Short-term Safety of one Anastomosis Gastric Bypass (OAGB) Versus Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S): 30-day Results from the OASIS trial.

BACKGROUND

Metabolic and bariatric surgery (MBS) is an effective treatment for obesity, but selecting the optimal technique remains challenging. One Anastomosis Gastric Bypass (OAGB) and Single Anastomosis Duodeno-Ileal with Sleeve Gastrectomy (SADI-S) are increasingly used, yet direct comparisons are scarce.

OBJECTIVES

To compare 30-day outcomes of OAGB and SADI-S in patients with a BMI of 45–50 kg/m², focusing on safety and short-term efficacy within the OASIS trial.

METHODS

In this randomized, single-blind trial, 89 patients underwent laparoscopic OAGB (n = 48) or SADI-S (n = 41). The primary endpoint is 5-year weight loss; this manuscript reports a planned 30-day safety analysis. Complications were graded using the Clavien-Dindo scale. Secondary outcomes included operative time, hospital stay, and early weight loss.

RESULTS

Severe complications (Clavien-Dindo ≥ IIIb) occurred in 7.3% of SADI-S and 2.1% of OAGB patients (p = 0.33). Reoperations were also more common in SADI-S (7.3% vs. 2.1%; p = 0.33). Operative time was significantly longer for SADI-S (103.8 ± 18.4 vs. 82.2 ± 23.9 min; p < 0.001). No significant differences were found in early weight loss or comorbidity resolution. No 30-day mortality was recorded.

CONCLUSIONS

OAGB was associated with fewer complications and shorter operative times compared to SADI-S, although differences in severe complications and reoperations were not statistically significant. Long-term data are needed to fully evaluate outcomes.