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oai:docta.ucm.es:20.500.14352/1163332025-03-18T15:11:06Zcom_20.500.14352_14col_20.500.14352_15

Side-to-side magnet anastomosis system duodeno-ileostomy with sleeve gastrectomy: early multi-center results Gagner, Michel Cadiere, Guy-Bernard Abuladze, David Krinke, Todd Buchwald, J. N. Van Sante, Nathalie Van Gossum, Marc Koiava, Levan Odovic, Maja Poras, Mathilde Almutlaq, Lamees Sánchez Pernaute, Andrés Dziakova, Jana Torres García, Antonio José 617 Duodeno-ileostomy Magnet system Magnetic compression anastomosis Metabolic/bariatric surgery Obesity; Sleeve gastrectomy Type 2 diabetes Ciencias Biomédicas 32 Ciencias Médicas Introduction Gastrointestinal anastomoses with classical sutures and/or metal staples have resulted in significant bleeding and leak rates. This multi-site study evaluated the feasibility, safety, and preliminary effectiveness of a novel linear magnetic compression anastomosis device, the Magnet System (MS), to form a side-to-side duodeno-ileostomy (DI) diversion for weight loss and type 2 diabetes (T2D) resolution. Methods In patients with class II and III obesity (body mass index [BMI, kg/m2] ≥ 35.0– ≤ 50.0 with/without T2D [HbA1C > 6.5%]), two linear MS magnets were delivered endoscopically to the duodenum and ileum with laparoscopic assistance and aligned, initiating DI; sleeve gastrectomy (SG) was added. There were no bowel incisions or retained sutures/staples. Fused magnets were expelled naturally. Adverse events (AEs) were graded by Clavien-Dindo Classification (CDC). Results Between November 22, 2021 and July 18, 2022, 24 patients (83.3% female, mean ± SEM weight 121.9 ± 3.3 kg, BMI 44.4 ± 0.8) in three centers underwent magnetic DI. Magnets were expelled at a median 48.5 days. Respective mean BMI, total weight loss, and excess weight loss at 6 months (n = 24): 32.0 ± 0.8, 28.1 ± 1.0%, and 66.2 ± 3.4%; at 12 months (n = 5), 29.3 ± 1.5, 34.0 ± 1.4%, and 80.2 ± 6.6%. Group mean respective mean HbA1C and glucose levels dropped to 1.1 ± 0.4% and 24.8 ± 6.6 mg/dL (6 months); 2.0 ± 1.1% and 53.8 ± 6.3 mg/dL (12 months). There were 0 device-related AEs, 3 procedure-related serious AEs. No anastomotic bleeding, leakage, stricture, or mortality. Conclusion In a multi-center study, side-to-side Magnet System duodeno-ileostomy with SG in adults with class III obesity appeared feasible, safe, and effective for weight loss and T2D resolution in the short term. Depto. de Cirugía Fac. de Medicina TRUE pub 2025-01-27T13:53:17Z 2025-01-27T13:53:17Z 2023-05-22 journal article VoR https://hdl.handle.net/20.500.14352/116333 0930-2794 10.1007/s00464-023-10134-6 1432-2218 eng Gagner M, Cadiere GB, Sanchez-Pernaute A, Abuladze D, Krinke T, Buchwald JN, Van Sante N, Van Gossum M, Dziakova J, Koiava L, Odovic M, Poras M, Almutlaq L, Torres AJ. Side-to-side magnet anastomosis system duodeno-ileostomy with sleeve gastrectomy: early multi-center results. Surg Endosc. 2023 Aug;37(8):6452-6463. doi: 10.1007/s00464-023-10134-6. Epub 2023 May 22. PMID: 37217682; PMCID: PMC10202352. Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ open access application/pdf Springer