An Australian perspective SADI-S/OADS: adverse events and nutritional deficiencies

Background: The rate of adverse events and the impact of single anastomosis duodenal-ileal bypass with sleeve gastrectomy or one anastomosis duodenal switch (SADI-S/OADS) on nutritional deficiencies has not been reported in the Australian population.
Objectives: To determine the rate of adverse events and nutritional deficiencies in Australians with obesity who received SADI-S/OADS.
Methods: Retrospective cohort study. Adults were eligible if they attended SADI-S/OADS. All patients received an individualised nutritional supplementation regimen.
Results: 85 patients underwent SADI-S/OADS. Eligible patients were 44.7 [S.D. 10.9] years of age, 64.7% female, with an average follow-up of 10.7 months. Baseline serum deficiencies were 91.2% for vitamin D, 26.5% for vitamin A, 5.9% for zinc, 20.6% for iron, 2.9% for albumin; and 0% for protein and vitamins B1, B6, and B12. At follow-up, there was no change the rate of deficiencies for serum vitamin B1 (0%), vitamin B12 (0%), iron (8.8%), protein (5.9%), or albumin (2.9%). The rate of vitamin D (61.8%; p=0.011) deficiency improved; however, the rates of vitamin B6 (23.5%; p=0.008), vitamin A (61.8%; p=0.007), and zinc (29.4%; p=0.009) increased. There were 3 surgical post-operative events: 1 repair inadvertent enterotomy day 1 post-op, 1 wound infection, 1 return to theatre for diagnostic laparoscopy which was unremarkable.
Conclusion: In Australia, initial results suggest SADI-S/OADS has a low rate of adverse events but requires intensive and individualised nutritional supplementation both pre- and post-surgery, and correction of deficiencies prior to surgery should be considered. Long-term follow-up is required.