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Updated: Jan 9, 2026
Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy Model in Mice
Published on: February 10, 2023
Single anastomosis sleeve ileal (SASI) bypass outcomes and complications: single-arm meta-analysis
Josélio Rodrigues de Oliveira Filho1,2, Pedro Bicudo Bregion3, Rafaela Hamada Juca3
1Department of Surgery, Massachusetts General Hospital (MGH), Boston, USA. jrodriguesdeoliveirafilho@mgh.harvard.edu.
Background:
Single Anastomosis Sleeve Ileal (SASI) bypass combines sleeve gastrectomy with a single anastomosis to the ileum, preserving digestive continuity to reduce deficiencies while treating obesity-related conditions.
Methods:
This study systematically reviewed SASI bypass outcomes and conducted a single-arm meta-analysis to assess its efficacy and safety. A comprehensive literature search across PubMed, Scopus, Embase, and Cochrane databases initially identified 387 articles, with 38 studies meeting inclusion criteria, contributing data on a maximum of 2,555 patients. Follow-up ranged from 6 to 60 months.
Results:
Meta-analysis showed significant weight loss, with pooled Excess Weight Loss Percentage (EWL%) of 63.07% at 6 months, 82.44% at 12 months, and 93.21% at 24 months. The procedure demonstrated high remission rates for obesity-related conditions, including diabetes (92.67%), hypertension (79.06%), dyslipidemia (82.64%), gastroesophageal reflux disease (GERD) (81.63%), and obstructive sleep apnea (OSA) (81.04%). Postoperative complications were classified using the Clavien-Dindo grading system, with an overall mean complication rate of 13.70%. Mild complications (Grades I-II) accounted for 7.74%, while severe complications (Grades III-IV) had a mean rate of 5.18%. No deaths were reported.
Conclusions:
These findings suggest SASI bypass is a highly effective metabolic and bariatric procedure, achieving substantial weight loss and high remission rates for multiple obesity-related conditions. Given its efficacy, SASI may benefit patients with higher body mass index (BMI) and multiple obesity-associated medical conditions. While most complications are mild and severe ones infrequent, further comparative studies are needed to establish its advantages over other bariatric techniques.
