Single anastomosis plication ileal (SAPI) bypass in the treatment of obesity – 1-year results

Abstract

Objectives Laparoscopic single anastomosis plication ileal (SAPI) bypass is a novel bariatric procedure. Few studies have presented early or intermediate results. The aim of this prospective study was to investigate early results after SAPI Bypass. Materials and Methods Between May 2019 and March 2020, 47 patients underwent SAPI bipartition (laparoscopic gastric greater curvature plication and handsewn gastroileal anastomosis 300 cm from caecum) and were followed up to 1 year after operation. Demographics, comorbidities, complications, and percentage of excess body mass index loss (%EBMIL) were analyzed. Results Forty-two women and 5 men with an average age of 45.8 ± 11.5 years and preoperative BMI of 41.9 ± 4.5 underwent SAPI Bypass. Average operation time was 99.3 ± 18.8 min. Fifteen patients had additional gastrofundoplication and 7 had only cruroplasty. Average hospital stays 2.5 ± 0.9 days. Postoperative complications rate - 4.3 % (2 patients), bleeding from gastroileal anastomosis, treated conservatively. Follow-up rate was 93.6 % after 1 year. Average %EBMIL after 1 month was 26.15 ± 9.11, 56.89 ± 16.54 after 6 months, and 63.81 ± 22.9 after 1 year. Preoperatively GERD was present in 44.7 % of patients. Prevalence of GERD 1 year after operation was 23.4 %. Remission rate of type 2 diabetes mellitus and hypertension were 54.5 % and 62.5 %, respectively. Conclusions Early results after SAPI Bypass is comparable to the results achieved by other weight loss surgery. Long-term follow-up data are needed to define the role of SAPI Bypass in the treatment of morbid obesity.