Short and intermediate-term effects of laparoscopic single anastomosis sleeve-jejunal bypass on type 2 diabetic morbidly obese patients.

Abstract

Background: Obesity and its comorbidities are considered one of the major health tolls. Bariatric surgery offers significant and long-lasting weight loss as well as significant enhancements in glycemic management for severely obese individuals with type 2 diabetes mellitus. The single anastomosis sleeve jejunal (SASJ) bypass procedure is a novel form of bariatric surgery, it combines both malabsorptive and restrictive techniques.Aim: To evaluate the efficacy of laparoscopic SASJ bypass as a novel bariatric procedure for managing type 2 diabetesmellitus in morbidly obese patients during the first year following surgery.Patients and Methods: The current combined prospective and retrospective study was conducted at Mansoura University Gastrointestinal Surgical Center from December 2019 to January 2023. A total of 25 patients were included in the study.They were diagnosed clinically with primary morbid obesity with a body mass index (BMI) greater than 35 kg/m2 anddocumented type 2 diabetes mellitus All patients underwent laparoscopic SASJ procedure and were followed-up for 1year after the operation.Results: The SASJ procedure was associated with significant weight loss outcomes, as the % excess weight loss (%EWL) was 26.29, 41.47, 53.33, and 67.52% at 3-, 6, 9-, 12-month follow-up visits, respectively, and % total weight loss(%TWL) values of 19.16, 30.16, 38.76, and 50.71% at the same intervals. Glycated hemoglobin, fasting blood sugar,and postprandial blood sugar showed a significant decrease at the scheduled follow-up visits compared with the baselinevalues. At 1-year follow-up, complete remission, partial remission, and improvement of diabetes were detected in 32, 40,and 28% of cases, respectively.Conclusion: The SASJ is a safe bariatric procedure that is associated with low morbidity rates. Besides excellent weightloss outcomes, it yields a beneficial impact on diabetes.