IBC-Oxford University2023_BJSOral_19Prospective Non-Randomized Study comparing the outcomes of Single Anastomosis Sleeve Jejunal Bypass (SASJ) with One Anastomosis Gastric Bypass (OAGB)

Abstract

Abstract Background Single anastomosis Sleeve Jejunal Bypass (SASJ) is a relatively new bariatric/metabolic procedure. It is the single anastomosis modification of the Sleeve Gastrectomy with Bipartition operation developed by Santoro in 2012. Few studies have been published on its efficacy and safety, and fewer studies have been performed comparing its outcome with recognized bariatric procedures. Patients and Methods This is a prospective nonrandomized comparative study. Eighty patients were included in the study, 40 patients underwent SASJ and 40 underwent OAGB, in Ain Shams University Hospitals over 12 months between June 2021 and June 2022. Patients were followed up for at least one year. Both groups are compared for operative time, complications, costs, postoperative weight loss, resolution of co-morbidities, and complications. Results The one year follow up was completed by 34 patients in the SASJ group, and 38 patients in the OAGB group. The difference in operative time was not statistically significant. Intraoperative bleeding occurred in 3 cases in the OAGB group, one was successfully managed by conservative management and 2 required re-laparoscopy for successful control of bleeding. No leakage occurred in both groups. There was no statistically significant difference in EWL%, as it was 68.6 % ± 7.2 one year after SASJ and 71.3 % ± 5.7 % after OAGB. TWL% was 35.9 % ± 4.2 one year after SASJ and 36.2 % ± 3.8 % after OAGB, with no statistical difference. T2 DM resolution took place in 100% of patients after both procedures. However, bile reflux was higher after SASJ (17.6%, 6/34 patients), as compared to OAGB (13.2 %, 5/38 patients), yet statistically, the difference was not significant. Conclusion SASJ is an effective and safe bariatric/metabolic operation. Its outcome is comparable to that of OAGB. It deserves further study.