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Open Access 01-04-2020 | Sleep Apnea | Original Contributions

Single Anastomosis Duodenal Switch: 1-Year Outcomes

Authors: Daniel Cottam, Mitchell Roslin, Paul Enochs, Matthew Metz, Dana Portenier, Dennis Smith

Published in: Obesity Surgery | Issue 4/2020

Abstract

Introduction

Single-anastomosis duodenal switch has been suggested to be an effective bariatric procedure that offers excellent weight loss and by lengthening the common channel the potential to reduce micronutrient deficiencies.

Purpose

To evaluate the weight loss, comorbidity resolution and the 1-year nutritional outcomes of the single-anastomosis duodenal switch (SADS) procedure.

Setting

Multiple US Hospitals.

Methods

From October 2014 to January 2017, 120 patients were enrolled at six sites across the USA and underwent the SADS procedure. Weight loss, comorbidities, quality of life, and adverse events were followed post-procedure for 12 months.

Results

At 1, 6, and 12 months, 98.3%, 85.5%, and 77.1% of the patients were available for assessment, respectively. At 12 months, patients showed significantly reduced body mass index when compared to baseline (46.8 ± 5.8 vs 29.8 ± 4.4, P < 0.001 respectively). Sixty-five patients had type 2 diabetes at baseline; however, 11 patients lost to follow-up. Of the available data (54 patients), 96.3% of the patients had a resolution of type 2 diabetes by 12 months with a mean A1C reduction from 7.8 ± 1.6 to 5.3 ± 0.7. Additionally, there were reductions in hyperlipidemia, sleep apnea, and hypertension at 12 months. Patient gastroesophageal reflux disease satisfaction and quality of life (SF-36) scores were significantly higher at 12 months post-procedure (P < 0.001 in all cases) while 12-month protein levels remained at normal values. There were abnormalities of parathyroid hormone and vitamin D at 1 year with all other nutritional markers being not significantly different at 1 year from baseline. There were 10, IIIb, or greater complications according to the Clavien-Dindo scoring system during the study period, not all of which were related to the surgery.

Conclusions

SADS is a highly efficacious weight loss procedure with significant comorbidity reduction at 1 year. At 1 year, complications and vitamin and mineral deficits appear to be consistent with other malabsorption operations. Long-term follow-up is needed, especially around complications and vitamin deficiencies.

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Title: Single Anastomosis Duodenal Switch: 1-Year Outcomes
Authors: Daniel Cottam
Mitchell Roslin
Paul Enochs
Matthew Metz
Dana Portenier
Dennis Smith
Publication date: 01-04-2020
Publisher: Springer US
Keywords: Sleep Apnea
Type 2 Diabetes
Published in: Obesity Surgery / Issue 4/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-019-04352-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Single Anastomosis Duodenal Switch: 1-Year Outcomes

Abstract

Introduction

Purpose

Setting

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Purpose

Setting

Methods

Results

Conclusions

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