Background

Single Anastomosis Duodeno-Ileostomy with Sleeve Gastrectomy (SADI-S) is a relatively recent bariatric and metabolic surgical procedure. However, limited comparative data exists regarding its efficacy compared to Roux-en-Y Gastric Bypass (RYGB) and One Anastomosis Gastric Bypass (OAGB) as both primary and revisional bariatric surgeries subsequent to sleeve gastrectomy (SG).

Methods

A systematic literature review was conducted following PRISMA guidelines. The random effects model was employed, utilizing odds ratio for dichotomous data and mean difference for continuous data as effect size metrics.

Results

Compared to RYGB: SADI-S showed significantly higher Total Weight Loss Percentage (TWL%) at 12, 24, 36, and 60 months. The incidence of internal hernias and vitamin B12 deficiency was significantly lower in the SADI-S group. No significant differences were observed in Length of Stay (LOS), readmissions, vitamin D levels, leaks, bleeding, or reoperations.Compared to OAGB: SADI-S demonstrated significantly higher TWL% and Excess Weight Loss Percentage (EWL%) at 12 and 24 months, along with a longer LOS. The incidence of bile reflux was significantly lower in the SADI-S group. No significant differences were observed in steatorrhea, leaks, or marginal and anastomotic ulcers.

Conclusions

SADI-S exhibits a superior weight loss profile compared to RYGB and OAGB. Furthermore, compared to RYGB, SADI-S may reduce the incidence of internal hernias and vitamin B12 deficiency. However, compared to OAGB, SADI-S might decrease bile reflux while increasing LOS.