{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T05:51:26Z","timestamp":1773899486009,"version":"3.50.1"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T00:00:00Z","timestamp":1721260800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T00:00:00Z","timestamp":1721260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006752","name":"Universidade do Porto","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006752","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Langenbecks Arch Surg"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>The Single Anastomosis Sleeve Ileal (SASI) bypass is a new bariatric surgery corresponding to an adaptation of the Santoro approach, consisting of a sleeve gastrectomy (SG) followed by loop gastroileostomy. Therefore, we aimed to systematically assess all the current literature on SASI bypass in terms of safety, weight loss, improvement in associated comorbidities, and complications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Following the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) recommendations, we conducted a systematic review and meta-analysis by searching three databases (PubMed, Scopus, and Web of Science). We performed a meta-analysis of risk ratios and mean differences to compare surgical approaches for excessive weight loss, improvement\/remission in type 2 diabetes mellitus (T2DM), hypertension (HT), dyslipidemia (DL), obstructive sleep apnea (OSA), and complications. Heterogeneity was assessed using the I<jats:sup>2<\/jats:sup> statistic.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Eighteen studies were included in the qualitative analysis and four in the quantitative analysis, comparing SASI bypass with SG and One-Anastomosis Gastric Bypass (OAGB). A comparison between Roux-en-Y Gastric Bypass (RYGB) and SASI bypass could not be performed. Compared to SG, the SASI bypass was associated with improved weight loss (MD\u2009=\u200911.32; 95% confidence interval (95%CI) [7.89;14.76]; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), and improvement or remission in T2DM (RR\u2009=\u20091.35; 95%CI [1.07;1.69]; <jats:italic>p<\/jats:italic>\u2009=\u20090.011), DL (RR\u2009=\u20091.41; 95%CI [1.00;1.99]; <jats:italic>p<\/jats:italic>\u2009=\u20090.048) and OSA (RR\u2009=\u20091.50; 95%CI [1.01;2.22]; <jats:italic>p<\/jats:italic>\u2009=\u20090.042). No statistically significant differences in any of the assessed outcomes were observed when compared with OAGB. When compared to both SG and OAGB, the complication rate of SASI was similar.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Although studies with longer follow-up periods are needed, this systematic review and meta-analysis showed that SASI bypass has a significant effect on weight loss and metabolic variables. Variations in outcomes between studies reinforce the need for standardization.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00423-024-03413-w","type":"journal-article","created":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T09:01:57Z","timestamp":1721293317000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Efficiency and safety of single anastomosis sleeve ileal (SASI) bypass in the treatment of obesity and associated comorbidities: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"409","author":[{"given":"Carolina Rodrigues","family":"Oliveira","sequence":"first","affiliation":[]},{"given":"Hugo","family":"Santos-Sousa","sequence":"additional","affiliation":[]},{"given":"Maria Pinho","family":"Costa","sequence":"additional","affiliation":[]},{"given":"Filipe","family":"Amorim-Cruz","sequence":"additional","affiliation":[]},{"given":"Raquel","family":"Bou\u00e7a-Machado","sequence":"additional","affiliation":[]},{"given":"Jorge","family":"Nogueiro","sequence":"additional","affiliation":[]},{"given":"Fernando","family":"Resende","sequence":"additional","affiliation":[]},{"given":"Andr\u00e9","family":"Costa-Pinho","sequence":"additional","affiliation":[]},{"given":"John","family":"Preto","sequence":"additional","affiliation":[]},{"given":"Eduardo","family":"Lima-da-Costa","sequence":"additional","affiliation":[]},{"given":"Silvestre","family":"Carneiro","sequence":"additional","affiliation":[]},{"given":"Bernardo","family":"Sousa-Pinto","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2024,7,18]]},"reference":[{"issue":"9945","key":"3413_CR1","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1016\/S0140-6736(14)60460-8","volume":"384","author":"M Ng","year":"2014","unstructured":"Ng M et al (2014) Global, regional, and national prevalence of overweight and obesity in children and adults during 1980\u20132013: a systematic analysis for the global burden of Disease Study 2013. Lancet 384(9945):766\u2013781","journal-title":"Lancet"},{"issue":"11","key":"3413_CR2","doi-asserted-by":"publisher","first-page":"1844","DOI":"10.1161\/CIRCRESAHA.116.307591","volume":"118","author":"BM Wolfe","year":"2016","unstructured":"Wolfe BM, Kvach E, Eckel RH (2016) Treat Obes Circulation Res 118(11):1844\u20131855","journal-title":"Treat Obes Circulation Res"},{"issue":"12","key":"3413_CR3","doi-asserted-by":"publisher","first-page":"3783","DOI":"10.1007\/s11695-018-3450-2","volume":"28","author":"L Angrisani","year":"2018","unstructured":"Angrisani L et al (2018) IFSO Worldwide Survey 2016: primary, endoluminal, and Revisional procedures. Obes Surg 28(12):3783\u20133794","journal-title":"Obes Surg"},{"issue":"2","key":"3413_CR4","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/j.ijscr.2013.12.002","volume":"5","author":"WL Mui","year":"2014","unstructured":"Mui WL, Lee DW, Lam KK (2014) Laparoscopic sleeve gastrectomy with loop bipartition: a novel metabolic operation in treating obese type II diabetes mellitus. Int J Surg Case Rep 5(2):56\u201358","journal-title":"Int J Surg Case Rep"},{"key":"3413_CR5","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.ijsu.2016.08.018","volume":"34","author":"T Mahdy","year":"2016","unstructured":"Mahdy T, Wahedi AA, Schou C (2016) Efficacy of single anastomosis sleeve ileal (SASI) bypass for type-2 diabetic morbid obese patients: gastric bipartition, a novel metabolic surgery procedure: a retrospective cohort study. Int J Surg 34:28\u201334","journal-title":"Int J Surg"},{"issue":"3","key":"3413_CR6","first-page":"610","volume":"38","author":"OH Khalil","year":"2019","unstructured":"Khalil OH et al (2019) Laparoscopic sleeve gastrectomy with loop bipartition versus laparoscopic sleeve gastrectomy in treating obese people with type II diabetes mellitus: a prospective randomized comparative study. Egypt J Surg 38(3):610\u2013617","journal-title":"Egypt J Surg"},{"issue":"6","key":"3413_CR7","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1097\/SLE.0000000000000541","volume":"28","author":"E Arslan","year":"2018","unstructured":"Arslan E, Sipahi M, Banli O (2018) Early results of laparoscopic sleeve gastrectomy with Loop Bipartition. Surg Laparosc Endosc Percutan Tech 28(6):385\u2013389","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"issue":"11\u201312","key":"3413_CR8","first-page":"504","volume":"102","author":"A Vennapusa","year":"2017","unstructured":"Vennapusa A, Panchangam BRK, Madivada MSS (2017) A feasibility study of Novel Laparoscopic Sleeve Gastrectomy with Loop Gastroileal bypass for obesity. Indian Experience Int Surg 102(11\u201312):504\u2013513","journal-title":"Indian Experience Int Surg"},{"key":"3413_CR9","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.ijso.2019.11.009","volume":"22","author":"MMB Abdulla Ismaeel Mohamed","year":"2020","unstructured":"Abdulla Ismaeel Mohamed MMB (2020) Abdulmenem Yahya Abulsel, Beta Jose, laparoscopic sleeve gastrectomy with transit loop bi-partition: a novel bariatric procedure. Int J Surg Open 22:33\u201337","journal-title":"Int J Surg Open"},{"key":"3413_CR10","doi-asserted-by":"crossref","unstructured":"Page MJ et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Reviews, 10(1)","DOI":"10.1186\/s13643-021-01626-4"},{"key":"3413_CR11","doi-asserted-by":"crossref","unstructured":"Cumpston M et al (2019) Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database of Systematic Reviews","DOI":"10.1002\/14651858.ED000142"},{"key":"3413_CR12","unstructured":"National Heart L, Health IB, NIo H, UDo, Services H Study quality assessment tools. [cited 2023 January, 22]; https:\/\/www.nhlbi.nih.gov\/health-topics\/study-quality-assessment-tools"},{"issue":"oct18 2","key":"3413_CR13","doi-asserted-by":"publisher","first-page":"d5928","DOI":"10.1136\/bmj.d5928","volume":"343","author":"JPT Higgins","year":"2011","unstructured":"Higgins JPT et al (2011) The Cochrane collaboration\u2019s tool for assessing risk of bias in randomised trials. BMJ 343(oct18 2):d5928\u2013d5928","journal-title":"BMJ"},{"key":"3413_CR14","doi-asserted-by":"crossref","unstructured":"Hosseini SV et al (2022) Optimal length of Biliopancreatic Limb in single anastomosis sleeve gastrointestinal bypass for treatment of severe obesity: efficacy and concerns. Obesity Surgery","DOI":"10.1007\/s11695-022-06107-8"},{"issue":"11","key":"3413_CR15","doi-asserted-by":"publisher","first-page":"2744","DOI":"10.1007\/s00268-022-06706-7","volume":"46","author":"SV Hosseini","year":"2022","unstructured":"Hosseini SV et al (2022) The effect of single-anastomosis sleeve ileal (SASI) bypass on patients with severe obesity in three consecutive years. World J Surg 46(11):2744\u20132750","journal-title":"World J Surg"},{"issue":"2","key":"3413_CR16","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1007\/s00464-020-07430-w","volume":"35","author":"SH Emile","year":"2021","unstructured":"Emile SH et al (2021) Single anastomosis sleeve ileal (SASI) bypass versus sleeve gastrectomy: a case-matched multicenter study. Surg Endosc 35(2):652\u2013660","journal-title":"Surg Endosc"},{"issue":"8","key":"3413_CR17","doi-asserted-by":"publisher","first-page":"3615","DOI":"10.1007\/s11695-021-05457-z","volume":"31","author":"T Mahdy","year":"2021","unstructured":"Mahdy T et al (2021) Roux-en-Y gastric bypass with long biliopancreatic limb compared to single anastomosis sleeve ileal (SASI) bypass in treatment of morbid obesity. Obes Surg 31(8):3615\u20133622","journal-title":"Obes Surg"},{"issue":"3","key":"3413_CR18","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1007\/s11695-019-04296-3","volume":"30","author":"T Mahdy","year":"2020","unstructured":"Mahdy T et al (2020) Evaluation of the efficacy of single anastomosis sleeve ileal (SASI) bypass for patients with morbid obesity: a Multicenter Study. Obes Surg 30(3):837\u2013845","journal-title":"Obes Surg"},{"issue":"4","key":"3413_CR19","doi-asserted-by":"publisher","first-page":"1579","DOI":"10.1007\/s11695-020-05159-y","volume":"31","author":"T Mahdy","year":"2021","unstructured":"Mahdy T et al (2021) Sleeve gastrectomy, one-anastomosis gastric bypass (OAGB), and single anastomosis sleeve ileal (SASI) bypass in treatment of morbid obesity: a Retrospective Cohort Study. Obes Surg 31(4):1579\u20131589","journal-title":"Obes Surg"},{"issue":"2","key":"3413_CR20","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1007\/s11695-020-04945-y","volume":"31","author":"M Khalaf","year":"2021","unstructured":"Khalaf M, Hamed H (2021) Single-anastomosis sleeve ileal (SASI) bypass: hopes and concerns after a two-year follow-up. Obes Surg 31(2):667\u2013674","journal-title":"Obes Surg"},{"issue":"2","key":"3413_CR21","doi-asserted-by":"publisher","first-page":"365","DOI":"10.5114\/wiitm.2022.114943","volume":"17","author":"W Tarnowski","year":"2022","unstructured":"Tarnowski W et al (2022) Single anastomosis sleeve ileal bypass (SASI): a single-center initial report. Videosurgery Other Miniinvasive Techniques 17(2):365\u2013371","journal-title":"Videosurgery Other Miniinvasive Techniques"},{"issue":"11","key":"3413_CR22","doi-asserted-by":"publisher","first-page":"4286","DOI":"10.1007\/s11695-020-04781-0","volume":"30","author":"M Kermansaravi","year":"2020","unstructured":"Kermansaravi M, Kabir A, Pazouki A (2020) 1-Year follow-up of single anastomosis sleeve ileal (SASI) Bypass in Morbid obese patients: efficacy and concerns. Obes Surg 30(11):4286\u20134292","journal-title":"Obes Surg"},{"issue":"5","key":"3413_CR23","doi-asserted-by":"publisher","first-page":"2339","DOI":"10.1007\/s11695-020-05145-4","volume":"31","author":"RJ Romero","year":"2021","unstructured":"Romero RJ et al (2021) Single anastomosis sleeve Ileal Bypass (SASI Bypass): short-term outcomes and concerns. Obes Surg 31(5):2339\u20132343","journal-title":"Obes Surg"},{"issue":"5","key":"3413_CR24","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1080\/08941939.2016.1241841","volume":"30","author":"TMS Salama","year":"2017","unstructured":"Salama TMS, Sabry K, Ghamrini YE (2017) Single anastomosis sleeve Ileal Bypass: New Step in the evolution of bariatric surgeries. J Invest Surg 30(5):291\u2013296","journal-title":"J Invest Surg"},{"issue":"11","key":"3413_CR25","first-page":"112","volume":"16","author":"M Mohamed","year":"2019","unstructured":"Mohamed M, Abouzeid MMH (2019) Mohamed Magdi Abdulaziz and Mootaz ElHusseini, single anastomosis sleeve Ileal Bypass (SASI) for management of obese patients with type 2 diabetes. Life Sci J 16(11):112\u2013120","journal-title":"Life Sci J"},{"issue":"2","key":"3413_CR26","doi-asserted-by":"publisher","first-page":"e13","DOI":"10.1097\/SLE.0000000000000763","volume":"30","author":"A Madyan","year":"2020","unstructured":"Madyan A et al (2020) Laparoscopic single anastomosis sleeve ileal (SASI) bypass for patients with morbid obesity: technical description and short-term outcomes. Surg Laparosc Endosc Percutan Tech 30(2):e13\u2013e17","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"key":"3413_CR27","volume-title":"Risk-of-bias VISualization (robvis): an R package and Shiny web app for visualizing risk-of-bias assessments","author":"LA McGuinness","year":"2020","unstructured":"McGuinness LA, Higgins JPT (2020) Risk-of-bias VISualization (robvis): an R package and Shiny web app for visualizing risk-of-bias assessments. Research Synthesis Methods, n\/a(n\/a)"},{"issue":"5","key":"3413_CR28","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1097\/SLE.0000000000000418","volume":"27","author":"SH Emile","year":"2017","unstructured":"Emile SH et al (2017) Laparoscopic sleeve gastrectomy then and now: an updated systematic review of the Progress and short-term outcomes over the last 5 years. Surg Laparosc Endosc Percutan Tech 27(5):307\u2013317","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"issue":"3","key":"3413_CR29","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1381\/096089201321336584","volume":"11","author":"R Rutledge","year":"2001","unstructured":"Rutledge R (2001) The mini-gastric bypass: experience with the First 1,274 cases. Obes Surg 11(3):276\u2013280","journal-title":"Obes Surg"},{"issue":"4","key":"3413_CR30","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1590\/S1516-31802006000400004","volume":"124","author":"S Santoro","year":"2006","unstructured":"Santoro S et al (2006) Preliminary results from digestive adaptation: a new surgical proposal for treating obesity, based on physiology and evolution. Sao Paulo Med J 124(4):192\u2013197","journal-title":"Sao Paulo Med J"},{"issue":"3","key":"3413_CR31","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1016\/j.soard.2012.12.009","volume":"9","author":"CN Ochner","year":"2013","unstructured":"Ochner CN et al (2013) Effect of preoperative body mass index on weight loss after obesity surgery. Surg Obes Relat Dis 9(3):423\u2013427","journal-title":"Surg Obes Relat Dis"},{"key":"3413_CR32","doi-asserted-by":"crossref","unstructured":"Singh B et al (2023) One anastomosis gastric bypass (OAGB) vs Roux en Y gastric bypass (RYGB) for remission of T2DM in patients with morbid obesity: a Randomized Controlled Trial. Obesity Surgery","DOI":"10.1007\/s11695-023-06515-4"},{"issue":"Suppl 4","key":"3413_CR33","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1007\/s11695-019-04032-x","volume":"29","author":"M Bhandari","year":"2019","unstructured":"Bhandari M, Fobi MAL, Buchwald JN (2019) Standardization of bariatric metabolic procedures: World Consensus Meeting Statement. Obes Surg 29(Suppl 4):309\u2013345","journal-title":"Obes Surg"},{"key":"3413_CR34","first-page":"1","volume":"2015","author":"A Tinoco","year":"2015","unstructured":"Tinoco A, Gottardi LF, Boechat ED (2015) Gastric Cancer in the excluded stomach 10 years after gastric bypass. Case Rep Surg 2015:1\u20133","journal-title":"Case Rep Surg"},{"issue":"4","key":"3413_CR35","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1007\/s11695-022-05920-5","volume":"32","author":"W Wu","year":"2022","unstructured":"Wu W et al (2022) Comparison of the outcomes of single anastomosis Duodeno-Ileostomy with Sleeve Gastrectomy (SADI-S), single anastomosis sleeve ileal (SASI) bypass with Sleeve Gastrectomy, and Sleeve Gastrectomy using a Rodent Model with Diabetes. Obes Surg 32(4):1209\u20131215","journal-title":"Obes Surg"}],"container-title":["Langenbeck's Archives of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00423-024-03413-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00423-024-03413-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00423-024-03413-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T09:02:16Z","timestamp":1721293336000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00423-024-03413-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,18]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["3413"],"URL":"https:\/\/doi.org\/10.1007\/s00423-024-03413-w","relation":{},"ISSN":["1435-2451"],"issn-type":[{"value":"1435-2451","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,18]]},"assertion":[{"value":"30 December 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 July 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"221"}}