Based on Propensity Matching Scores: Comparison of the Mid-term Outcomes of Two Bariatric Surgeries for the Treatment of Obesity and its Complications

BACKGROUND: To compare the mid-term efficacy and postoperative complications of two common bariatric procedures-single anastomotic duodeno-ileal bypass with sleeve gastrectomy (SADI-S) and sleeve gastrectomy (SG)-in treating obesity and metabolic syndrome. METHODS: Data from 186 patients undergoing SADI-S or SG between September 2013 and October 2021 were retrospectively analyzed. Propensity score matching (PSM) was applied in a 1:1 ratio, resulting in 78 patients included in the final analysis (39 per group). Differences between groups were compared regarding weight loss outcomes (weight, BMI, waist circumference, waist-to-height ratio, %TWL, %EWL), metabolic syndrome remission rates (diabetes, hypertension, hyperuricemia, dyslipidemia, fatty liver), and postoperative complications (bone density abnormalities, anemia, gallstones). RESULTS: Following matching, the SADI-S group achieved significantly greater weight loss (P < 0.05), particularly in %TWL and %EWL. Additionally, the SADI-S group exhibited greater efficacy in metabolic syndrome remission (diabetes, hypertension, dyslipidemia). However, the SADI-S group showed a higher incidence of postoperative bone mineral density abnormalities (P < 0.05) and more severe anemia compared to the SG group. CONCLUSION: While SADI-S demonstrates superior weight loss and metabolic disease remission, SG may be preferable for patients with concurrent bone density issues,a higher risk of anemia,or nutritional deficiencies. Further optimization of postoperative management is recommended to reduce these complications.