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A Study to Reduce the Reflux After a Sleeve Gastrectomy in Obese Patients

Not Applicable
Withdrawn
Conditions
Obesity
Gastroesophageal Reflux
Interventions
Procedure: DPC
Procedure: LSG
Registration Number
NCT04287972
Lead Sponsor
Fabio Garofalo
Brief Summary

This is a monocentric randomized controlled prospective study. A total of 122 patients will be recruited and randomized 1: 1 in the experimental group - Laparoscopic Sleeve Gastrectomy and Diaphragmatic Pillar Closure - or in the control group - Laparoscopic Sleeve Gastrectomy.

At 6 months post surgery a gastroscopy, an oesophageal manometry and a PH-study will be perform to detect de novo GastroEsophageal Reflux Disease and hiatal hernia appearance.

Detailed Description

Not available

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
Not specified
Inclusion Criteria
  • Age between 18-65 years
  • Patient with BMI between 35 and 50 Kg/m2 for whom laparoscopic sleeve gastrectomy indication was made
  • Patients with no preoperative gastroesophageal reflux disease symptoms
  • Hill 2-3 or 4 (with HH <2 cm) hypogastric valve diagnosed preoperatively
Exclusion Criteria
  • Gastroesophageal reflux disease with daily symptoms or daily use of proton pump inhibitors drugs or daily use of anti-H2 drugs
  • Hiatal Hernia >2cm and/or esophagitis and/or Barrett metaplasia
  • Previous bariatric and/or gastric surgery
  • Normal gastroesophageal valve (Hill 1)
  • Motility disorders of the esophagus (documented on manometry)
  • PH-study positive for gastro-oesophageal reflux disease (DeMeester Score >14.1)
  • Contraindications to gastroscopy or manometry or ph-study
  • Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc. of the participant
  • Patient not legally competent
  • Pregnancy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
LSG-DPCLSGLaparoscopic Sleeve Gastrectomy and Diaphragmatic Pillar Closure.
LSGLSGLaparoscopic Sleeve Gastrectomy
LSG-DPCDPCLaparoscopic Sleeve Gastrectomy and Diaphragmatic Pillar Closure.
Primary Outcome Measures
NameTimeMethod
De novo GastroEsophageal Reflux Disease (GERD) onset6 months post surgery

At 6 months post surgery a gastroscopy, an oesophageal manometry and a PH-study will be perform to detect de novo GERD (GastroEsophageal Reflux Disease)

Secondary Outcome Measures
NameTimeMethod
hiatal hernia appearance6 months post surgery

At 6 months post surgery a gastroscopy, an oesophageal manometry and a PH-study will be perform to detect hiatal hernia appearance

change in patient-reported quality of life using Gastroparesis Cardinal Symptom Index (GCSI) questionnairebaseline and 6 months post surgery

Evaluation of benefits in term of life quality by Gastroparesis Cardinal Symptom Index (GCSI) self-assessment of gastroparesis symptoms.

The Gastroparesis Cardinal Symptom Index (GCSI), is a questionnaire that assess severity of symptoms associated with gastroparesis. Symptoms are rated from 0 (no symptom) to 5 (very severe)

change in patient-reported quality of life using GERD-Health Related Quality of Life Questionnaire (GERD-HRQL) questionnairebaseline and 6 months post surgery

Evaluation of benefits in term of life quality and reduction of Protonic Pomp Inhibitors drugs by GERD-Health Related Quality of Life questionnaire.

Questionnaire (GERD-HRQL) for symptoms related to GERD. Symptoms are rated from 0 (no symptom) to 5 (Symptoms are incapacitating to do daily activities). The total Score is calculated by summing the individual scores to 15 questions.

* Greatest possible score (worst symptoms) = 75

* Lowest possible score (no symptoms) = 0

Number of participants with treatment-related adverse events as assessed by CTCAE v4.06 months post surgery

Evaluation of number of participants with treatment-related adverse events ( short and long term surgical complications)

Trial Locations

Locations (1)

Ospedale Regionale di Lugano, Civico e Italiano

🇨🇭

Lugano, Switzerland

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