Primary SADI-S in Chinese with Diabetes and BMI < 35 kg/m2: a Retrospective Study with 2-Year Follow-up

Background Single-anastomosis duodeno–ileal bypass with sleeve gastrectomy (SADI-S) is a bariatric procedure based on the standard duodenal switch surgery. It was first introduced in 2007 as a procedure for individuals with clinically severe obesity. Till date, primary SADI-S has not been used on Chinese with diabetes and body mass index (BMI) < 35 kg/m 2 . Objectives Here, we account the use of this novel surgery in Chinese with diabetes and BMI < 35 kg/m 2 . Methods All relevant medical information, involving patients with diabetes and BMI < 35 kg/m 2 , who received primary SADI-S at Beijing Shijitan Hospital from June 2017 to December 2018, was retrospectively assessed. Results Twenty-six patients were selected for evaluation, and all of them completed a 2-year follow-up. The age, diabetic duration, and preoperative BMI were 35.5 (range 20–63) years, 3.5 (range 0.5–18) years, and 34.40 (range 28.74–34.96) kg/m 2 , respectively. At 24 months, the percentage of total body weight loss (%TWL) and BMI were 26.26 (range 13.33–43.88) and 24.72 (range 17.96–29.07) kg/m 2 , respectively. There were no serious complications or sequelae within a 2-year follow-up. In addition, for diabetes, 20/23 people achieved complete remission, whereas 3 achieved partial remission. Conclusion SADI-S is a highly effective and feasible bariatric surgery for Chinese having diabetes and BMI < 35 kg/m 2 . However, care must be taken to follow a strict criteria for patient selection and to monitor patients carefully for the detection of postoperative nutritional sequelae. Graphical abstract