title: Sleeve gastrectomy plus side-to-side jejunoileal anastomosis for the treatment of morbid obesity and metabolic diseases: a promising operation.
abstract: BACKGROUND
  The continuing need for simple, safe, and effective procedures led us to design a new operation for treating morbid obesity.
  
  
  METHODS
  Thirty-two patients underwent our novel procedure, sleeve gastrectomy plus side-to-side jejunoileal anastomosis (SG plus), and were followed for 6 to 24 months. A matched cohort of 32 patients underwent sleeve gastrectomy over the same period and was used as the control group. Weight loss, comorbidity outcomes, and the duodenum to cecum transit time after a gastrografin swallow, performed at postoperative day 4, were compared.
  
  
  RESULTS
  There were no deaths and no major perioperative complications. Three patients developed long-term complications requiring surgical intervention (intestinal obstruction, nausea-vomiting, and hypoalbuminemia). In the SG plus group, a 77.8 % excess weight loss was achieved at 12 months postoperatively, which was significantly better (p < 0.01) than the 67 % observed in the control group. The comorbidity outcomes, particularly diabetes resolution, were also significantly superior in the SG plus patients. The duodenum to cecum transit time of 11 min in the SG plus group was significantly shorter (p < 0.01) than the 31 min observed in the control group.
  
  
  CONCLUSIONS
  Sleeve gastrectomy plus side-to-side jejunoileal anastomosis appears to be a simple, considerably safe, and effective procedure for treating obesity and its metabolic comorbidities.
authors.affiliation: Bariatric Unit, Department of Surgical Oncology, Heraklion University Hospital, Stavrakia, Voutes, PO Box 1352, Heraklion, 711 10 Crete, Greece. melissas@med.uoc.gr
authors.forename: John
authors.initials: J
authors.lastname: Melissas
authors.forename: Anastasia
authors.initials: A
authors.lastname: Peppe
authors.forename: John
authors.initials: J
authors.lastname: Askoxilakis
authors.forename: Efstathios
authors.initials: E
authors.lastname: Dimitriadis
authors.forename: John
authors.initials: J
authors.lastname: Grammatikakis
mesh_terms: D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects / Q000379:methods; D015992:Body Mass Index; D002432:Cecum / Q000503:physiopathology; D015331:Cohort Studies; D015897:Comorbidity; D004386:Duodenum / Q000503:physiopathology; D005260:Female; D005772:Gastrointestinal Transit; D015391:Gastroplasty / Q000379:methods; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D015431:Weight Loss