Abstract：
CONCLUSIONS: SADIS with short common limb (< 250 cm) is a malabsorptive operation. Reoperation is advised in patients requiring admission for severe malnutrition. Elongation of the common channel is the preferred revisional technique Introduction: Single-Anastomosis Duodeno-Ileal bypass with Sleeve gastrectomy (SADI-S) is a modification of the duodenal switch. Initial common channel\'s length was 200, and after malnutrition was detected in some patients, it was elongated to 250 or 300 cm. The present study analyzes presentation and treatment of malnutrition after SADI-S.
METHODS: Three hundred and thirty-three consecutive patients undergoing SADI-S between May 2007 and February 2019 were included. The common limb length was 200 cm in 50 cases, 250 cm in 211, 300 in 71 and 350 in 1. Thirty-one patients were admitted for severe hypoalbuminemia and 17 patients were submitted to revisional surgery, and constitute the series of our study. Mean weight before reoperation was 57 kg and mean body mass index (BMI) was 21 kg/m2. Mean number of daily bowel movements was 5,6.
RESULTS: Mean time to reoperation was 56 months. The limb was found shorter than expected in 6 cases. Revisional surgery was conversion into a Roux en Y duodenal switch in 3 cases, elongation of the common limb in 11 patients, duodeno-duodenostomy in 1 and duodeno-jejunostomy to the first jejunal loop in 2. Mean weight regain was 14 kg, and mean final BMI 26 kg/m2. Daily bowel movements were reduced to 1,3. Factors related to hypoalbuminemia were hypertension, poor-controlled diabetes, shorter common limb and liver-test alterations.
CONCLUSIONS: SADI-S is expected to be less malabsorptive than previous biliopancreatic diversions. However, caution must be taken with certain patients to avoid postoperative malnutrition. Adequate follow up with long-term supplementation is required.
METHODS: Three hundred and thirty-three consecutive patients undergoing SADI-S between May 2007 and February 2019 were included. The common limb length was 200 cm in 50 cases, 250 cm in 211, 300 in 71 and 350 in 1. Thirty-one patients were admitted for severe hypoalbuminemia and 17 patients were submitted to revisional surgery, and constitute the series of our study. Mean weight before reoperation was 57 kg and mean body mass index (BMI) was 21 kg/m2. Mean number of daily bowel movements was 5,6.
RESULTS: Mean time to reoperation was 56 months. The limb was found shorter than expected in 6 cases. Revisional surgery was conversion into a Roux en Y duodenal switch in 3 cases, elongation of the common limb in 11 patients, duodeno-duodenostomy in 1 and duodeno-jejunostomy to the first jejunal loop in 2. Mean weight regain was 14 kg, and mean final BMI 26 kg/m2. Daily bowel movements were reduced to 1,3. Factors related to hypoalbuminemia were hypertension, poor-controlled diabetes, shorter common limb and liver-test alterations.
CONCLUSIONS: SADI-S is expected to be less malabsorptive than previous biliopancreatic diversions. However, caution must be taken with certain patients to avoid postoperative malnutrition. Adequate follow up with long-term supplementation is required.
摘要：
结论：SADIS伴短肢（<250cm）是一种吸收不良手术。对于因严重营养不良而需要入院的患者，建议再次手术。常见通道的延长是首选的修订技术简介：袖状胃切除术（SADI-S）的单吻合术十二指肠回肠旁路术是十二指肠开关的一种改进。最初的公共通道长度为200，在一些患者中发现营养不良后，它被拉长到250或300厘米。本研究分析了SADI-S后营养不良的表现和治疗。
方法：纳入了2007年5月至2019年2月期间接受SADI-S治疗的33例连续患者。50例常见肢体长度为200cm，250cm中的211、300中的71和350中的1。31名患者因严重低蛋白血症入院，17名患者接受了修正性手术，构成了我们研究的系列。再次手术前的平均体重为57kg，平均体重指数（BMI）为21kg/m2。平均每日排便次数为5,6。
结果：平均再手术时间为56个月。在6例中发现肢体比预期的短。3例修正手术转换为RouxenY十二指肠开关，11例患者的共同肢体伸长，十二指肠-十二指肠造口术为1，十二指肠-空肠造口术为2。平均体重恢复为14公斤，和平均最终BMI26kg/m2。每日排便减少到1,3。与低蛋白血症相关的因素是高血压，控制不良的糖尿病，较短的普通肢体和肝脏测试改变。
结论：SADI-S的吸收不良预期比以前的胆胰脏转移少。然而,必须谨慎对待某些患者，以避免术后营养不良。需要长期补充足够的随访。
方法：纳入了2007年5月至2019年2月期间接受SADI-S治疗的33例连续患者。50例常见肢体长度为200cm，250cm中的211、300中的71和350中的1。31名患者因严重低蛋白血症入院，17名患者接受了修正性手术，构成了我们研究的系列。再次手术前的平均体重为57kg，平均体重指数（BMI）为21kg/m2。平均每日排便次数为5,6。
结果：平均再手术时间为56个月。在6例中发现肢体比预期的短。3例修正手术转换为RouxenY十二指肠开关，11例患者的共同肢体伸长，十二指肠-十二指肠造口术为1，十二指肠-空肠造口术为2。平均体重恢复为14公斤，和平均最终BMI26kg/m2。每日排便减少到1,3。与低蛋白血症相关的因素是高血压，控制不良的糖尿病，较短的普通肢体和肝脏测试改变。
结论：SADI-S的吸收不良预期比以前的胆胰脏转移少。然而,必须谨慎对待某些患者，以避免术后营养不良。需要长期补充足够的随访。
