背景:单吻合术袖状回肠(SASI)搭桥术是一种新的减肥手术,与Santoro方法的适应相对应,包括袖状胃切除术(SG),然后进行环形胃回肠造口术。因此,我们旨在从安全性方面系统地评估所有关于SASI旁路的现有文献,减肥,相关合并症的改善,和并发症。
方法:遵循系统审查和元分析(PRISMA)建议的首选报告项目,我们通过搜索三个数据库(PubMed,Scopus,和WebofScience)。我们进行了风险比和平均差异的荟萃分析,以比较过度体重减轻的手术方法,2型糖尿病(T2DM)的改善/缓解,高血压(HT),血脂异常(DL),阻塞性睡眠呼吸暂停(OSA)和并发症。使用I2统计量评估异质性。
结果:18项研究纳入定性分析,4项纳入定量分析,比较SASI旁路术与SG和一次吻合胃旁路术(OAGB)。无法进行Roux-en-Y胃旁路术(RYGB)和SASI旁路术之间的比较。与SG相比,SASI旁路与改善的体重减轻相关(MD=11.32;95%置信区间(95CI)[7.89;14.76];p<0.0001),和改善或缓解T2DM(RR=1.35;95CI[1.07;1.69];p=0.011),DL(RR=1.41;95CI[1.00;1.99];p=0.048)和OSA(RR=1.50;95CI[1.01;2.22];p=0.042)。与OAGB相比,任何评估结果均未观察到统计学上的显着差异。与SG和OAGB相比,SASI的并发症发生率相似。
结论:尽管需要更长的随访时间的研究,本系统综述和荟萃分析显示,SASI旁路术对体重减轻和代谢变量有显著影响.研究之间结果的差异加强了标准化的必要性。
BACKGROUND: The Single Anastomosis Sleeve Ileal (SASI) bypass is a new bariatric surgery corresponding to an adaptation of the Santoro approach, consisting of a sleeve gastrectomy (SG) followed by loop gastroileostomy. Therefore, we aimed to systematically assess all the current literature on SASI bypass in terms of safety, weight loss, improvement in associated comorbidities, and complications.
METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) recommendations, we conducted a systematic
review and meta-analysis by searching three databases (PubMed, Scopus, and Web of Science). We performed a meta-analysis of risk ratios and mean differences to compare surgical approaches for excessive weight loss, improvement/remission in type 2 diabetes mellitus (T2DM), hypertension (HT), dyslipidemia (DL), obstructive sleep apnea (OSA), and complications. Heterogeneity was assessed using the I2 statistic.
RESULTS: Eighteen studies were included in the qualitative analysis and four in the quantitative analysis, comparing SASI bypass with SG and One-Anastomosis Gastric Bypass (OAGB). A comparison between Roux-en-Y Gastric Bypass (RYGB) and SASI bypass could not be performed. Compared to SG, the SASI bypass was associated with improved weight loss (MD = 11.32; 95% confidence interval (95%CI) [7.89;14.76]; p < 0.0001), and improvement or remission in T2DM (RR = 1.35; 95%CI [1.07;1.69]; p = 0.011), DL (RR = 1.41; 95%CI [1.00;1.99]; p = 0.048) and OSA (RR = 1.50; 95%CI [1.01;2.22]; p = 0.042). No statistically significant differences in any of the assessed outcomes were observed when compared with OAGB. When compared to both SG and OAGB, the complication rate of SASI was similar.
CONCLUSIONS: Although studies with longer follow-up periods are needed, this systematic
review and meta-analysis showed that SASI bypass has a significant effect on weight loss and metabolic variables. Variations in outcomes between studies reinforce the need for standardization.