surg. 2021;31(4):1438–48.CrossRefPubMed Surve A, Cottam D, Richards C, et al. A matched cohort comparison of long-term outcomes of Roux-en-Y gastric bypass (RYGB) versus single-anastomosis duodeno-ileostomy with sleeve gastrectomy (SADI-S). Obes Surg. 2021;31(4):1438–48.CrossRefPubMed
20.
go back to reference Gonzalez R, Nelson LG, Gallagher SF, et al. Anastomotic leaks after laparoscopic gastric bypass. Obes Surg. 2004;14(10):1299–307.CrossRefPubMed Gonzalez R, Nelson LG, Gallagher SF, et al. Anastomotic leaks after laparoscopic gastric bypass. Obes Surg. 2004;14(10):1299–307.CrossRefPubMed
21.
go back to reference Fernandez Jr AZ, DeMaria EJ, Tichansky DS, et al. Experience with over 3,000 open and laparoscopic bariatric procedures: multivariate analysis of factors related to leak and resultant mortality. Surg Endosc. 2004;18(2):193–7.CrossRefPubMed Fernandez Jr AZ, DeMaria EJ, Tichansky DS, et al. Experience with over 3,000 open and laparoscopic bariatric procedures: multivariate analysis of factors related to leak and resultant mortality. Surg Endosc. 2004;18(2):193–7.CrossRefPubMed
22.
go back to reference Papasavas PK, Caushaj PF, McCormick JT, et al. Laparoscopic management of complications following laparoscopic Roux-en-Y gastric bypass for morbid obesity. Surg Endosc. 2003;17(4):610–4.CrossRefPubMed Papasavas PK, Caushaj PF, McCormick JT, et al. Laparoscopic management of complications following laparoscopic Roux-en-Y gastric bypass for morbid obesity. Surg Endosc. 2003;17(4):610–4.CrossRefPubMed
23.
go back to reference Peterli R, Wolnerhanssen BK, Peters T, et al. Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y gastric bypass on weight loss in patients with morbid obesity: the SM-BOSS randomized clinical trial. JAMA. 2018;319(3):255–65.CrossRefPubMedPubMedCentral Peterli R, Wolnerhanssen BK, Peters T, et al. Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y gastric bypass on weight loss in patients with morbid obesity: the SM-BOSS randomized clinical trial. JAMA. 2018;319(3):255–65.CrossRefPubMedPubMedCentral
24.
go back to reference Alasfar F, Chand B. Intraoperative endoscopy for laparoscopic Roux-en-Y gastric bypass: leak test and beyond. Surg Laparosc Endosc Percutan Tech. 2010;20(6):424–7.CrossRefPubMed Alasfar F, Chand B. Intraoperative endoscopy for laparoscopic Roux-en-Y gastric bypass: leak test and beyond. Surg Laparosc Endosc Percutan Tech. 2010;20(6):424–7.CrossRefPubMed
25.
go back to reference Kligman MD. Intraoperative endoscopic pneumatic testing for gastrojejunal anastomotic integrity during laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2007;21(8):1403–5.CrossRefPubMed Kligman MD. Intraoperative endoscopic pneumatic testing for gastrojejunal anastomotic integrity during laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2007;21(8):1403–5.CrossRefPubMed
26.
go back to reference Shin RB. Intraoperative endoscopic test resulting in no postoperative leaks from the gastric pouch and gastrojejunal anastomosis in 366 laparoscopic Roux-en-Y gastric bypasses. Obes Surg. 2004;14(8):1067–9.CrossRefPubMed Shin RB. Intraoperative endoscopic test resulting in no postoperative leaks from the gastric pouch and gastrojejunal anastomosis in 366 laparoscopic Roux-en-Y gastric bypasses. Obes Surg. 2004;14(8):1067–9.CrossRefPubMed
27.
go back to reference Mocanu V, Verhoeff K, Forbes H, et al. Comparing patient selection and 30-day outcomes between single anastomosis gastric bypass and Roux-en-Y gastric bypass: a retrospective cohort study of 47,384 patients. Obes Surg. 2023;33(1):188–94.CrossRefPubMed Mocanu V, Verhoeff K, Forbes H, et al. Comparing patient selection and 30-day outcomes between single anastomosis gastric bypass and Roux-en-Y gastric bypass: a retrospective cohort study of 47,384 patients. Obes Surg. 2023;33(1):188–94.CrossRefPubMed
28.
go back to reference Mocanu V, Verhoeff K, Forbes H, Birch DW, Karmali S, Switzer NJ. Comparing PatientSelection and 30-day Outcomes Between Single Anastomosis Gastric Bypass and Roux-en-YGastric Bypass: a Retrospective Cohort Study of 47,384 Patients. Obes Surg. 2023 Jan;33(1):188–94. Mocanu V, Verhoeff K, Forbes H, Birch DW, Karmali S, Switzer NJ. Comparing PatientSelection and 30-day Outcomes Between Single Anastomosis Gastric Bypass and Roux-en-YGastric Bypass: a Retrospective Cohort Study of 47,384 Patients. Obes Surg. 2023 Jan;33(1):188–94.
29.
go back to reference Bruzzi M, Rau C, Voron T, et al. Single anastomosis or mini-gastric bypass: long-term results and quality of life after a 5-year follow-up. Surg Obes Relat Dis. 2015;11(2):321–6.CrossRefPubMed Bruzzi M, Rau C, Voron T, et al. Single anastomosis or mini-gastric bypass: long-term results and quality of life after a 5-year follow-up. Surg Obes Relat Dis. 2015;11(2):321–6.CrossRefPubMed
30.
go back to reference Bhandari M, Nautiyal HK, Kosta S, Mathur W, Fobi M. Comparison of one anastomosis gastric bypass and Roux en-Y gastric bypass for treatment of obesity: a 5-year study. Surg Obes Relat Dis. 2019 May 24. Bhandari M, Nautiyal HK, Kosta S, Mathur W, Fobi M. Comparison of one anastomosis gastric bypass and Roux en-Y gastric bypass for treatment of obesity: a 5-year study. Surg Obes Relat Dis. 2019 May 24.
31.
go back to reference Magouliotis DE, Tasiopoulou VS, Tzovaras G. One Anastomosis gastric bypass versus Roux-en-Y gastric bypass for morbid obesity: an updated meta-analysis. Obes Surg. 2019;29(9):2721–30.CrossRefPubMed Magouliotis DE, Tasiopoulou VS, Tzovaras G. One Anastomosis gastric bypass versus Roux-en-Y gastric bypass for morbid obesity: an updated meta-analysis. Obes Surg. 2019;29(9):2721–30.CrossRefPubMed
32.
go back to reference Uhe I, Douissard J, Podetta M, et al. Roux-en-Y gastric bypass, sleeve gastrectomy, or one-anastomosis gastric bypass? A systematic review and meta-analysis of randomized-controlled trials. Obesity (Silver Spring). 2022;30(3):614–27.CrossRefPubMed Uhe I, Douissard J, Podetta M, et al. Roux-en-Y gastric bypass, sleeve gastrectomy, or one-anastomosis gastric bypass? A systematic review and meta-analysis of randomized-controlled trials. Obesity (Silver Spring). 2022;30(3):614–27.CrossRefPubMed
33.
go back to reference Moustafa AAS, Eskandaros MS, Ebrahim AH, et al. Comparative study between single anastomosis duodeno-ileal bypass and one anastomosis-gastric bypass as regard remission of Type-2 DM after application of DIAREM Scoring System. Med Sci. 2020;24(106) Moustafa AAS, Eskandaros MS, Ebrahim AH, et al. Comparative study between single anastomosis duodeno-ileal bypass and one anastomosis-gastric bypass as regard remission of Type-2 DM after application of DIAREM Scoring System. Med Sci. 2020;24(106) 
Metadata
Title
Outcomes of SADI and OAGB Compared to RYGB from the Metabolic and Bariatric Surgery Quality Improvement Program: The North American Experience
Authors
Grace F. Chao
Joseph Canner
Safraz Hamid
Lee D. Ying
Saber Ghiassi
Jennifer S. Schwartz
Karen E. Gibbs
Publication date
03-01-2024
Publisher
Springer US
Published in
Obesity Surgery / Issue 2/2024
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-023-07019-x
SPONSORED

Mastering chronic pancreatitis pain: A multidisciplinary approach and practical solutions

  • Webinar | 06-02-2024 | 20:00 (CET)

Severe pain is the most common symptom of chronic pancreatitis. In this webinar, experts share the latest insights in pain management for chronic pancreatitis patients. Experts from a range of disciplines discuss pertinent cases and provide practical suggestions for use within clinical practice.

Sponsored by:
  • Viatris
Developed by: Springer Healthcare
Watch now