Single-anastomosis duodenoileal bypass versus one-anastomosis gastric bypass: 1-year results of the OASIS randomized trial.
Sergi Sanchez-Cordero, Ruth Lopez-Gonzalez, Paula Garcia et al.
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In 30 seconds
This single-centre, prospective, randomized, single-blind trial compared SADI-S with OAGB as primary bariatric procedures in adults with BMI 45–50 kg/m². Of 99 enrolled patients, 90 underwent surgery. At 1 year, weight loss, BMI, comorbidity resolution, nutritional deficiencies, and quality-of-life outcomes did not differ significantly between groups. Late complications were more frequent after OAGB than SADI-S (35.4% vs 7.1%; P = .0003), mainly involving bile reflux. SADI-S had fewer complications overall but included two cases requiring surgical reintervention; one death in that group was not directly attributable to the procedure.
Key findings
- One-year excess weight loss was 84.34% with SADI-S and 79.61% with OAGB (P = .209); total weight loss and BMI also showed no significant between-group differences.
- Late complications occurred more often after OAGB than SADI-S (35.4% vs 7.1%; P = .0003), mainly related to bile reflux.
- Nutritional deficiencies were infrequent (7.3% vs 4.3%; P = .878), and all reported cases were iron deficiency.
- SADI-S complications included two cases requiring surgical reintervention; one death in this group was not directly attributable to the procedure.
Why it matters
The trial suggests that these procedures can produce comparable weight loss and metabolic outcomes at 1 year in patients with BMI 45–50 kg/m², while their complication profiles differ. Considering both the frequency and severity of complications may therefore inform procedure selection. The findings are short-term and do not establish which procedure has better longer-term outcomes.
What to keep in mind
Single-centre trial with 90 patients undergoing surgery and only 1-year follow-up; longer-term outcomes remain unknown.