Single anastomosis sleeve ileal bypass (SASI): a single-center initial report

Introduction
Single anastomosis sleeve ileal (SASI) bypass is a recently introduced bariatric procedure that combines the advantages of restrictive and malabsorptive operations, at the same time reducing the risk of nutrient deficiencies by maintaining passage through all the alimentary tract.

Aim
To present the outcomes of the first group of patients that underwent the SASI bypass in our clinic and assess the safety and efficiency of the procedure.

Material and methods
We analyzed patients qualified for SASI bypass between January 2020 and February 2021. Retrospective analysis was performed and outpatient treatment results were evaluated.

Results
A group of nineteen patients (18 women) underwent SASI bypass. The mean preoperative body mass index was 40.3 ±3.74 kg/m2, mean age: 43.3 ±7.83. The mean excess weight loss (% EWL) after 3, 6, 9 and 12 months of follow-up was 43%, 56%, 72.5%, 88.83% respectively. Remission of obesity related diseases was as followed: hypertension in 8 patients (80%, p < 0.05), type II diabetes in 6 patients (100%, p < 0.05), pre-diabetes in 4 patients (50%, p = 0.13). Complications occurred in 4 cases: hematemesis, dysphagia, diarrhea, short bowel syndrome. A patient who developed symptoms of short bowel syndrome was reoperated on and gastrointestinal anastomosis was disconnected. Postoperatively, unwanted symptoms resolved and a good bariatric effect was preserved.

Conclusions
Our first experience is consistent with that reported in previous studies: very good EWL and a rapid resolution of obesity related diseases after SASI bypass as well as safety of the procedure.