Randomized Comparative Study of Sleeve Gastrectomy Versus MGB and SASI Bypass , Randomized Study
Randomized Comparative Study of Sleeve Gastrectomy Versus MGB and SASI Bypass , Randomized Study
the investigator Randomized and compare the efficacy of 3 types of metabolic surgery in the
 treatment of type 2 diabetes in obese patients, one of them is SASI bypass which is a
 modification of Santoro's operation by performing a loop rather than Roux-en-Y bipartition
 reconstruction and the investigator are reporting the first comparative clinical trial as
 regards the clinical results of the outcomes of SASI bypass as a mode of functional
 restrictive and neuroendocrine modulation therapeutic option for obese type 2 diabetes.
from 2011 to 2017, investigators Randomized and collect data for the 3 operations SASI bypass
 , Mini gastric bypass and Sleeve gastrectomy ) about thorough history, clinical examination
 and laboratory investigations including basic preoperative investigations, lipid profile,
 thyroid and suprarenal hormonal evaluation. In addition, patients may undergo further
 assessment for pulmonary functions or gastroesophageal disease including endoscope. .
 Abdominal ultrasound was done to exclude gall stones and to evaluate the degree of fatty
 liver. Reduction the size of fatty liver was done by putting all patients on low-calorie
 protein diet for 6 weeks. Deep vein thrombosis prophylaxis started 12 h before surgery with
 low molecular weight heparin subcutaneous injections . Preoperative data included age,
 gender, initial weight, initial body mass index (BMI), obesity complications and treatment
 medications used (chest problems, diabetes, arterial hypertension and cardiac ischaemia,
 hyperlipidemia, obstructive sleep apnea syndrome, gall stones, urinary stress incontinence,
 joint pain, depression, infertility and heart burn). Postoperative data included hospital
 stay, early postoperative complications during the first month (e.g. fever, collection,
 bleeding, vomiting, leak and port site problems .Long-term complications more than 1 month
 after surgery (e.g. nausea, vomiting, reflux, stricture, intestinal obstruction ,
 hypoalbuminemia , anemia and calcium or iron or vitamin D , vitamin B12 deficiency and),
 excess weight loss and BMI were collected.
Inclusion Criteria:

 Type 2 diabetic obese patients

 Exclusion Criteria:

 -  patients age above 65 or below 18 years old

 -  history of upper laparotomy

 -  unfit for anesthesia or laparoscopy

 -  major psychological instability

 -  drug abuse