Sleeve gastrectomy with transit bipartition in a series of 883 patients with mild obesity: early effectiveness and safety outcomes

Surg Endosc. 2022 Apr;36(4):2631-2642. doi: 10.1007/s00464-021-08769-4. Epub 2021 Oct 20.

Abstract

Background: At least 25 metabolic/bariatric procedures have been proposed globally, 5 formally endorsed. A newer procedure, sleeve gastrectomy with transit bipartition (SG + TB), appears to markedly reduce weight and improve metabolic syndrome while being relatively simple technically and protective of long-term nutritional stability. We aimed to investigate SG + TB effectiveness and safety.

Methods: In a single-center retrospective analysis of prospectively collected data, SG + TB patients were followed through 12 months. Primary outcomes were changes in weight [body mass index (BMI), total weight loss (TWL)], metabolic parameters [HbA1C, LDL cholesterol, triglycerides (TG), hypertension], and nutritional status. Repeated-measures analysis of variance (ANOVA) was used to assess changes in weight and metabolic parameters at 1, 3, 6, 9, and 12 months after surgery.

Results: Between 2015 and 2019, 883 patients (mean age 51.8 yrs, BMI 34.1 ± 5.0 kg/m2) underwent SG + TB. Mean operative time was 124 ± 25.4 min; hospitalization, 4.0 ± 2.5 days. ANOVA indicated significant reductions in weight and metabolic parameters (p < 0.005). In 646 patients with complete weight data at 12 months, mean BMI was reduced to 27.2 ± 3.4 kg/m2 (p < 0.001), TWL 19.8 ± 6.0%. HbA1C was normalized in 83.3% of SG + TB patients; hyperlipidemia, hypertension, and hypertriglyceridemia were significantly reduced (p < 0.001). Also, there was a significant reduction in the proportion of patients outside normal nutritional reference ranges. The overall complication rate was 10.2%. There was no mortality.

Conclusion: In a series of 833 lower-BMI patients who underwent SG + TB and were followed through 12 months (73.2% follow-up), significant weight loss, comorbidity reduction, and nutritional stability were attained with few major complications and no mortality.

Keywords: Bariatric surgery; Obesity; SG + TB; T2DM; Transit bipartition; Type 2 diabetes.

MeSH terms

  • Diabetes Mellitus, Type 2* / complications
  • Gastrectomy / adverse effects
  • Gastrectomy / methods
  • Gastric Bypass*
  • Glycated Hemoglobin
  • Humans
  • Hypertension* / complications
  • Laparoscopy* / methods
  • Middle Aged
  • Obesity, Morbid* / complications
  • Obesity, Morbid* / surgery
  • Retrospective Studies
  • Treatment Outcome
  • Weight Loss

Substances

  • Glycated Hemoglobin A