Background

Sleeve gastrectomy (SG) is effective and versatile, but weight recidivism or insufficient loss is up to 30%. SADI is a safe, reproducible, and effective solution. Aim. Evaluate the results of an international multicenter series of SADI as a rescue for SG.

Methods

Retrospective survey for patients converted to SADI from SG Data from SG, and SADI were collected. Weight loss and safety were the main variables.

Results

5 centers from Spain, Portugal and United States participated. 141 cases were collected, 65.6% women, mean age of 42.28 (18-63) at the time of SG. Initial BMI was 51.65kg/m2 (SD 9.13, range 36.57 to 89.35). Time interval was 39.11 months (SD 27.35, range 3 to 111). BMI at conversion was 39.93kg/m2 (SD 7.37, range 21.04 to 63.91). TWL after 60 months of SADI was 32.26% (SD 12.02) and BMI 34.33kg/m2 (SD 5.77). Time interval between procedures did not present an any influence weight loss on an overall view, and neither after stratifying it by quartiles. When we put all cases in a continuous timeline from SG to SADI, we observe up to 10 years follow-up and final BMI and TWL (32.92kg/m2 ± 6.42 and 33.56% ± 10.49, respectively) equivalent to primary SADI-S. Overall major morbidity was below 1.5% and there was no mortality.

Conclusions

SADI as a rescue of SG is safe and effective procedure. Time interval does not seem to have any influence in final weight loss. Second step SADI seems to behave same way as primary procedures.