MODERN SURGICAL METHODS FOR THE TREATMENT OF METABOLIC SYNDROME: A COMPARATIVE ANALYSIS OF SADI-S, SASI-S, MINI GASTRIC BYPASS, AND ROUX-EN-Y GASTRIC BYPASS

Abstract

Metabolic syndrome is one of the leading medical and social problems of modern medicine. Over the past decades, metabolic surgery has been considered the most effective method for achieving long-term remission in patients with obesity, type 2 diabetes mellitus (T2DM), and metabolic syndrome. The most commonly performed procedures include Roux-en-Y gastric bypass (RYGB), mini gastric bypass/one-anastomosis gastric bypass (MGB/OAGB), single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S), and single anastomosis sleeve ileal bypass (SASI-S). The aim of this review is to provide a comparative analysis of the efficacy, metabolic outcomes, technical characteristics, and complications of these procedures in the treatment of T2DM. Analysis of current studies demonstrates that all methods produce significant antidiabetic effects; however, they differ in the degree of malabsorption, the risk of nutritional deficiencies, and the duration of diabetes remission. SADI-S demonstrates the most pronounced metabolic effect, whereas RYGB remains the “gold standard” with the most extensively studied long-term outcomes.