Sleeve Gastrectomy Plus Side-to-Side Jejunoileal Anastomosis for the Treatment of Morbid Obesity and Metabolic Diseases: a Promising Operation
Obesity Surgery, 05/08/2012
Melissas J et al. – Sleeve gastrectomy plus side–to–side jejunoileal anastomosis appears to be a simple, considerably safe, and effective procedure for treating obesity and its metabolic comorbidities.Methods
- Thirty–two patients underwent the novel procedure, sleeve gastrectomy plus side–to–side jejunoileal anastomosis (SG plus), and were followed for 6 to 24 months.
- A matched cohort of 32 patients underwent sleeve gastrectomy over the same period and was used as the control group.
- Weight loss, comorbidity outcomes, and the duodenum to cecum transit time after a gastrografin swallow, performed at postoperative day 4, were compared.
- There were no deaths and no major perioperative complications.
- Three patients developed long–term complications requiring surgical intervention (intestinal obstruction, nausea–vomiting, and hypoalbuminemia).
- In the SG plus group, a 77.8 % excess weight loss was achieved at 12 months postoperatively, which was significantly better (p<0.01) than the 67 % observed in the control group.
- The comorbidity outcomes, particularly diabetes resolution, were also significantly superior in the SG plus patients.
- The duodenum to cecum transit time of 11 min in the SG plus group was significantly shorter (p<0.01) than the 31 min observed in the control group.