Analysis of clinical efficacy of single-anastomosis sleeve jejunal bypass and one-anastomosis gastric bypass in the treatment of obesity

doi:10.3877/cma.j.issn.2095-9605.2025.04.003

Abstract

Abstract:

Objective

To compare the clinical efficacy of Single-Anastomosis Sleeve Jejunal Bypass (SASJ) and One-Anastomosis Gastric Bypass (OAGB) for the treatment of obesity.

Methods

Retrospective clinical data were collected from patients who underwent SASJ and OAGB from January 2023 to January 2024 at the Department of Weight Loss and Metabolic Surgery, Drum Tower Hospital, School of Medicine, Nanjing University, China, and the main indexes included the patients' preoperative and postoperative weights, BMI, and glycemic-lipid metabolism indexes from 6 to 12 months after surgery, and the remission of comorbidities was also recorded. The data were statistically analyzed using chi-square test and independent sample t-test.

Results

Total 152 patients were included in this study and were categorized into SASJ group (n=82) and OAGB group (n=70) according to the type of surgery they underwent. Significant weight loss as well as remission of complications were recorded at 6 and 12 months after both procedures. The weights at 6 and 12 months postoperatively were (93.1±15.7) kg and (84.2±16.6) kg in the SASJ group and (94.1±26.2) kg and (85.3±22.7) kg in the OAGB group, respectively.The remission rates for T2DM were 91.7% in the SASJ group and 91.7% in the OAGB group. and OAGB showed remission rates of 91.7% and 90% for T2DM and 81.3% and 80% for GERD, respectively. In addition, a relatively high risk of postoperative malnutrition in OAGB was documented at 12 months postoperatively. This was manifested by low postoperative nutritional markers such as albumin, serum calcium, and 25 hydroxyvitamin D, which were still within the normal range. Postoperative gastroscopic findings revealed anastomotic ulcers in 6 patients after OAGB, whereas SASJ had fewer abnormal postoperative gastroscopic findings, with only 1 anastomotic ulcer as well as 2 cases of reflux esophagitis.

Conclusions

SASJ and OAGB have similar efficacy in weight loss and relief of complications, while the risk of malnutrition after SASJ is lower than that after OAGB, and the probability of anastomotic ulcer after SASJ is lower.

Key words: Obesity, Bariatric surgery, Single-Anastomosis Sleeve Jejunal, One-Anastomosis Gastric Bypass

Xing Kang, Hang Yu, Xiaodong Shan, Xitai Sun, Xuehui Chu. Analysis of clinical efficacy of single-anastomosis sleeve jejunal bypass and one-anastomosis gastric bypass in the treatment of obesity[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2025, 11(04): 270-275.

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References 18

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变量	SASJ（n=82）	OAGB（n=70）	P值
男/女	42/40	29/41	0.521
年龄（岁）	34.59±7.8	34.5±5.2	0.632
体重（kg）	102.5±12	106.3±19.5	0.131
BMI（kg/m²）	39.2±5.1	40.7±4.2	0.375
2型糖尿病（%）	36（43.9）	30（42.9）	0.665
高血压（%）	23(28)	22(31.4)	0.052
高脂血症（%）	36(43.9)	32(45.7)	0.301
睡眠呼吸暂停综合征（%）	5(6)	8(11.4)	0.031
胃食管反流病（%）	16(19.5)	10(14.3)	0.381

变量	SASJ（n=82）	OAGB（n=70）	P值
男/女	42/40	29/41	0.521
年龄（岁）	34.59±7.8	34.5±5.2	0.632
体重（kg）	102.5±12	106.3±19.5	0.131
BMI（kg/m²）	39.2±5.1	40.7±4.2	0.375
2型糖尿病（%）	36（43.9）	30（42.9）	0.665
高血压（%）	23(28)	22(31.4)	0.052
高脂血症（%）	36(43.9)	32(45.7)	0.301
睡眠呼吸暂停综合征（%）	5(6)	8(11.4)	0.031
胃食管反流病（%）	16(19.5)	10(14.3)	0.381

变量		SASJ（n=82）	OAGB（n=70）	P值
体重（kg）	术后6m	93.1±15.7	94.1±26.2	0.193
	术后12m	84.2±16.6	85.3±22.7	0.181
	P值	<0.001	0.003
BMI (kg/m²)	术后6m	35.1±6.9	36.1±4.2	0.053
	术后12m	32.4±4.8	31.2±5.4	0.084
	P值	<0.001	0.002
%TWL	术后6m	21.6±4.3	21.2±5.3	0.032
	术后12m	27.5±5.2	27.9±5.1	0.718
	P值	<0.001	<0.001
%EWL	术后6m	59.7±23.7	58.9±19.1	0.134
	术后12m	74.9±21.3	72.8±19.7	0.001
	P值	<0.001	<0.001
%EBMIL	术后6m	59.2±21.9	58.5±25.5	0.162
	术后12m	75.2±22.6	74.8±18.7	0.417
	P值	<0.001	0.001

变量		SASJ（n=82）	OAGB（n=70）	P值
体重（kg）	术后6m	93.1±15.7	94.1±26.2	0.193
	术后12m	84.2±16.6	85.3±22.7	0.181
	P值	<0.001	0.003
BMI (kg/m²)	术后6m	35.1±6.9	36.1±4.2	0.053
	术后12m	32.4±4.8	31.2±5.4	0.084
	P值	<0.001	0.002
%TWL	术后6m	21.6±4.3	21.2±5.3	0.032
	术后12m	27.5±5.2	27.9±5.1	0.718
	P值	<0.001	<0.001
%EWL	术后6m	59.7±23.7	58.9±19.1	0.134
	术后12m	74.9±21.3	72.8±19.7	0.001
	P值	<0.001	<0.001
%EBMIL	术后6m	59.2±21.9	58.5±25.5	0.162
	术后12m	75.2±22.6	74.8±18.7	0.417
	P值	<0.001	0.001

并发症	SASJ（n=82）	OAGB（n=70）	P值
2型糖尿病（%）	33/36(91.7)	27/30(90)	0.638
高血压（%）	21/23(91.3)	20/22(91)	0.681
高脂血症（%）	34/36(94.4)	30/32(93.8)	0.569
胃食管反流病（%）	13/16(81.3)	8/10(80)	0.773
睡眠呼吸暂停综合征（%）	5/5(100)	8/8(100)	0.99

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