Abstract Introduction The SADI procedure represents one of the recent approaches to metabolic and bariatric surgery, which provides excellent weight reduction and improvement of obesity related diseases. The purpose of this study was to evaluate the 6-year outcomes of the SADI-S procedure in a single center. Methods Data were collected retrospectively for patients who underwent SADI from June 2018 to October 2024, including primary (one-stage), staged, and conversional cases after prior metabolic and bariatric procedures (sleeve gastrectomy, gastric band, or vertical banded gastroplasty) or gastric balloon. The data included in this study were the BMI Pre and Post SADI, total body weight loss (TBWL), excess weight loss (EWL), gastrointestinal reflux effect with GERD-Health Related Quality of Life Questionnaire (GERD-HRQL) score assessment, nutritional status, improvement or resolution of obesity related diseases, and perioperative adverse events. Results A total of 27 (18 female, 9 male) patients were operated. The patients showed successful weight reduction (BMI 53.4 ± 10.6 kg/m2 to BMI 33.4 ± 6.9 kg/m2, P 0.0000). Three patients with diabetes type II had complete resolution (pre op HgA1c 7.1 ± 0.71%, post op HgA1c 5.1 ± 0.53%). Hypertension was resolved in two patients, and one patient required a single antihypertensive agent. Complete resolution of obstructive sleep apnea was observed in both patients (7.1%). Although four patients developed iron deficiency anemia in 4/27 (14.8%), 8patients (29.6%) showed improvement of hemoglobin levels (1 g/dL). Hypoalbuminemia occurred in 3 patients (11.1%). GERD-HRQL decreased by ∼67% postoperatively (pre op GERD-HRQL 13.8 ± 16.8, post op GERD-HRQL 4.6 ± 6.4, P = 0.02). There was zero procedure related mortality, reoperation or readmission. Conclusion The SADI is a safe and highly effective procedure for patients with extreme obesity in well-selected and compliant patients. Continuous monitoring and supplementation are required to prevent malnutrition. Long- term follow up is essential to assess the effects on cardiovascular outcomes, cancer risk, and obesity-related mortality.
Alayed et al. (Thu,) studied this question.