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Clinico-functional Evaluation of GERD: Comparative Study of Vertical Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass

Not Applicable
Completed
Conditions
Gastroesophageal Reflux Disease
Morbid Obesity
Interventions
Procedure: Vertical Sleeve Gastrectomy
Procedure: Roux-en-Y Gastric Bypass
Registration Number
NCT03692455
Lead Sponsor
Clinica Gastrobese
Brief Summary

The hypothesis of this study is that surgical techniques primarily designed for weight loss, ameliorates gastroesophageal reflux disease (GERD) in morbidly obese patients.

Therefore the present study intends to evaluate such impact on patients submitted to two of the most common techniques available, the Roux-en-Y Gastric Bypass and Vertical Sleeve Gastrectomy.

Detailed Description

In order to determine if weight loss surgeries do indeed ameliorate GERD in morbidly obese patients, esophageal syndromes will be evaluated following the Montreal Consensus, where troublesome symptoms were defined as score ≥ 2 on a validated questionnaire of symptoms for Portuguese language along with esophageal syndromes with injury assessed through upper endoscopy.

Esophageal acid exposure will be determined through 24h pH monitoring. Increased acid exposure will be characterized when total esophageal pH \< 4 for at least 4% of its total monitoring time.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
77
Inclusion Criteria
  • BMI > 40 Kg/m2, or BMI > 35 Kg/m2 along with clinical comorbidities (such as Diabetes Mellitus, Systemic Arterial Hypertension or Articular Lesions)
  • Been unable to loose or sustain weight loss after 2 years medical and nutritional treatments.
Exclusion Criteria
  • Been previously submitted to any gastroesophageal surgical procedure
  • Presence of chronical diseases that affects esophageal motility
  • Do not tolerate any of the required exams

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Sleeve GroupVertical Sleeve GastrectomyPatients will be submitted to Vertical Sleeve Gastrectomy Surgery.
BPG GroupRoux-en-Y Gastric BypassPatients will be submitted to Roux-en-Y Bypass Gastric Surgery.
Primary Outcome Measures
NameTimeMethod
Change in number of Participants With Gastroesophageal Reflux Disease (GERD)Before Intervention, 1 year after intervention

Prevalence of GERD in patients will be characterized according to troublesome symptomatic syndromes assessed through a validated questionnaire based on the Montreal Consensus.

Secondary Outcome Measures
NameTimeMethod
Change in Total Esophageal Acid Exposure at 24h pH MonitoringBefore Intervention, 1 year after intervention

Esophageal acid exposure will be measured through 24h pH monitoring. During such period, esophageal pH will be measured and recorded as the percent of time pH stays below 4.

Change in Esophageal Acid Exposure at 24h pH Monitoring in Upright PositionBefore Intervention, 1 year after intervention

Esophageal acid exposure will be measured through 24h pH monitoring. Esophageal pH will be measured and recorded as the percent of time pH stays below 4 while participant in upright position

Change in Esophageal Acid Exposure at 24h pH Monitoring in Supine PositionBefore Intervention, 1 year after intervention

Esophageal acid exposure will be measured through 24h pH monitoring. Esophageal pH will be measured and recorded as the percent of time pH stays below 4 while participant in supine position

Change in number of Participants With Esophageal InjuryBefore Intervention, 1 year after intervention

Syndromes with esophageal injury should be determined exclusively by the presence of reflux esophagitis

Change in number of Participants With Increased Acid ExposureBefore Intervention, 1 year after intervention

Increased Acid Exposure occurs when esophageal pH is \<4 for a period longer than 4% of the total test time on a 24h pH monitoring.

Change in number of Participants Presenting Reflux SymptomsBefore Intervention, 1 year after Intervention

Prevalence of typical reflux syndrome as classified according to the Montreal Consensus.

This Consensus institutes that GERD can be outlined when troublesome symptoms and/or complications induced by reflux of the gastric content back to the esophagus are present.

In order to assess such troublesome symptoms a validated questionnaire translated into Portuguese language will be used.

Trial Locations

Locations (1)

Gastrobese Clinic

🇧🇷

Passo Fundo, RS, Brazil

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