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The aims of this study were to compare mid-term outcomes up to 5\u00a0years after primary vs secondary SADI-S and between different common channel (CC) lengths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Multicenter retrospective cohort study including 103 patients who underwent SADI-S between 06\u20132015 and 02\u20132019. Outcomes on weight loss, nutrient status, health-related quality of life (HRQoL) and gastro-intestinal symptoms until 5\u00a0years postoperatively were evaluated and compared between primary (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200919) vs secondary SADI-S (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200984), and CC length\u2009\u2264\u2009250\u00a0cm (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200966,) vs\u2009&gt;\u2009250\u00a0cm (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200933).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean total weight loss (TWL) at 5\u00a0years of follow-up was higher for patients who underwent primary SADI-S compared to secondary SADI-S (34.8 (29.8\u201339.9)% vs 15.9 (13.0\u201318.9)%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and for CC length\u2009\u2264\u2009250\u00a0cm compared to\u2009&gt;\u2009250\u00a0cm (25.3 (21.8\u201328.9)% vs 21.3 (17.2\u201325.4)%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.12). Patients who underwent primary SADI-S also had significantly higher scores on the domains of the BODY-Q HRQoL questionnaire (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 for all), with the exception of sexual well-being. Nutrient status and gastro-intestinal symptoms were comparable between the indication groups, but CC length\u2009\u2264\u2009250\u00a0cm tended to result in more nutrient deficiencies and higher defecation frequency.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both primary and secondary SADI-S result in durable weight loss outcomes up to 5\u00a0years postoperatively. It is imperative that CC length should be at least 250\u00a0cm to prevent malnutrition and\u00a0gastro-intestinal complaints. Furthermore, focus on HRQoL is essential in future research into SADI-S.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s11695-025-07888-4","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T04:13:31Z","timestamp":1746764011000},"page":"2160-2173","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Five year outcomes of primary and secondary Single-Anastomosis Duodeno-Ileal bypass with Sleeve gastrectomy (SADI-S)"],"prefix":"10.1007","volume":"35","author":[{"given":"Mitchell J. 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