title: A Matched Cohort Analysis of Sleeve Gastrectomy With and Without 300 cm Loop Duodenal Switch With 18-Month Follow-Up.
abstract: In bariatric surgery, a significant question remains unanswered-What proportion of weight loss comes from each component and does this differ with time? Single anastomosis duodenal switch (LDS) combines a vertical sleeve gastrectomy (VSG) with a loop attachment of the duodenal stump. There are two major variables the sleeve, and the intestine that processes ingested food. A comparison of patients that had a VSG with those that have had a LDS approximates the contribution of each component.
  
  
  
  A retrospective matched cohort analysis of VSG and LDS patients was obtained by matching every LDS patient to a VSG patient of the same sex and BMI. Excess weight lost percentage (%EWL) and the total weight loss percentage (%TWL) was analyzed. The data was compared through descriptive statistics and non-linear regression analysis.
  
  
  
  Over 18 months, patients who received the LDS lost more %TWL and %EWL and the difference was statistically significant (p < 0.05). Additionally, with time, the difference became more profound. Weight loss stabilized at approximately 9-12 months and 15 to 18 for VSG and LDS patients', respectively. At 6 months post op, there was approximately 13 % difference in weight loss. This increased to 29 % difference at 18 months.
  
  
  
  LDS patients lose more weight than VSG. Preserving 3 m of intestinal length adds 30 % greater weight loss at 18 months. Early weight loss is similar between the two operations, while the intestinal component becomes more important with weight loss differentials increasing as time since surgery lengthens.
authors.affiliation: Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT, 84102, USA.
authors.forename: Austin
authors.initials: A
authors.lastname: Cottam
authors.affiliation: Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT, 84102, USA. drdanielcottam@yahoo.com.
authors.forename: Daniel
authors.initials: D
authors.lastname: Cottam
authors.affiliation: Lenox Hill Hospital, 100 E 77th Street, New York, NY, 10075, USA.
authors.forename: Mitchell
authors.initials: M
authors.lastname: Roslin
authors.affiliation: Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT, 84102, USA.
authors.forename: Samuel
authors.initials: S
authors.lastname: Cottam
authors.affiliation: Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT, 84102, USA.
authors.forename: Walter
authors.initials: W
authors.lastname: Medlin
authors.affiliation: Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT, 84102, USA.
authors.forename: Christina
authors.initials: C
authors.lastname: Richards
authors.affiliation: Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT, 84102, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Surve
authors.affiliation: Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT, 84102, USA.
authors.forename: Hinali
authors.initials: H
authors.lastname: Zaveri
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D016022:Case-Control Studies; D015331:Cohort Studies; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000601:surgery*; D012189:Retrospective Studies; D015431:Weight Loss
keywords: Loop duodenal switch; Malabsoptive procedures; Single anastomosis duodenal switch; Sleeve gastrectomy