Ten-Year Comparative Outcomes of One-Anastomosis Gastric Bypass Versus Single-Anastomosis Duodeno-Ileal Bypass as Revisional Procedures After Sleeve Gastrectomy

Ten-Year Comparative Outcomes of One-Anastomosis Gastric Bypass Versus Single-Anastomosis Duodeno-Ileal Bypass as Revisional Procedures After Sleeve Gastrectomy | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Ten-Year Comparative Outcomes of One-Anastomosis Gastric Bypass Versus Single-Anastomosis Duodeno-Ileal Bypass as Revisional Procedures After Sleeve Gastrectomy Asaad F. Salama, Abdelwahed Yahmadi, Hamzah Elbaba, Jawher Baazaoui, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9395886/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background A substantial proportion of patients have insufficient weight loss or clinically significant weight regain after sleeve gastrectomy (SG) and require revisional surgery. One-anastomosis gastric bypass (OAGB) and single-anastomosis duodeno-ileal bypass (SADI-S) are commonly used conversion procedures, but long-term comparative data are limited. Objectives To compare 10-year weight, metabolic, nutritional and safety outcomes of OAGB versus SADI-S performed as conversion procedures for weight recurrence after SG. Setting: Tertiary referral bariatric centre. Methods In this retrospective comparative cohort study, adults undergoing conversion of SG to OAGB or SADI-S for weight recurrence between January 2014 and January 2016 were identified. Demographic, anthropometric, metabolic and micronutrient data, comorbidity status and complications were collected at baseline (time of conversion) and at 1, 5 and 10 years. Between-group comparisons used appropriate parametric/non-parametric tests for continuous variables and Fisher’s exact/chi-square tests for categorical variables (two-sided p < 0.05). Results Ninety patients underwent revisional surgery (OAGB n = 47; SADI-S n = 43). At 1 year, weight outcomes were similar between groups. SADI-S achieved higher %EWL and %TWL at 5 years; however, 10-year weight and BMI outcomes were comparable. Lipid profiles were more favourable after SADI-S (lower total cholesterol at 1, 5 and 10 years; lower triglycerides at 5 and 10 years), whereas several micronutrient levels were higher after OAGB (including calcium, zinc, vitamin D and folate at multiple time points), with higher vitamin B12 after SADI-S. Comorbidity outcomes and overall complication rates were similar, and no mortality was observed during follow-up. Conclusions In this single-centre retrospective cohort with 10-year follow-up, OAGB and SADI-S provided comparable long-term weight outcomes when used as conversion procedures after SG. SADI-S was associated with more favourable lipid parameters, whereas OAGB showed higher levels of several micronutrients over follow-up. Procedure selection should balance metabolic targets against nutritional risk and ensure structured long-term surveillance. Health sciences/Health care/Weight management Health sciences/Diseases/Endocrine system and metabolic diseases/Obesity Health sciences/Anatomy/Gastrointestinal system/Stomach revisional bariatric surgery sleeve gastrectomy one-anastomosis gastric bypass single-anastomosis duodeno-ileal bypass weight regain micronutrient deficiency Introduction Obesity is a major global health challenge associated with increased morbidity, mortality, and substantial economic burden ( 1 , 2 ). Bariatric surgery is widely recognized as the most effective long-term treatment for severe obesity, resulting in sustained weight loss and marked improvement of obesity-related comorbidities ( 3 , 4 ). Laparoscopic SG(SG) is considered the most widely used primary operation globally because it is technically straightforward, has favorable perioperative safety data, and acceptable short-term outcomes ( 5 ). Long-term follow-up studies have shown that a substantial proportion of patients experience suboptimal outcomes after sleeve gastrectomy, despite its widespread adoption. Inadequate weight loss or weight recurrence, along with late complications such as gastroesophageal reflux disease, have been reported in up to 20–50% of patients and often necessitate revisional bariatric surgery ( 6 , 7 ). As obesity is a chronic and relapsing disease, durable conversional strategies are required for patients with weight regain after SG( 3 ). OAGB and SADI-S are among the most widely accepted conversional procedures in the case of weight recurrence after SG( 10 – 12 ). These procedures differ markedly in their anatomical reconstruction, mechanisms of action, degree of malabsorption, metabolic effects, and potential nutritional consequences ( 7 , 8 ). Consequently, the choice between OAGB and SADI-S remains debated and is typically individualized based on patient characteristics, predominant clinical indication, and surgical expertise ( 8 , 9 ). Previous studies have demonstrated that revisional bariatric surgery can achieve further weight loss and improve obesity-related comorbidities after SG( 7 , 8 ). However, most comparative studies available report only short- to mid-term outcomes, typically limited to a follow-up period of three to five years ( 8 ). Long-term comparative data evaluating OAGB and SADI-S beyond five years remain scarce, which is essential for determining the durability of weight loss, sustained metabolic efficacy, long-term nutritional safety, and procedure-specific complications ( 9 , 13 ). Additionally, although both OAGB and SADI-S can be effective weight-loss procedures, the long-term metabolic outcomes, nutritional deficiencies, and symptom management, particularly gastroesophageal reflux, remain incompletely defined. This underscores the need for long-term comparative studies to guide evidence-based decision-making in revisional bariatric surgery. Hence, the present study aims to compare the ten-year outcomes of OAGB and SADI-S as conversional procedures following sleeve gastrectomy. We evaluated anthropometric, metabolic, and nutritional outcomes, as well as obesity-related comorbidities, to provide clinically relevant data to support procedure selection in this complex patient population. Methods Study Design and Setting This retrospective comparative cohort study was conducted at a tertiary bariatric surgery Center. It included all patients who underwent conversion to OAGB or SADI-S after SG between January 2014 and December 2016. The study evaluated the long-term outcomes of these two conversional bariatric procedures after SG, with the aim of comparing their effectiveness and safety using routinely collected clinical data. Study Population For this study, only adult patients who underwent conversion to OAGB or SADI-S after SG for weight-related indications were included. Procedure selection reflected real-world clinical decision-making rather than random allocation, and residual confounding cannot be excluded. Weight recurrence or suboptimal weight loss after SG was defined according to accepted international criteria as either insufficient weight loss—defined as percentage of total weight loss (%TWL) < 20% and/or percentage of excess weight loss (%EWL) < 50% at 18–24 months postoperatively—or significant weight recurrence gain after an initial satisfactory weight loss response ( 6 , 7 ). Patients were excluded if revisional surgery was performed for reasons unrelated to weight (such as isolated anatomical complications), if the conversion involved a procedure other than OAGB or SADI-S, or if postoperative follow-up data were missing or incomplete. Patients were divided into two groups based on the conversional procedure performed (OAGB or SADI-S). During the study period, these two procedures were among several revisional options for weight-related indications after SG at our institution (like RYGB and Duodenal switch). The choice of the procedure was not randomized but reflected routine clinical practice, taking into consideration the patient’s characteristics and shared decision-making between the surgeon and the patient. Surgical Technique: OAGB procedure: A long gastric pouch was created by dividing the sleeved stomach at the level of the incisura angularis. The duodenojejunal junction was then identified, and a jejunal loop measuring of around 150–200 cm was brought up in an antecolic manner to create a side-to-side gastrojejunal anastomosis. The anastomosis was performed either as a totally hand-sewn or a stapled-and-hand-sewn technique, at the surgeon's discretion. SADI-S: After evaluation of the abdominal cavity, a retro pyloric dissection was performed until 3 cm of duodenum distal to the pylorus was free, and then the duodenum was transected. The limb length from the ileocaecal junction was measured to be 300 cm. All the revisional surgeries were laparoscopically performed with no conversions to open surgery occurred. Perioperative management and postoperative care protocols were similar in both groups. Data Collection Demographic and baseline clinical data were collected using electronic medical records. Collected variables included age, sex, anthropometric measurements before sleeve gastrectomy, nadir weight after sleeve gastrectomy, and measurements at the time of conversional surgery. Preoperative comorbidities assessed included type 2 diabetes mellitus, hypertension, dyslipidemia, obstructive sleep apnea, asthma, and gastroesophageal reflux disease. Perioperative variables included operative time and length of hospital stay. Follow-up data were collected at 1, 5, and 10 years after the conversional surgery. Outcome Measures Outcome Measures The primary outcomes were the long-term anthropometric outcomes, including body weight, body mass index (BMI), percentage of excess weight loss (%EWL), percentage of total weight loss (%TWL), and BMI reduction. Secondary outcomes included metabolic and nutritional parameters assessed using laboratory measurements, as well as obesity-related comorbidity outcomes. Comorbidity outcomes were defined as remission, improvement, or lack of change/worsening, based on commonly used clinical terms. Standard laboratory markers were used to determine nutritional status, with special consideration given to micronutrient deficiencies. Statistical Analysis The Statistical Package for the Social Sciences (SPSS) was used for statistical analysis. Continuous variables were expressed as mean ± standard deviation or median with interquartile range, depending on data distribution. Categorical variables were presented as frequencies and percentages. Continuous variables were compared using independent-sample t-tests or non-parametric equivalents, as appropriate. Categorical variables were compared using chi-square or Fisher’s exact tests. A p-value < 0.05 was considered statistically significant. Ethical Considerations Ethical approval was obtained from the institutional review board for this retrospective study. The research was conducted in accordance with the principles of the Declaration of Helsinki. Since this entailed a retrospective analysis of preexisting clinical data, the need for individual informed consent was waived. Results Patient Characteristics Between January 2014 and January 2016, a total of 90 patients underwent conversion to either OAGB or SADI-S for weight recurrence following SG; 47 patients received OAGB and 43 underwent SADI-S. Baseline demographic and clinical characteristics (Tables 1 and 1 b); were comparable between groups. Mean age at conversion did not differ between the OAGB and SADI-S cohorts (38.15 ± 9.22 vs 39.35 ± 9.28 years; p = 0.54). The interval from SG to conversional surgery was similar ( p = 0.44), as was preoperative BMI at the time of conversion (43.31 ± 7.07 vs 43.51 ± 7.07 kg/m²; p = 0.89). Table 1 Baseline characteristics Variable OAGB (n = 47) Mean (SD) SADI-S (n = 43) Mean (SD) P-value Age (years) 38.15 (9.22) 39.35 (9.28) 0.54 Sex (M/F) n (%) F 40 (85.1) 27 (62.8) 0.01 M 7 (14.9) 16 (37.2) Years from SG to conversion 3.75 (1.31) 3.53 (1.29) 0.44 Height (cm) 162.17 (10.49) 165.12 (8.64) 0.15 Weight Before SG (kg) 132.98 (27.75) 141.02 (27.14) 0.17 BMI Before SG (kg/m²) 50.37 (8.52) 50.40 (11.46) 0.98 Lowest Weight after SG (kg) 96.40 (20.25) 101.84 (21.58) 0.23 Lowest BMI after SG (kg/m²) 36.60 (6.72) 32.92 (13.99) 0.12 Weight before conversional surgery (kg) 113.83 (20.13) 119.05 (23.53) 0.25 BMI before conversional surgery (kg/m²) 43.31 (7.07) 43.51 (7.07) 0.89 ASA Score (I–IV) 2.09 (0.28) 2.12 (0.39) 0.66 Table 1 b : Co-morbidities pre-op Variable OAGB (n = 47) SADI-S (n = 43) P-value Diabetes No 41 (87.2) 36 (83.7) 0.63 Yes 6 (12.8) 7 (16.3) Hypertension No 40 (85.1) 35 (81.4) 0.63 Yes 7 (14.9) 8 (18.6) Dyslipidemia No 43 (91.5) 39 (90.7) 0.99* Yes 4 (8.5) 4 (9.3) OSA No 47 (100) 43 (100) - Yes 0 (0.0) 0 (0.0) Asthma No 42 (89.4) 41 (95.3) 0.5* Yes 5 (10.6) 2 (4.7) GERD No 44 (93.6) 39 (90.7) 0.9* Yes 3 (6.4) 4 (9.3) *Values are presented as n (%). P-values were calculated using Fisher’s exact test, as appropriate. No statistical comparison was performed as no cases of OSA were observed in either group. Female sex was more prevalent in the OAGB group (85.1% vs 62.8%; p = 0.01), whereas all other baseline characteristics were comparable between cohorts. Preoperative comorbidities, including diabetes, hypertension, dyslipidemia, asthma, and gastroesophageal reflux disease, showed no statistically significant differences between the two cohorts. Baseline laboratory values (Table 2 ), most parameters were comparable between groups. However, preoperative folate levels were significantly higher in the OAGB group compared with the SADI-S group (p = 0.01). Table 2 Preop lab tests comparison of OAGB and SADI-S Hb OAGB (n = 47) SADI-S (n = 43) P value 12.16 (1.71) 12.66 (1.67) 0.17 Calcium 2.28 (0.11) 2.28 (0.10) 0.69 Phosphorus 1.15 (0.18) 1.17 (0.18) 0.78 Magnesium 1.08 (1.34) 0.82 (0.08) 0.31 Total protein 69.81 (4.44) 67.88 (8.37) 0.17 Albumin 36.72 (3.66) 36.49 (3.11) 0.74 Uric Acid 328.00 (88.10) 318.07 (94.9) 0.67 Cholesterol 5.10 (0.96) 5.15 (0.73) 0.79 TG 1.62 (1.11) 1.61 (0.94) 0.96 HDL 1.41 (0.40) 1.62 (1.56) 0.41 LDL_Calc 2.71 (1.14) 2.61 (1.30) 0.70 Iron 13.27 (11.80) 11.91 (5.24) 0.52 HbA1c 5.57 (0.70) 5.67 (0.80) 0.55 Copper 19.14 (4.98) 22.58 (7.45) 0.06 Zinc 11.71 (1.71) 11.60 (2.32) 0.82 Vitamin D 17.13 (10.4) 14.72 (6.86) 0.20 Ferritin 28.06 (32.81) 25.18 (27.25) 0.75 Folate 20.39 (9.64) 15.40 (6.67) 0.01 Vit B12 254.24 (96.08) 297.79 (241.738) 0.26 Operative and Perioperative Outcomes (Table 3 ) Table 3 Intraoperative data Variable OAGB (n = 47) Mean ± SD SADI-S (n = 43) Mean ± SD P-value Operative time (minutes) 82.3 ± 30.2 123.3 ± 30.1 < 0.001 Length of hospital stay (days) 3.36 ± 1.28 3.59 ± 0.74 0.84 Mean operative time was significantly longer in the SADI-S group compared with the OAGB group (p < 0.001). Length of hospital stay was similar between the two groups (p = 0.84). All procedures were completed laparoscopically, and no intraoperative conversions to open surgery were reported. Anthropometric Outcomes (Table 4 ) Table 4 Anthropometric outcomes comparison of OAGB and SADI-S Weight at 1 year OAGB (n = 47) SADI-S (n = 40) P value 92.22 (16.48) 93.45 (18.11) 0.74 BMI at 1 year 35.20 (6.43) 34.09 (6.12) 0.41 %EWL at 1 year 47.38 (24.33) 53.75 (22.83) 0.21 %TW at 1 year 18.75 (9.11) 21.63 (8.25) 0.13 BMI reduction at 1 year 8.23 (4.65) 9.54 (4.08) 0.17 Weight at 5 years 96.06 (19.10) 93.07 (15.58) 0.42 BMI at 5 years 36.64 (7.28) 34.34 (5.85) 0.11 %EWL at 5 years 36.78 (31.39) 49.67 (30.13) 0.05 %TW at 5 years 15.07 (13.31) 20.52 (12.09) 0.05 BMI reduction at 5 years 6.79 (6.57) 9.27 (6.28) 0.07 Weight at 10 years 91.38 (18.10) 94.89 (16.49) 0.35 BMI at 10 years 35.23 (7.35) 34.73 (5.52) 0.73 %EWL at 10 years 45.75 (31.78) 46.67 (29.36) 0.89 %TW at 10 years 18.75 (13.06) 19.59 (11.97) 0.76 BMI reduction at 10 years 8.35 (6.23) 8.94 (6.08) 0.66 Values are presented as mean (SD). The number of available cases varied between 45–46 in the OAGB group and 39–41 in the SADI-S group across follow-up intervals. Anthropometric outcomes (weight, BMI, %EWL and %TWL), were similar at 1 year. SADI-S achieved greater %EWL and %TWL at 5 years, although this advantage was not sustained at 10 years, when weight and BMI outcomes were comparable between groups. Postoperative Laboratory Outcomes (Table 5 ) Table 5 Postop lab tests (1, 5, and 10 years) comparison of OAGB and SADI-S Hb_1year OAGB (n = 47) SADI-S (n = 43) P value 11.67 (1.59) 11.79 (2.54) 0.79 Hb_5 years 11.74 (1.89) 12.07 (2.07) 0.43 Hb_10 years 11.82 (1.76) 11.78 (1.31) 0.90 Calcium_1year 2.24 (0.10) 2.20 (0.10) 0.03 Calcium_5 years 2.24 (0.09) 2.17 (0.09) 0.002 Calcium_10 years 2.26 (0.16) 2.17 (0.12) 0.02 Phosphorus_1year 1.21 (0.12) 1.14 (0.17) 0.44 Phosphorus_5 years 1.15 (0.13) 1.11 (0.30) 0.69 Phosphorus_10 years 1.11 (0.24) 1.14 (0.36) 0.78 Magnesium_1year 0.87 (0.23) 0.81 (0.10) 0.36 Magnesium_5 years 0.83 (0.06) 0.87 (0.11) 0.18 Magnesium_10 years 0.83 (0.06) 0.84 (0.04) 0.74 Total protein_1year 67.57 (5.27) 67.61 (3.70) 0.97 Total protein_5 years 68.21 (4.49) 68.03 (4.46) 0.85 Total protein_10 years 68.47 (4.56) 68.97 (3.34) 0.57 Albumin_1year 36.86 (4.27) 36.31 (3.26) 0.51 Albumin_5 years 37.16 (4.30) 36.24 (4.16) 0.32 Albumin_10 years 38.67 (3.67) 37.95 (3.30) 0.35 Uric Acid_1year 282.04 (57.10) 280.61 (85.73) 0.94 Uric Acid_5 years 282.08 (61.00) 254.55 (58.86) 0.12 Uric Acid_10 years 270.20 (57.46) 277.65 (66.98) 0.68 Cholesterol_1year 4.44 (0.75) 4.05 (0.80) 0.02 Cholesterol_5 years 4.59 (0.75) 4.08 (0.77) 0.006 Cholesterol_10 years 4.65 (0.75) 4.21 (0.71) 0.01 TG_1year 0.95 (0.31) 0.92 (0.53) 0.75 TG_5 years 0.95 (0.34) 0.77 (0.24) 0.01 TG_10 years 0.97 (0.36) 0.77 (0.28) 0.008 HDL_1year 1.55 (0.39) 1.28 (0.29) 0.001 HDL_5 years 1.60 (0.37) 1.33 (0.28) 0.001 HDL_10 years 1.57 (0.44) 1.42 (0.27) 0.07 LDL_Calc_1year 2.44 (0.58) 2.34 (0.72) 0.47 LDL_Calc_5 years 2.56 (0.67) 2.39 (0.60) 0.26 LDL_Calc_10 years 2.62 (0.64) 2.43 (0.62) 0.19 Iron_1year 12.41 (6.15) 12.7 (6.32) 0.84 Iron_5 years 8.68 (5.02) 11.51 (6.15) 0.05 Iron_10 years 11.36 (5.14) 10.77 (5.32) 0.67 HbA1c_1year 5.18 (0.62) 5.08 (0.40) 0.41 HbA1c_5 years 5.52 (0.71) 5.29 (0.53) 0.12 HbA1c_10 years 5.52 (0.94) 5.48 (0.69) 0.84 Copper_1year 18.25 (5.29) 15.98 (4.38) 0.17 Copper_5 years 19.74 (4.83) 18.21 (5.05) 0.40 Copper_10 years 18.55 (3.33) 17.01 (3.93) 0.33 Zinc_1year 10.48 (1.80) 9.41 (2.36) 0.06 Zinc_5 years 11.66 (2.36) 9.94 (1.53) 0.009 Zinc_10 years 10.82 (1.67) 9.51 (1.30) 0.01 Vitamin D_1year 18.98 (11.68) 13.90 (7.43) 0.02 Vitamin D_5 years 25.14 (13.69) 16.43 (10.59) 0.002 Vitamin D_10 years 23.05 (13.04) 22.11 (10.09) 0.72 Ferritin_1year 39.44 (47.57) 57.15 (64.66) 0.21 Ferritin_5 years 46.61 (81.25) 91.47 (184.71) 0.18 Ferritin_10 years 49.66 (90.48) 75.51 (120.47) 0.32 Folate_1year 24.25 (16.19) 13.20 (7.71) 0.001 Folate_5 years 29.44 (14.35) 16.52 (12.09) 0.001 Folate_10 years 23.20 (11.94) 14.22 (9.96) 0.01 Vit B12_1year 266.76 (157.68) 386.53 (282.82) 0.02 Vit B12_5 years 286.45 (209.25) 405.54 (329.00) 0.06 Vit B12_10 years 287.00 (172.91) 465.25 (285.78) 0.002 OAGB was associated with consistently higher serum calcium levels at 1, 5, and 10 years. In contrast, SADI-S demonstrated significantly lower total cholesterol across all follow-up intervals and lower triglyceride levels at 5 and 10 years. HDL cholesterol levels were higher in the OAGB group at 1 and 5 years, while LDL cholesterol levels were comparable between groups throughout follow-up. Hemoglobin levels did not differ at any time point. Zinc, vitamin D, and folate levels were consistently higher following OAGB, whereas vitamin B12 levels were higher after SADI-S. Comorbidity Outcomes (Table 6 ) Table 6 Comorbidity Outcomes Comparison of OAGB versus SADI-S after Sleeve Gastrectomy Variable OAGB N (%) SADI-S N (%) p-value* Diabetes: Complete Remission or Improved 5 (83.3) 5 (83.3) 0.99* No Changes/Worse 1 (16.7) 1 (16.7) Hypertension: Complete Remission or Improved 2 (40.0) 2 (28.6) 0.99* No Changes/Worse 3 (60.0) 5 (71.4) Dyslipidemia: Complete Remission or Improved 2 (50.0) 3 (60.0) 0.99* No Changes/Worse 2 (50.0) 2 (40.0) Asthma: Complete Remission or Improved 1 (25.0) 0 (0.0) 0.99* No Change/Worse 3 (75.0) 1 (100.0) GERD: Complete Remission or Improved 1 (12.5) 1 (16.7) 0.99* No Change/Worse 7 (87.5) 5 (83.3) *Values are presented as n (%). P-values were calculated using Fisher’s exact test. GERD: gastro-esophageal reflux disease. Comorbidity remission and improvement rates were similar between OAGB and SADI-S across all evaluated conditions. Postoperative Complications (Table 7 ) Table 7 Comparison of Complications Outcomes Following OAGB versus SADI-S Variable OAGB N (%) SADI-S N (%) p-value Bleeding Yes 1 (2.1) 0 (0.0) 0.99 No 46 (97.9) 43 (100) Leak Yes 1 (2.1) 0 (0.0) 0.99 No 46 (97.9) 43 (100) Marginal ulcer Yes 3 (6.4) 1 (2.3) 0.67 No 44 (93.6) 42 (97.7) Dumping syndrome Yes 4 (8.5) 2 (4.7) 0.75 No 43 (91.5) 41 (95.3) Vitamin deficiencies Yes 8 (17.0) 11 (25.6) 0.32 No 39 (83.0) 32 (74.4) Severe malnutrition Yes 0 (0.0) 2 (4.7) 0.43 No 47 (100.0) 41 (95.3) IDA Yes 27 (57.4) 22 (51.2) 0.55 No 20 (42.6) 21 (48.8) Values are presented as n (%). P-values were calculated using Fisher’s exact test. No cases of internal hernia, bowel obstruction, or stricture were observed in either group. IDA: iron deficiency anemia. Early and late complication rates were low and comparable between groups. Vitamin deficiencies and iron-deficiency anemia occurred frequently but did not differ significantly, and no mortality was observed during follow-up. Discussion In this retrospective comparative cohort study, we compared ten-year outcomes of OAGB and SADI-S as conversional procedures following SG. The present analysis demonstrates that both procedures provide durable weight loss through 10 years of follow-up, with generally comparable long-term anthropometric effects. The metabolic and micronutrient profiles, however, reflected inherent physiological differences between the two procedures. Both SADI-S and OAGB achieved sustained long-term weight loss. Whereas no significant changes were observed at 1 year, SADI-S demonstrated higher %EWL and %TWL at 5 years, suggesting a more pronounced mid-term malabsorptive impact. Notably, this difference was no longer statistically significant at 10 years, which implies the convergence of the weight trajectories in the long-term. The importance of effective revisional strategies is supported by reports of long-term weight recurrence gain after primary SG ( 18 ). These findings are consistent with previously published data demonstrating the effectiveness of both OAGB and SADI-S as revisional procedures following SG. The longer biliopancreatic limb and shorter common channel associated with SADI-S likely contribute to its greater malabsorptive effect and temporary mid-term advantage. However, the long-term durability of weight loss ultimately became comparable between procedures ( 7 , 14 , 15 ). Distinct metabolic trends were observed between groups. SADI-S was associated with significantly lower total cholesterol and triglyceride levels at multiple follow-up intervals, which may reflect greater fat malabsorption and altered bile acid physiology, as reported for more malabsorptive bariatric procedures. On the other hand, the OAGB group had consistently higher HDL cholesterol levels at early and mid-term follow-ups, and LDL levels were similar. These findings suggest that lipid modulation differs according to anatomical configuration and degree of malabsorption, although both procedures exert substantial metabolic effects ( 10 , 14 ). There was also a difference in the micronutrient profiles between procedures. The level of serum calcium, zinc, vitamin D, and folate was typically elevated in the OAGB group at various follow-up periods. On the contrary, the vitamin B12 concentration was greater in the SADI-S cohort at the chosen intervals. These variations likely reflect differences in absorptive surface area and nutrient transit time. Considering that the common channel is longer in OAGB than in SADI-S, this may plausibly explain differences in micronutrient absorption patterns ( 16 ). Notably, although biochemical variations existed, serious malnutrition was rare, and overall complication rates were acceptable in both groups. Although biochemical differences were observed, clinically significant malnutrition was uncommon, and most deficiencies were managed with routine supplementation. These findings highlight the importance of structured long-term nutritional monitoring, as recommended in current bariatric guidelines ( 17 ). Resolution or improvement of obesity-related comorbidities was comparable between OAGB and SADI-S. Both procedures appear effective in achieving metabolic disease control after SG ( 19 ). Although the study may have been underpowered to detect subtle intergroup differences, the findings indicate that both conversional approaches provide meaningful metabolic benefit. In this study, GERD outcomes were comparable between groups, suggesting that reflux concerns alone should not preclude either procedure when appropriately selected. The profile of complications was acceptable in these two cohorts. Early postoperative complication rates were low and did not differ significantly between procedures. Severe malnutrition occurred only in the SADI-S group, but it was not statistically significant. Iron deficiency anemia was observed in both groups, which was in line with the known risks of revisional malabsorptive procedures ( 16 ). Long-term follow-up did not show any mortality, supporting the safety of both approaches when performed in experienced centers. Clinically, procedure choice should be individualized: in our cohort, SADI-S showed more favorable lipid parameters, whereas OAGB showed a more favorable micronutrient profile. Given converging long-term weight outcomes, selection should align with metabolic goals, baseline nutritional status, and tolerance for malabsorption, with structured long-term nutritional surveillance ( 28 – 31 ). This study provides long-term comparative data extending to 10 years following revisional surgery, a period that is rarely reported in the literature. Its clinical relevance is increased by the overall consideration of anthropometric, metabolic, and micronutrient parameters. The present findings are consistent with previously published comparative studies demonstrating that both OAGB and SADI-S are effective revisional strategies after unsuccessful sleeve gastrectomy ( 7 , 11 , 17 , 18 , 27 ). Prior mid-term analyses have reported superior weight loss with SADI-S, likely attributable to its greater malabsorptive component ( 22 , 23 , 24 ). However, similar to our findings, long-term convergence of weight outcomes has been observed in extended follow-up studies, suggesting that early differences may attenuate over time. This reinforces the concept that the durability of revisional bariatric surgery depends not only on anatomical configuration but also on long-term metabolic adaptation and patient adherence ( 25 , 26 ). From a clinical perspective, the distinct metabolic and micronutrient profiles observed between procedures highlight the importance of individualized surgical planning. Patients with severe dyslipidaemia or requiring greater mid-term weight reduction may benefit from SADI-S, whereas individuals at higher nutritional risk may be better suited for OAGB due to its comparatively favourable micronutrient profile. These findings emphasize that revisional bariatric surgery should not follow a uniform approach but rather be guided by patient-specific metabolic objectives and nutritional vulnerability ( 21 , 24 – 26 ). Limitations This study has several limitations. First, the retrospective design introduces potential selection bias and limits causal inference. Second, the study was conducted in a single tertiary referral center, which may restrict generalizability to broader bariatric populations. Outcomes reflect experience in a specialized tertiary center and may differ in lower-volume settings. Third, although long-term follow-up was achieved, the overall sample size, particularly within comorbidity subgroups, may have limited statistical power to detect subtle intergroup differences. Additionally, loss to follow-up is inherent in long-term surgical research and may have influenced outcome assessment. Finally, the non-randomized allocation of conversional procedure reflects real-world clinical practice but introduces potential treatment selection bias. Conclusion In this retrospective comparative cohort study, both OAGB and SADI-S provided durable long-term weight loss with comparable anthropometric outcomes up to 10 years after sleeve gastrectomy. Although SADI-S was associated with greater mid-term excess weight loss and more pronounced improvements in selected lipid parameters, these advantages were not sustained at long-term follow-up. In contrast, OAGB demonstrated a comparatively more favorable micronutrient profile across several follow-up intervals. Both procedures achieved similar rates of comorbidity improvement and acceptable safety profiles when performed in an experienced tertiary center. Given the convergence of long-term weight outcomes and the distinct metabolic and nutritional profiles observed, procedure selection should be individualized based on patient-specific metabolic goals, baseline nutritional status, and tolerance for malabsorption. Prospective multicenter studies are warranted to further define optimal conversional strategies following sleeve gastrectomy. Declarations Conflict of Interest Drs. Abdelwahed Yahmadi, Asaad Salama, Hamzah El Baba, Jawher Baazaoui, Mohamed Bougmiza and Mohammed Al Kuwari have no conflicts of interest or financial ties to disclose. Funding: No funding was received for the conduct of this study or the preparation of this manuscript. Data Availability The data that support the findings of this study are derived from institutional clinical databases and are not publicly available due to ethical, legal, and privacy restrictions. De-identified data may be made available from the corresponding author upon reasonable request and subject to approval by the institutional review board. References World Health Organization. Obesity and overweight. WHO Fact Sheet . 2023. Blüher M. Obesity: global epidemiology and pathogenesis. Nat Rev Endocrinol . 2019;15:288–298. Sjöström L, Peltonen M, Jacobson P, et al. Bariatric surgery and long-term outcomes. J Intern Med . 2013;273:219–234. Adams TD, Gress RE, Smith SC, et al. Long-term mortality after gastric bypass surgery. N Engl J Med . 2007;357:753–761. Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2018. Obes Surg . 2020;30:420–427. Courcoulas AP, King WC, Belle SH, et al. Seven-year weight trajectories and health outcomes in the Longitudinal Assessment of Bariatric Surgery study. JAMA Surg . 2018;153:427–434. Thaher O, Daza JFM, Croner RS, Stroh C. Outcome of revisional bariatric surgery after failed sleeve gastrectomy: a German multicenter study. Obes Surg . 2023;33:3362–3372. Noel P, Nedelcu M, Eddbali I, Manos T, Gagner M. What are the long-term results 8 years after sleeve gastrectomy? Surg Obes Relat Dis . 2017;13:1110–1115. Mechanick JI, Apovian C, Brethauer S, et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures – 2019 update. Surg Obes Relat Dis . 2019;16:175–247. Sánchez-Pernaute A, Rubio MÁ, Cabrerizo L, et al. Single-anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S) for obese diabetic patients. Surg Obes Relat Dis . 2015;11:1092–1098. Salama AF, Baazaoui J, Shahid F, Singh R, Torres AJ, Bashah MM. Comparative analysis of 5-year efficacy and outcomes of single anastomosis procedures as revisional surgery for weight regain following sleeve gastrectomy. Surg Endosc . 2023;37:7548–7555. Lacy A, Obarzabal A, Pando E, et al. Revisional surgery after sleeve gastrectomy. Surg Laparosc Endosc Percutan Tech . 2010;20:351–356. Pennestrì F, Sessa L, Prioli F, et al. Single anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S): experience from a high-bariatric volume center. Langenbecks Arch Surg . 2022;407:1851–1862. Gletsu-Miller N, Wright BN. Mineral malnutrition following bariatric surgery. Adv Nutr . 2013;4:506–517. Carbajo MA, Luque-de-León E, Jiménez JM, et al. Laparoscopic one-anastomosis gastric bypass: technique, results, and long-term follow-up in 1200 patients. Obes Surg . 2017;27:1153–1167. Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg . 2010;252:319–324. Poghosyan T, Alameh A, Bruzzi M, et al. Conversion of sleeve gastrectomy to one anastomosis gastric bypass for weight loss failure. Obes Surg . 2019;29:2436–2441. Kermansaravi M, Karami R, Valizadeh R, et al. Five-year outcomes of one anastomosis gastric bypass as conversional surgery following sleeve gastrectomy for weight loss failure. Sci Rep . 2022;12:10304. Buchwald H, Estok R, Fahrbach K, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med . 2009;122:248–256. Brethauer SA, Kim J, El Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Obes Surg . 2015;25:587–606. De Luca M, Piatto G, Merola G, et al. IFSO update position statement on one anastomosis gastric bypass (OAGB). Obes Surg . 2021;31:3251–3278. Balibrea JM, Vilallonga R, Hidalgo M, et al. Mid-term results and responsiveness predictors after two-step single-anastomosis duodeno-ileal bypass with sleeve gastrectomy. Obes Surg . 2017;27:1302–1308. Lee WJ, Lin YH, Kuo YC, et al. Laparoscopic single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S): surgical technique and preliminary results. Obes Surg . 2014;24:698–703. Surve A, Zaveri H, Cottam A, Cottam D. Mid-term outcomes of single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S). Obes Surg . 2016;26:1738–1746. Mahawar KK, Parmar C, Carr WRJ, et al. Single-anastomosis duodeno-ileal bypass (SADI-S): systematic review of efficacy and safety. Obes Surg . 2017;27:789–796. Musella M, Milone M, Gaudioso D, et al. One-anastomosis gastric bypass: long-term outcomes and nutritional consequences. Obes Surg . 2019;29:1729–1736. De Luca M, Tie T, Ooi GJ, et al. Revisional bariatric surgery after sleeve gastrectomy: a systematic review of surgical options and outcomes. Surg Endosc . 2020;34:587–597. El-Masry H, Zidan MH, Hany M, Abokhozima A. Nutritional concerns in the meta-analysis comparing SADI and OAGB as revisional procedures following sleeve gastrectomy. Obes Surg . 2025; 35:1178–1181. Ahmed Y, Ataya K, Almubarak I, et al. Laparoscopic single-anastomosis duodeno–ileal bypass (SADI) versus one anastomosis gastric bypass (OAGB) as revisional procedures after sleeve gastrectomy: systematic review and meta-analysis. Br J Surg . 2025;112(Suppl 5): znaf036.030. Abedalqader T, Jawhar N, Gajjar A, et al. Hypoabsorption in bariatric surgery: is the benefit worth the risk? Medicina (Kaunas) . 2025;61(3):398. Mitra A, Bhambri A, Fehervari M, Parmar C. Long-term outcomes of one anastomosis gastric bypass: a systematic review and meta-analysis of 5-year and beyond. Obes Surg . 2026; 36:71–87. Additional Declarations There is NO conflict of interest to disclose Cite Share Download PDF Status: Under Review Version 1 posted Reviewer # 2 agreed at journal 11 May, 2026 Reviewer # 1 agreed at journal 21 Apr, 2026 Reviewers invited by journal 19 Apr, 2026 Submission checks completed at journal 15 Apr, 2026 First submitted to journal 14 Apr, 2026 Unknown event 13 Apr, 2026 Editor assigned by journal 12 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Salama","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA70lEQVRIie3RMQrCMBSA4Uqg0ytuJaXgGVICiqD2LKXgFPEG8qCDi+4VPIQ3aKWgS8G1q3gBO6koaqrgJFE3h/xThnw88mIYOt0fZtaXmJVXGiTjSWtf4ihIkGx3oCB1Gi53DnaCRZ4zb4Y0WBgm53MFcWIz5Bb2OSsEk4eKgO1eFIQV0HQtzBoVCbtIOTPAdIWKbHJJjhn4sWDZQBL/I0nFYwr0qPCiwTdT/HR4OFt4A04FJ22kjQdRbew1xYtFk9SexFaTQhJHEpav+rUpUmBELllJqueXFVlH6/3pMgJ/HKm/8k3kt+s6nU6ne9MdSdhUDGUqJSUAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0003-1354-8756","institution":"Hamad Medical Corporation","correspondingAuthor":true,"prefix":"","firstName":"Asaad","middleName":"F.","lastName":"Salama","suffix":""},{"id":625801168,"identity":"6aeea042-5d25-4991-8f8a-f76d174b000d","order_by":1,"name":"Abdelwahed Yahmadi","email":"","orcid":"https://orcid.org/0000-0002-4947-2629","institution":"Hamad Medical Corporation","correspondingAuthor":false,"prefix":"","firstName":"Abdelwahed","middleName":"","lastName":"Yahmadi","suffix":""},{"id":625801169,"identity":"0e280cae-0e70-4d20-9d83-a133e62334bb","order_by":2,"name":"Hamzah Elbaba","email":"","orcid":"","institution":"Hamad Medical Corporation","correspondingAuthor":false,"prefix":"","firstName":"Hamzah","middleName":"","lastName":"Elbaba","suffix":""},{"id":625801170,"identity":"833b734f-d806-4411-9dc1-b7769c3e3cfc","order_by":3,"name":"Jawher Baazaoui","email":"","orcid":"","institution":"Hamad Medical Corporation","correspondingAuthor":false,"prefix":"","firstName":"Jawher","middleName":"","lastName":"Baazaoui","suffix":""},{"id":625801171,"identity":"b463ab85-dc3b-4205-a881-8524833317ac","order_by":4,"name":"Mohamed Bougmiza","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Mohamed","middleName":"","lastName":"Bougmiza","suffix":""},{"id":625801172,"identity":"98237510-7a43-4238-b137-16457fd685b2","order_by":5,"name":"Mohammed Al Kuwari","email":"","orcid":"","institution":"Hamad Medical Corporation","correspondingAuthor":false,"prefix":"","firstName":"Mohammed","middleName":"Al","lastName":"Kuwari","suffix":""}],"badges":[],"createdAt":"2026-04-12 17:02:27","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9395886/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9395886/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107870131,"identity":"6068ddd3-09b1-4655-b5dd-ac24d94fc894","added_by":"auto","created_at":"2026-04-27 07:38:54","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":622766,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9395886/v1/3ec19d56-ce6a-4c84-9ee6-bd799a5668b8.pdf"}],"financialInterests":"There is \u003cb\u003eNO\u003c/b\u003e conflict of interest to disclose","formattedTitle":"Ten-Year Comparative Outcomes of One-Anastomosis Gastric Bypass Versus Single-Anastomosis Duodeno-Ileal Bypass as Revisional Procedures After Sleeve Gastrectomy","fulltext":[{"header":"Introduction","content":"\u003cp\u003eObesity is a major global health challenge associated with increased morbidity, mortality, and substantial economic burden (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Bariatric surgery is widely recognized as the most effective long-term treatment for severe obesity, resulting in sustained weight loss and marked improvement of obesity-related comorbidities (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Laparoscopic SG(SG) is considered the most widely used primary operation globally because it is technically straightforward, has favorable perioperative safety data, and acceptable short-term outcomes (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eLong-term follow-up studies have shown that a substantial proportion of patients experience suboptimal outcomes after sleeve gastrectomy, despite its widespread adoption. Inadequate weight loss or weight recurrence, along with late complications such as gastroesophageal reflux disease, have been reported in up to 20\u0026ndash;50% of patients and often necessitate revisional bariatric surgery (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). As obesity is a chronic and relapsing disease, durable conversional strategies are required for patients with weight regain after SG(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOAGB and SADI-S are among the most widely accepted conversional procedures in the case of weight recurrence after SG(\u003cspan additionalcitationids=\"CR11\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). These procedures differ markedly in their anatomical reconstruction, mechanisms of action, degree of malabsorption, metabolic effects, and potential nutritional consequences (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Consequently, the choice between OAGB and SADI-S remains debated and is typically individualized based on patient characteristics, predominant clinical indication, and surgical expertise (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePrevious studies have demonstrated that revisional bariatric surgery can achieve further weight loss and improve obesity-related comorbidities after SG(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). However, most comparative studies available report only short- to mid-term outcomes, typically limited to a follow-up period of three to five years (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Long-term comparative data evaluating OAGB and SADI-S beyond five years remain scarce, which is essential for determining the durability of weight loss, sustained metabolic efficacy, long-term nutritional safety, and procedure-specific complications (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAdditionally, although both OAGB and SADI-S can be effective weight-loss procedures, the long-term metabolic outcomes, nutritional deficiencies, and symptom management, particularly gastroesophageal reflux, remain incompletely defined. This underscores the need for long-term comparative studies to guide evidence-based decision-making in revisional bariatric surgery.\u003c/p\u003e \u003cp\u003eHence, the present study aims to compare the ten-year outcomes of OAGB and SADI-S as conversional procedures following sleeve gastrectomy. We evaluated anthropometric, metabolic, and nutritional outcomes, as well as obesity-related comorbidities, to provide clinically relevant data to support procedure selection in this complex patient population.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design and Setting\u003c/h2\u003e \u003cp\u003eThis retrospective comparative cohort study was conducted at a tertiary bariatric surgery Center. It included all patients who underwent conversion to OAGB or SADI-S after SG between January 2014 and December 2016. The study evaluated the long-term outcomes of these two conversional bariatric procedures after SG, with the aim of comparing their effectiveness and safety using routinely collected clinical data.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy Population\u003c/h3\u003e\n\u003cp\u003eFor this study, only adult patients who underwent conversion to OAGB or SADI-S after SG for weight-related indications were included. Procedure selection reflected real-world clinical decision-making rather than random allocation, and residual confounding cannot be excluded.\u003c/p\u003e \u003cp\u003eWeight recurrence or suboptimal weight loss after SG was defined according to accepted international criteria as either insufficient weight loss\u0026mdash;defined as percentage of total weight loss (%TWL)\u0026thinsp;\u0026lt;\u0026thinsp;20% and/or percentage of excess weight loss (%EWL)\u0026thinsp;\u0026lt;\u0026thinsp;50% at 18\u0026ndash;24 months postoperatively\u0026mdash;or significant weight recurrence gain after an initial satisfactory weight loss response (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePatients were excluded if revisional surgery was performed for reasons unrelated to weight (such as isolated anatomical complications), if the conversion involved a procedure other than OAGB or SADI-S, or if postoperative follow-up data were missing or incomplete.\u003c/p\u003e \u003cp\u003ePatients were divided into two groups based on the conversional procedure performed (OAGB or SADI-S). During the study period, these two procedures were among several revisional options for weight-related indications after SG at our institution (like RYGB and Duodenal switch). The choice of the procedure was not randomized but reflected routine clinical practice, taking into consideration the patient\u0026rsquo;s characteristics and shared decision-making between the surgeon and the patient.\u003c/p\u003e\n\u003ch3\u003eSurgical Technique:\u003c/h3\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eOAGB procedure:\u003c/h2\u003e \u003cp\u003eA long gastric pouch was created by dividing the sleeved stomach at the level of the incisura angularis. The duodenojejunal junction was then identified, and a jejunal loop measuring of around 150\u0026ndash;200 cm was brought up in an antecolic manner to create a side-to-side gastrojejunal anastomosis. The anastomosis was performed either as a totally hand-sewn or a stapled-and-hand-sewn technique, at the surgeon's discretion.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSADI-S:\u003c/h3\u003e\n\u003cp\u003eAfter evaluation of the abdominal cavity, a retro pyloric dissection was performed until 3 cm of duodenum distal to the pylorus was free, and then the duodenum was transected. The limb length from the ileocaecal junction was measured to be 300 cm.\u003c/p\u003e \u003cp\u003eAll the revisional surgeries were laparoscopically performed with no conversions to open surgery occurred. Perioperative management and postoperative care protocols were similar in both groups.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData Collection\u003c/h2\u003e \u003cp\u003eDemographic and baseline clinical data were collected using electronic medical records. Collected variables included age, sex, anthropometric measurements before sleeve gastrectomy, nadir weight after sleeve gastrectomy, and measurements at the time of conversional surgery. Preoperative comorbidities assessed included type 2 diabetes mellitus, hypertension, dyslipidemia, obstructive sleep apnea, asthma, and gastroesophageal reflux disease. Perioperative variables included operative time and length of hospital stay. Follow-up data were collected at 1, 5, and 10 years after the conversional surgery.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eOutcome Measures\u003c/h3\u003e\n\u003cdiv class=\"Heading\"\u003eOutcome Measures\u003c/div\u003e \u003cp\u003eThe primary outcomes were the long-term anthropometric outcomes, including body weight, body mass index (BMI), percentage of excess weight loss (%EWL), percentage of total weight loss (%TWL), and BMI reduction. Secondary outcomes included metabolic and nutritional parameters assessed using laboratory measurements, as well as obesity-related comorbidity outcomes.\u003c/p\u003e \u003cp\u003eComorbidity outcomes were defined as remission, improvement, or lack of change/worsening, based on commonly used clinical terms. Standard laboratory markers were used to determine nutritional status, with special consideration given to micronutrient deficiencies.\u003c/p\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eThe Statistical Package for the Social Sciences (SPSS) was used for statistical analysis. Continuous variables were expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation or median with interquartile range, depending on data distribution. Categorical variables were presented as frequencies and percentages. Continuous variables were compared using independent-sample t-tests or non-parametric equivalents, as appropriate. Categorical variables were compared using chi-square or Fisher\u0026rsquo;s exact tests. A p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eEthical Considerations\u003c/h2\u003e \u003cp\u003e \u003cstrong\u003eEthical approval\u003c/strong\u003e \u003cp\u003e was obtained from the institutional review board for this retrospective study. The research was conducted in accordance with the principles of the Declaration of Helsinki. Since this entailed a retrospective analysis of preexisting clinical data, the need for individual informed consent was waived.\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003ePatient Characteristics\u003c/h2\u003e \u003cp\u003eBetween January 2014 and January 2016, a total of 90 patients underwent conversion to either OAGB or SADI-S for weight recurrence following SG; 47 patients received OAGB and 43 underwent SADI-S.\u003c/p\u003e \u003cp\u003eBaseline demographic and clinical characteristics (Tables\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e and \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003eb); were comparable between groups. Mean age at conversion did not differ between the OAGB and SADI-S cohorts (38.15\u0026thinsp;\u0026plusmn;\u0026thinsp;9.22 vs 39.35\u0026thinsp;\u0026plusmn;\u0026thinsp;9.28 years; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.54). The interval from SG to conversional surgery was similar (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.44), as was preoperative BMI at the time of conversion (43.31\u0026thinsp;\u0026plusmn;\u0026thinsp;7.07 vs 43.51\u0026thinsp;\u0026plusmn;\u0026thinsp;7.07 kg/m\u0026sup2;; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.89).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBaseline characteristics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOAGB (n\u0026thinsp;=\u0026thinsp;47)\u003c/p\u003e \u003cp\u003eMean (SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSADI-S (n\u0026thinsp;=\u0026thinsp;43)\u003c/p\u003e \u003cp\u003eMean (SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38.15 (9.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39.35 (9.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.54\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex (M/F) n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e40 (85.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27 (62.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (14.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16 (37.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYears from SG to conversion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.75 (1.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.53 (1.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.44\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHeight (cm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e162.17 (10.49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e165.12 (8.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeight Before SG (kg)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e132.98 (27.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e141.02 (27.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.17\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI Before SG (kg/m\u0026sup2;)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e50.37 (8.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50.40 (11.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLowest Weight after SG (kg)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e96.40 (20.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e101.84 (21.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLowest BMI after SG (kg/m\u0026sup2;)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36.60 (6.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32.92 (13.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeight before conversional surgery (kg)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e113.83 (20.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e119.05 (23.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI before conversional surgery (kg/m\u0026sup2;)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e43.31 (7.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e43.51 (7.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.89\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eASA Score (I\u0026ndash;IV)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.09 (0.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.12 (0.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eb\u003c/b\u003e: Co-morbidities pre-op\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOAGB (n\u0026thinsp;=\u0026thinsp;47)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSADI-S (n\u0026thinsp;=\u0026thinsp;43)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e41 (87.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36 (83.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (12.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (16.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40 (85.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35 (81.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (14.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (18.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDyslipidemia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43 (91.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39 (90.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.99*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (8.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (9.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOSA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAsthma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42 (89.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41 (95.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.5*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (10.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (4.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGERD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44 (93.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39 (90.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.9*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (6.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (9.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e*Values are presented as n (%). P-values were calculated using Fisher\u0026rsquo;s exact test, as appropriate. No statistical comparison was performed as no cases of OSA were observed in either group.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFemale sex was more prevalent in the OAGB group (85.1% vs 62.8%; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.01), whereas all other baseline characteristics were comparable between cohorts.\u003c/p\u003e \u003cp\u003ePreoperative comorbidities, including diabetes, hypertension, dyslipidemia, asthma, and gastroesophageal reflux disease, showed no statistically significant differences between the two cohorts.\u003c/p\u003e \u003cp\u003eBaseline laboratory values (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e2\u003c/span\u003e), most parameters were comparable between groups. However, preoperative folate levels were significantly higher in the OAGB group compared with the SADI-S group (p\u0026thinsp;=\u0026thinsp;0.01).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePreop lab tests comparison of OAGB and SADI-S\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHb\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOAGB (n\u0026thinsp;=\u0026thinsp;47)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSADI-S (n\u0026thinsp;=\u0026thinsp;43)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12.16 (1.71)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.66 (1.67)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.17\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCalcium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.28 (0.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.28 (0.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.69\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhosphorus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.15 (0.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.17 (0.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMagnesium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.08 (1.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.82 (0.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal protein\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e69.81 (4.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e67.88 (8.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.17\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlbumin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36.72 (3.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36.49 (3.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUric Acid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e328.00 (88.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e318.07 (94.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCholesterol\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.10 (0.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.15 (0.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.79\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTG\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.62 (1.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.61 (0.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.96\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHDL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.41 (0.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.62 (1.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.41\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLDL_Calc\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.71 (1.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.61 (1.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIron\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13.27 (11.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11.91 (5.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHbA1c\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.57 (0.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.67 (0.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.55\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCopper\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19.14 (4.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22.58 (7.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eZinc\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11.71 (1.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11.60 (2.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.82\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVitamin D\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17.13 (10.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.72 (6.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFerritin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28.06 (32.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25.18 (27.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.75\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFolate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20.39 (9.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.40 (6.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVit B12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e254.24 (96.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e297.79 (241.738)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.26\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eOperative and Perioperative Outcomes (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e3\u003c/span\u003e)\u003c/h2\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eIntraoperative data\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOAGB (n\u0026thinsp;=\u0026thinsp;47) Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSADI-S (n\u0026thinsp;=\u0026thinsp;43) Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOperative time (minutes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e82.3\u0026thinsp;\u0026plusmn;\u0026thinsp;30.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e123.3\u0026thinsp;\u0026plusmn;\u0026thinsp;30.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLength of hospital stay (days)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e3.36\u0026thinsp;\u0026plusmn;\u0026thinsp;1.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e3.59\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eMean operative time was significantly longer in the SADI-S group compared with the OAGB group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Length of hospital stay was similar between the two groups (p\u0026thinsp;=\u0026thinsp;0.84).\u003c/p\u003e \u003cp\u003eAll procedures were completed laparoscopically, and no intraoperative conversions to open surgery were reported.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eAnthropometric Outcomes (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e4\u003c/span\u003e)\u003c/h2\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAnthropometric outcomes comparison of OAGB and SADI-S\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWeight at 1 year\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOAGB (n\u0026thinsp;=\u0026thinsp;47)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSADI-S (n\u0026thinsp;=\u0026thinsp;40)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e92.22 (16.48)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e93.45 (18.11)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.74\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI at 1 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35.20 (6.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34.09 (6.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.41\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e%EWL at 1 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47.38 (24.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53.75 (22.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e%TW at 1 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18.75 (9.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21.63 (8.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.13\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI reduction at 1 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.23 (4.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.54 (4.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.17\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeight at 5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e96.06 (19.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e93.07 (15.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.42\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI at 5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36.64 (7.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34.34 (5.85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.11\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e%EWL at 5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36.78 (31.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49.67 (30.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e%TW at 5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15.07 (13.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20.52 (12.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI reduction at 5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6.79 (6.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.27 (6.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.07\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeight at 10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e91.38 (18.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e94.89 (16.49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.35\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI at 10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35.23 (7.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34.73 (5.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e%EWL at 10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e45.75 (31.78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46.67 (29.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.89\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e%TW at 10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18.75 (13.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19.59 (11.97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.76\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI reduction at 10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.35 (6.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.94 (6.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eValues are presented as mean (SD). The number of available cases varied between 45\u0026ndash;46 in the OAGB group and 39\u0026ndash;41 in the SADI-S group across follow-up intervals.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAnthropometric outcomes (weight, BMI, %EWL and %TWL), were similar at 1 year. SADI-S achieved greater %EWL and %TWL at 5 years, although this advantage was not sustained at 10 years, when weight and BMI outcomes were comparable between groups.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003ePostoperative Laboratory Outcomes (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e5\u003c/span\u003e)\u003c/h2\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePostop lab tests (1, 5, and 10 years) comparison of OAGB and SADI-S\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHb_1year\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOAGB (n\u0026thinsp;=\u0026thinsp;47)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSADI-S (n\u0026thinsp;=\u0026thinsp;43)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.67 (1.59)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.79 (2.54)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.79\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHb_5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11.74 (1.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12.07 (2.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHb_10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11.82 (1.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11.78 (1.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCalcium_1year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.24 (0.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.20 (0.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCalcium_5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.24 (0.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.17 (0.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCalcium_10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.26 (0.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.17 (0.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhosphorus_1year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.21 (0.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.14 (0.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.44\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhosphorus_5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.15 (0.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.11 (0.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.69\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhosphorus_10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.11 (0.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.14 (0.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMagnesium_1year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.87 (0.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.81 (0.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMagnesium_5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.83 (0.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.87 (0.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMagnesium_10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.83 (0.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.84 (0.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal protein_1year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e67.57 (5.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e67.61 (3.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.97\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal protein_5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e68.21 (4.49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68.03 (4.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.85\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal protein_10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e68.47 (4.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68.97 (3.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.57\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlbumin_1year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36.86 (4.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36.31 (3.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.51\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlbumin_5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37.16 (4.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36.24 (4.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlbumin_10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38.67 (3.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37.95 (3.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.35\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUric Acid_1year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e282.04 (57.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e280.61 (85.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.94\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUric Acid_5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e282.08 (61.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e254.55 (58.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUric Acid_10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e270.20 (57.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e277.65 (66.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCholesterol_1year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.44 (0.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.05 (0.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCholesterol_5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.59 (0.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.08 (0.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCholesterol_10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.65 (0.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.21 (0.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTG_1year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.95 (0.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.92 (0.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.75\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTG_5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.95 (0.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.77 (0.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTG_10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.97 (0.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.77 (0.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHDL_1year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.55 (0.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.28 (0.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHDL_5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.60 (0.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.33 (0.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHDL_10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.57 (0.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.42 (0.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.07\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLDL_Calc_1year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.44 (0.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.34 (0.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.47\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLDL_Calc_5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.56 (0.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.39 (0.60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.26\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLDL_Calc_10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.62 (0.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.43 (0.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIron_1year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12.41 (6.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12.7 (6.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIron_5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.68 (5.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11.51 (6.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIron_10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11.36 (5.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.77 (5.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHbA1c_1year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.18 (0.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.08 (0.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.41\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHbA1c_5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.52 (0.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.29 (0.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHbA1c_10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.52 (0.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.48 (0.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCopper_1year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18.25 (5.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.98 (4.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.17\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCopper_5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19.74 (4.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.21 (5.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCopper_10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18.55 (3.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17.01 (3.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eZinc_1year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10.48 (1.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.41 (2.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eZinc_5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11.66 (2.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.94 (1.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eZinc_10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10.82 (1.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.51 (1.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVitamin D_1year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18.98 (11.68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13.90 (7.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVitamin D_5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25.14 (13.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.43 (10.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVitamin D_10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23.05 (13.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22.11 (10.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.72\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFerritin_1year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e39.44 (47.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57.15 (64.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFerritin_5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e46.61 (81.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e91.47 (184.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFerritin_10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e49.66 (90.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e75.51 (120.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFolate_1year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24.25 (16.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13.20 (7.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFolate_5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29.44 (14.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.52 (12.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFolate_10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23.20 (11.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.22 (9.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVit B12_1year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e266.76 (157.68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e386.53 (282.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVit B12_5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e286.45 (209.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e405.54 (329.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVit B12_10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e287.00 (172.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e465.25 (285.78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eOAGB was associated with consistently higher serum calcium levels at 1, 5, and 10 years. In contrast, SADI-S demonstrated significantly lower total cholesterol across all follow-up intervals and lower triglyceride levels at 5 and 10 years. HDL cholesterol levels were higher in the OAGB group at 1 and 5 years, while LDL cholesterol levels were comparable between groups throughout follow-up. Hemoglobin levels did not differ at any time point. Zinc, vitamin D, and folate levels were consistently higher following OAGB, whereas vitamin B12 levels were higher after SADI-S.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eComorbidity Outcomes (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e6\u003c/span\u003e)\u003c/h2\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComorbidity Outcomes Comparison of OAGB versus SADI-S after Sleeve Gastrectomy\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOAGB\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSADI-S\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep-value*\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetes:\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComplete Remission or Improved\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (83.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5 (83.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.99*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo Changes/Worse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (16.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (16.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypertension:\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComplete Remission or Improved\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (40.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (28.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.99*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo Changes/Worse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (60.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5 (71.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDyslipidemia:\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComplete Remission or Improved\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (60.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.99*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo Changes/Worse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (40.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAsthma:\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComplete Remission or Improved\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.99*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo Change/Worse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (75.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (100.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGERD:\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComplete Remission or Improved\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (16.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.99*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo Change/Worse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (87.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5 (83.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e*Values are presented as n (%). P-values were calculated using Fisher\u0026rsquo;s exact test. GERD: gastro-esophageal reflux disease.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eComorbidity remission and improvement rates were similar between OAGB and SADI-S across all evaluated conditions.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003ePostoperative Complications (Table\u0026nbsp;\u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e7\u003c/span\u003e)\u003c/h2\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of Complications Outcomes Following OAGB versus SADI-S\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOAGB\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSADI-S\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBleeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (2.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.99\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46 (97.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeak\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (2.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.99\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46 (97.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarginal ulcer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (6.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (2.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e44 (93.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42 (97.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDumping syndrome\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 (8.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (4.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.75\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e43 (91.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41 (95.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVitamin deficiencies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8 (17.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11 (25.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39 (83.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32 (74.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSevere malnutrition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (4.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47 (100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41 (95.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIDA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27 (57.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22 (51.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.55\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20 (42.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21 (48.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eValues are presented as n (%). P-values were calculated using Fisher\u0026rsquo;s exact test. No cases of internal hernia, bowel obstruction, or stricture were observed in either group. IDA: iron deficiency anemia.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eEarly and late complication rates were low and comparable between groups. Vitamin deficiencies and iron-deficiency anemia occurred frequently but did not differ significantly, and no mortality was observed during follow-up.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this retrospective comparative cohort study, we compared ten-year outcomes of OAGB and SADI-S as conversional procedures following SG. The present analysis demonstrates that both procedures provide durable weight loss through 10 years of follow-up, with generally comparable long-term anthropometric effects. The metabolic and micronutrient profiles, however, reflected inherent physiological differences between the two procedures.\u003c/p\u003e \u003cp\u003eBoth SADI-S and OAGB achieved sustained long-term weight loss. Whereas no significant changes were observed at 1 year, SADI-S demonstrated higher %EWL and %TWL at 5 years, suggesting a more pronounced mid-term malabsorptive impact. Notably, this difference was no longer statistically significant at 10 years, which implies the convergence of the weight trajectories in the long-term. The importance of effective revisional strategies is supported by reports of long-term weight recurrence gain after primary SG (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). These findings are consistent with previously published data demonstrating the effectiveness of both OAGB and SADI-S as revisional procedures following SG. The longer biliopancreatic limb and shorter common channel associated with SADI-S likely contribute to its greater malabsorptive effect and temporary mid-term advantage. However, the long-term durability of weight loss ultimately became comparable between procedures (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDistinct metabolic trends were observed between groups. SADI-S was associated with significantly lower total cholesterol and triglyceride levels at multiple follow-up intervals, which may reflect greater fat malabsorption and altered bile acid physiology, as reported for more malabsorptive bariatric procedures. On the other hand, the OAGB group had consistently higher HDL cholesterol levels at early and mid-term follow-ups, and LDL levels were similar. These findings suggest that lipid modulation differs according to anatomical configuration and degree of malabsorption, although both procedures exert substantial metabolic effects (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThere was also a difference in the micronutrient profiles between procedures. The level of serum calcium, zinc, vitamin D, and folate was typically elevated in the OAGB group at various follow-up periods. On the contrary, the vitamin B12 concentration was greater in the SADI-S cohort at the chosen intervals. These variations likely reflect differences in absorptive surface area and nutrient transit time. Considering that the common channel is longer in OAGB than in SADI-S, this may plausibly explain differences in micronutrient absorption patterns (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Notably, although biochemical variations existed, serious malnutrition was rare, and overall complication rates were acceptable in both groups. Although biochemical differences were observed, clinically significant malnutrition was uncommon, and most deficiencies were managed with routine supplementation. These findings highlight the importance of structured long-term nutritional monitoring, as recommended in current bariatric guidelines (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eResolution or improvement of obesity-related comorbidities was comparable between OAGB and SADI-S. Both procedures appear effective in achieving metabolic disease control after SG (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Although the study may have been underpowered to detect subtle intergroup differences, the findings indicate that both conversional approaches provide meaningful metabolic benefit.\u003c/p\u003e \u003cp\u003eIn this study, GERD outcomes were comparable between groups, suggesting that reflux concerns alone should not preclude either procedure when appropriately selected.\u003c/p\u003e \u003cp\u003eThe profile of complications was acceptable in these two cohorts. Early postoperative complication rates were low and did not differ significantly between procedures. Severe malnutrition occurred only in the SADI-S group, but it was not statistically significant. Iron deficiency anemia was observed in both groups, which was in line with the known risks of revisional malabsorptive procedures (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Long-term follow-up did not show any mortality, supporting the safety of both approaches when performed in experienced centers.\u003c/p\u003e \u003cp\u003eClinically, procedure choice should be individualized: in our cohort, SADI-S showed more favorable lipid parameters, whereas OAGB showed a more favorable micronutrient profile. Given converging long-term weight outcomes, selection should align with metabolic goals, baseline nutritional status, and tolerance for malabsorption, with structured long-term nutritional surveillance (\u003cspan additionalcitationids=\"CR29 CR30\" citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis study provides long-term comparative data extending to 10 years following revisional surgery, a period that is rarely reported in the literature. Its clinical relevance is increased by the overall consideration of anthropometric, metabolic, and micronutrient parameters.\u003c/p\u003e \u003cp\u003eThe present findings are consistent with previously published comparative studies demonstrating that both OAGB and SADI-S are effective revisional strategies after unsuccessful sleeve gastrectomy (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). Prior mid-term analyses have reported superior weight loss with SADI-S, likely attributable to its greater malabsorptive component (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). However, similar to our findings, long-term convergence of weight outcomes has been observed in extended follow-up studies, suggesting that early differences may attenuate over time. This reinforces the concept that the durability of revisional bariatric surgery depends not only on anatomical configuration but also on long-term metabolic adaptation and patient adherence (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFrom a clinical perspective, the distinct metabolic and micronutrient profiles observed between procedures highlight the importance of individualized surgical planning. Patients with severe dyslipidaemia or requiring greater mid-term weight reduction may benefit from SADI-S, whereas individuals at higher nutritional risk may be better suited for OAGB due to its comparatively favourable micronutrient profile. These findings emphasize that revisional bariatric surgery should not follow a uniform approach but rather be guided by patient-specific metabolic objectives and nutritional vulnerability (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan additionalcitationids=\"CR25\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e).\u003c/p\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eThis study has several limitations. First, the retrospective design introduces potential selection bias and limits causal inference. Second, the study was conducted in a single tertiary referral center, which may restrict generalizability to broader bariatric populations. Outcomes reflect experience in a specialized tertiary center and may differ in lower-volume settings.\u003c/p\u003e \u003cp\u003eThird, although long-term follow-up was achieved, the overall sample size, particularly within comorbidity subgroups, may have limited statistical power to detect subtle intergroup differences. Additionally, loss to follow-up is inherent in long-term surgical research and may have influenced outcome assessment. Finally, the non-randomized allocation of conversional procedure reflects real-world clinical practice but introduces potential treatment selection bias.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn this retrospective comparative cohort study, both OAGB and SADI-S provided durable long-term weight loss with comparable anthropometric outcomes up to 10 years after sleeve gastrectomy. Although SADI-S was associated with greater mid-term excess weight loss and more pronounced improvements in selected lipid parameters, these advantages were not sustained at long-term follow-up. In contrast, OAGB demonstrated a comparatively more favorable micronutrient profile across several follow-up intervals.\u003c/p\u003e \u003cp\u003eBoth procedures achieved similar rates of comorbidity improvement and acceptable safety profiles when performed in an experienced tertiary center. Given the convergence of long-term weight outcomes and the distinct metabolic and nutritional profiles observed, procedure selection should be individualized based on patient-specific metabolic goals, baseline nutritional status, and tolerance for malabsorption. Prospective multicenter studies are warranted to further define optimal conversional strategies following sleeve gastrectomy.\u003c/p\u003e"},{"header":"Declarations","content":" \u003ch2\u003eConflict of Interest\u003c/h2\u003e \u003cp\u003eDrs. Abdelwahed Yahmadi, Asaad Salama, Hamzah El Baba, Jawher Baazaoui, Mohamed Bougmiza and Mohammed Al Kuwari have no conflicts of interest or financial ties to disclose.\u003c/p\u003e \u003ch2\u003eFunding:\u003c/h2\u003e \u003cp\u003eNo funding was received for the conduct of this study or the preparation of this manuscript.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e \u003cp\u003eThe data that support the findings of this study are derived from institutional clinical databases and are not publicly available due to ethical, legal, and privacy restrictions. De-identified data may be made available from the corresponding author upon reasonable request and subject to approval by the institutional review board.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. 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Standardized outcomes reporting in metabolic and bariatric surgery. \u003cem\u003eObes Surg\u003c/em\u003e. 2015;25:587\u0026ndash;606.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDe Luca M, Piatto G, Merola G, et al. IFSO update position statement on one anastomosis gastric bypass (OAGB). \u003cem\u003eObes Surg\u003c/em\u003e. 2021;31:3251\u0026ndash;3278.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBalibrea JM, Vilallonga R, Hidalgo M, et al. Mid-term results and responsiveness predictors after two-step single-anastomosis duodeno-ileal bypass with sleeve gastrectomy. \u003cem\u003eObes Surg\u003c/em\u003e. 2017;27:1302\u0026ndash;1308.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLee WJ, Lin YH, Kuo YC, et al. Laparoscopic single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S): surgical technique and preliminary results. \u003cem\u003eObes Surg\u003c/em\u003e. 2014;24:698\u0026ndash;703.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSurve A, Zaveri H, Cottam A, Cottam D. Mid-term outcomes of single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S). \u003cem\u003eObes Surg\u003c/em\u003e. 2016;26:1738\u0026ndash;1746.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMahawar KK, Parmar C, Carr WRJ, et al. Single-anastomosis duodeno-ileal bypass (SADI-S): systematic review of efficacy and safety. \u003cem\u003eObes Surg\u003c/em\u003e. 2017;27:789\u0026ndash;796.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMusella M, Milone M, Gaudioso D, et al. 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Laparoscopic single-anastomosis duodeno\u0026ndash;ileal bypass (SADI) versus one anastomosis gastric bypass (OAGB) as revisional procedures after sleeve gastrectomy: systematic review and meta-analysis. \u003cem\u003eBr J Surg\u003c/em\u003e. 2025;112(Suppl 5): znaf036.030.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbedalqader T, Jawhar N, Gajjar A, et al. Hypoabsorption in bariatric surgery: is the benefit worth the risk? \u003cem\u003eMedicina (Kaunas)\u003c/em\u003e. 2025;61(3):398.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMitra A, Bhambri A, Fehervari M, Parmar C. Long-term outcomes of one anastomosis gastric bypass: a systematic review and meta-analysis of 5-year and beyond. \u003cem\u003eObes Surg\u003c/em\u003e. 2026; 36:71\u0026ndash;87.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"international-journal-of-obesity","isNatureJournal":false,"hasQc":false,"allowDirectSubmit":false,"externalIdentity":"ijo","sideBox":"Learn more about [International Journal of Obesity](http://www.nature.com/ijo/)","snPcode":"41366","submissionUrl":"https://mts-ijo.nature.com/cgi-bin/main.plex","title":"International Journal of Obesity","twitterHandle":"@intjobesity","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"ejp","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"revisional bariatric surgery, sleeve gastrectomy, one-anastomosis gastric bypass, single-anastomosis duodeno-ileal bypass, weight regain, micronutrient deficiency","lastPublishedDoi":"10.21203/rs.3.rs-9395886/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9395886/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eA substantial proportion of patients have insufficient weight loss or clinically significant weight regain after sleeve gastrectomy (SG) and require revisional surgery. One-anastomosis gastric bypass (OAGB) and single-anastomosis duodeno-ileal bypass (SADI-S) are commonly used conversion procedures, but long-term comparative data are limited.\u003c/p\u003e\u003ch2\u003eObjectives\u003c/h2\u003e \u003cp\u003eTo compare 10-year weight, metabolic, nutritional and safety outcomes of OAGB versus SADI-S performed as conversion procedures for weight recurrence after SG.\u003c/p\u003e\u003ch2\u003eSetting:\u003c/h2\u003e \u003cp\u003eTertiary referral bariatric centre.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eIn this retrospective comparative cohort study, adults undergoing conversion of SG to OAGB or SADI-S for weight recurrence between January 2014 and January 2016 were identified. Demographic, anthropometric, metabolic and micronutrient data, comorbidity status and complications were collected at baseline (time of conversion) and at 1, 5 and 10 years. Between-group comparisons used appropriate parametric/non-parametric tests for continuous variables and Fisher\u0026rsquo;s exact/chi-square tests for categorical variables (two-sided \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eNinety patients underwent revisional surgery (OAGB \u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;47; SADI-S \u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;43). At 1 year, weight outcomes were similar between groups. SADI-S achieved higher %EWL and %TWL at 5 years; however, 10-year weight and BMI outcomes were comparable. Lipid profiles were more favourable after SADI-S (lower total cholesterol at 1, 5 and 10 years; lower triglycerides at 5 and 10 years), whereas several micronutrient levels were higher after OAGB (including calcium, zinc, vitamin D and folate at multiple time points), with higher vitamin B12 after SADI-S. Comorbidity outcomes and overall complication rates were similar, and no mortality was observed during follow-up.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eIn this single-centre retrospective cohort with 10-year follow-up, OAGB and SADI-S provided comparable long-term weight outcomes when used as conversion procedures after SG. SADI-S was associated with more favourable lipid parameters, whereas OAGB showed higher levels of several micronutrients over follow-up. Procedure selection should balance metabolic targets against nutritional risk and ensure structured long-term surveillance.\u003c/p\u003e","manuscriptTitle":"Ten-Year Comparative Outcomes of One-Anastomosis Gastric Bypass Versus Single-Anastomosis Duodeno-Ileal Bypass as Revisional Procedures After Sleeve Gastrectomy","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-27 03:44:43","doi":"10.21203/rs.3.rs-9395886/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"This content is not available.","date":"2026-05-11T23:23:41+00:00","index":2,"fulltext":"This content is not available."},{"type":"reviewerAgreed","content":"This content is not available.","date":"2026-04-21T07:14:38+00:00","index":1,"fulltext":"This content is not available."},{"type":"reviewersInvited","content":"","date":"2026-04-19T18:54:05+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-15T11:55:15+00:00","index":"","fulltext":""},{"type":"submitted","content":"International Journal of Obesity","date":"2026-04-14T13:37:04+00:00","index":"","fulltext":""},{"type":"checksFailed","content":"","date":"2026-04-13T10:59:15+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-12T16:59:30+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"international-journal-of-obesity","isNatureJournal":false,"hasQc":false,"allowDirectSubmit":false,"externalIdentity":"ijo","sideBox":"Learn more about [International Journal of Obesity](http://www.nature.com/ijo/)","snPcode":"41366","submissionUrl":"https://mts-ijo.nature.com/cgi-bin/main.plex","title":"International Journal of Obesity","twitterHandle":"@intjobesity","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"ejp","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"bbc6a40e-ab4a-4013-94bc-ef6ecfaab6e9","owner":[],"postedDate":"April 27th, 2026","published":true,"recentEditorialEvents":[{"type":"reviewerAgreed","content":"This content is not available.","date":"2026-05-11T23:23:41+00:00","index":2,"fulltext":"This content is not available."}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":66604973,"name":"Health sciences/Health care/Weight management"},{"id":66604974,"name":"Health sciences/Diseases/Endocrine system and metabolic diseases/Obesity"},{"id":66604975,"name":"Health sciences/Anatomy/Gastrointestinal system/Stomach"}],"tags":[],"updatedAt":"2026-04-27T03:44:43+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-27 03:44:43","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9395886","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9395886","identity":"rs-9395886","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}