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Abstract

Background: The single anastomosis sleeve ileal (SASI) bypass is a novel metabolic/bariatric surgery operation based on mini gastric bypass operation and Santoro's operation in which a sleeve gastrectomy is followed by a side to side gastro-ileal anastomosis. Objectives: The purpose of this study is to report 2 years follow up of the outcomes of SASI bypass as a therapeutic option for obese T2DM patients. Methods: 120 obese patients with type-2 diabetes underwent laparoscopic SASI bypass with one year follow up. Sleeve gastrectomy performed over a 36-Fr bougie, 6 cm from the pylorus, and 250 cm from the ileocecal valve, the ileum brought to be anastomosis side to side with the antrum. Data collected included comorbidity resolution, percent excess weight loss (%EWL) and one-year morbidity and mortality. Results: The mean BMI of 48.7�±7.6 kg/m2 and mean age 40.5�±7.9 years were operated on percentage EWL reached 90% at one year and all patients have normal glucose level in the first 3 months after surgery. Hypertension remitted in 86%, hypercholesterolemia in 100% and hypertriglyceridemia in 97% of patients. Postoperative complications were; one pulmonary embolism, one postoperative bleeding, one leak from biliary limb and one complete obstruction at the gastro-ileal anastomosis. Six months postoperative, one patient diagnosed as marginal ulcer, 12 months after surgery, one patient re-operated for fear of more excessive weight loss. Conclusion: SASI bypass is a promising operation that offers excellent weight loss and metabolic result.

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