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Background <p>Single-anastomosis sleeve jejunal bypass (SASJ) is a recently introduced bariatric procedure combining restrictive and malabsorptive components. Comparative evidence evaluating SASJ against established bariatric procedures remains limited.</p> Methods <p>In this retrospective cohort study, adult patients undergoing SASJ, sleeve gastrectomy (SG), or Roux-en-Y gastric bypass (RYGB) between 2019 and 2024 were identified. Propensity score matching (1:1) was performed based on age, sex, and preoperative body mass index between SASJ and RYGB, and between SASJ and SG. Anthropometric and biochemical parameters were evaluated at baseline and 12 months postoperatively. Weight-loss outcomes included percentage of total weight loss (%TWL) and percentage of excess weight loss (%EWL).</p> Results <p>After matching, 40 patients were included in the SASJ–RYGB comparison and 26 in the SASJ–SG comparison. At 12 months, all procedures were associated with significant reductions in weight and body mass index (<i>p</i> &lt; 0.001 for all). %TWL was comparable between SASJ and RYGB (35.7 ± 10.2% vs. 32.1 ± 8.4%, <i>p</i> = 0.09) and between SASJ and SG (34.4 ± 10.8% vs. 33.7 ± 6.5%, <i>p</i> = 0.4). %EWL was significantly higher following SASJ than RYGB (76.3 ± 21.6% vs. 66.8 ± 15.8%, <i>p</i> = 0.009), whereas no difference was observed between SASJ and SG. Fasting blood sugar improved after all procedures, with a greater reduction following RYGB (<i>p</i> = 0.033 vs. SASJ). SASJ demonstrated significant improvements in lipid parameters, including reductions in low-density lipoprotein and triglycerides.</p> Conclusions <p>SASJ achieves substantial weight loss and meaningful metabolic improvement at one year, with outcomes comparable to SG and RYGB. These findings suggest that SASJ may represent a promising bariatric option for severe obesity; however, larger studies with longer follow-up and comprehensive safety assessment are required before definitive conclusions can be drawn.</p>

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Comparison of 12-Month Outcome of Single Anastomosis Sleeve Jejunal Bypass Compared to Roux-en-Y Gastric Bypass and Sleeve Gastrectomy: A Propensity Score Matching Analysis

  • 期刊论文

  • 发表日期：

    2026年7月22日

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  • Nader Moeinvaziri,
  • Seyed Vahid Hosseini,
  • Masoud Amini,
  • Babak Hosseini,
  • Mavlonbeg Karimov,
  • Mohammadreza Minaei,
  • Mohammad Ali Mohsenpour,
  • Maryam Ahanjani,
  • Neda Haghighat

摘要

Background

Single-anastomosis sleeve jejunal bypass (SASJ) is a recently introduced bariatric procedure combining restrictive and malabsorptive components. Comparative evidence evaluating SASJ against established bariatric procedures remains limited.

Methods

In this retrospective cohort study, adult patients undergoing SASJ, sleeve gastrectomy (SG), or Roux-en-Y gastric bypass (RYGB) between 2019 and 2024 were identified. Propensity score matching (1:1) was performed based on age, sex, and preoperative body mass index between SASJ and RYGB, and between SASJ and SG. Anthropometric and biochemical parameters were evaluated at baseline and 12 months postoperatively. Weight-loss outcomes included percentage of total weight loss (%TWL) and percentage of excess weight loss (%EWL).

Results

After matching, 40 patients were included in the SASJ–RYGB comparison and 26 in the SASJ–SG comparison. At 12 months, all procedures were associated with significant reductions in weight and body mass index (p < 0.001 for all). %TWL was comparable between SASJ and RYGB (35.7 ± 10.2% vs. 32.1 ± 8.4%, p = 0.09) and between SASJ and SG (34.4 ± 10.8% vs. 33.7 ± 6.5%, p = 0.4). %EWL was significantly higher following SASJ than RYGB (76.3 ± 21.6% vs. 66.8 ± 15.8%, p = 0.009), whereas no difference was observed between SASJ and SG. Fasting blood sugar improved after all procedures, with a greater reduction following RYGB (p = 0.033 vs. SASJ). SASJ demonstrated significant improvements in lipid parameters, including reductions in low-density lipoprotein and triglycerides.

Conclusions

SASJ achieves substantial weight loss and meaningful metabolic improvement at one year, with outcomes comparable to SG and RYGB. These findings suggest that SASJ may represent a promising bariatric option for severe obesity; however, larger studies with longer follow-up and comprehensive safety assessment are required before definitive conclusions can be drawn.