SADI-S and RYGB are both powerful bariatric operations with different complication profiles. Maintenance of the pylorus and duodeno-ileal anastomosis in SADI-S may ameliorate some of the known complications with gastrojejunal anastomosis in RYGB. We aim to capture some of these complications by comparing GIQOL between patients who underwent SADI-S and RYGB.
A matched retrospective cohort study was performed across two centres on patients who underwent SADI-S and RYGB between 2017 and 2018. Gastrointestinal quality of life index(GIQLI), Short Form-12(SF12v2) and Sigstad dumping questionnaire were surveyed across all matched patients in their second postoperative year. % excess weight loss(EWL) and complications were also analysed. Non-parametric quantitative data were analysed with Wilcoxon-Mann-Whitney test.
Out of 140 patients surveyed, the first 50 patients in each group responding to the survey were included (response rate 77%). There were no significant differences in age(p=0.54), gender(p=0.45), initial body mass index(p=0.54) and revisional surgery rate(p=0.99) between the two groups. The median GIQLI total score was significantly higher in the SADI-S group indicating better GIQOL compared to RYGB (SADI-S:110[101,119];RYGB:104[84, 111],p=0.004). Based on SF-12v2, SADI-S group had a higher mental component summary score than RYGB (SADI-S:51[41,56];RYGB:45[36,51],p=0.02), with no difference in physical component summary score between groups (SADI-S:53[46,57];RYGB:52[39,56],p=0.17). Based on a Sigstad score >7, the number of patients with dumping syndrome was significantly lower in the SADI-S group compared to RYGB (SADI-S:4(8%);RYGB:15(30%),p=0.009). % EWL at 18 months (SADI-S:75.9%[70.7, 90.4];RYGB:69.4%[56.5,81.4],p=0.29) and rate of complications (SADI-S:7(14%);RYGB:14(28%),p=0.14) were not significantly different between these two groups.
GIQOL in the second-year post-surgery was better in patients who underwent SADI-S compared to RYGB based on a small cohort study. Notably, SADI-S patients were found to have less anastomotic ulcers, strictures, internal hernias and dumping symptoms which could relate to preservation of the pylorus. Larger, multicentre, long-term studies are required to validate findings.