Laparoscopic SADI-S versus OAGB as Revisional Procedures after Failed Sleeve Gastrectomy; Comparative Study after 2 Years of Follow up

Abstract

Background: Sleeve gastrectomy has taken the upper hand as a bariatric surgery. Unfortunately, the procedure has high rate of weight regain. Yet, the lack of standard revisional surgery is driving the bariatric surgery community to compare different procedures to help find the most convenient one.Objectives: The present study aims to compare SADI-S and OAGB as redo surgeries after failed sleeve gastrectomy in morbidly obese patients as regard short term outcome including intra and early postoperative complications; and outcome at 2 years follow up including weight loss and maintenance, resolution of preoperative comorbidities andpostoperative malnutrition.Patients and methods: This is a prospective randomized study that started on January 2018 till June 2022. The study included fifty morbidly obese patients who had previously undergone successful sleeve gastrectomy followed by failure due to weight regain. Patients were randomly divided into 2 groups; group A that included 25 patients who underwent SADI-S and group B that included 25 patients who underwent OAGB. Patients were operated from 2018 to 2020 and followed up for at least 2 years.Results: SADI-S has a significantly longer operative time than OAGB. Yet, both procedures have comparable results as regard weight loss, resolution of preoperative comorbidities and postoperative nutritional outcome.Conclusion: Both SADI-S and OAGB are effective revisional procedures after failed sleeve gastrectomy on shorttermand after 2 years follow up. Yet, multicenter studies a with large series of patients and long term follow up are needed for better assessment of both procedures.