MedPath

Bougie Sleeve Trial

Not Applicable
Recruiting
Conditions
Morbid Obesity
Interventions
Procedure: Laparoscopic sleeve gastrectomy using 48-Fr bougie
Procedure: Laparoscopic sleeve gastrectomy using standard care bougie
Registration Number
NCT02937649
Lead Sponsor
Assistance Publique - Hôpitaux de Paris
Brief Summary

Staple-line leak is the most frequent and incapacitating complication after laparoscopic sleeve gastrectomy (LSG). The aim of this prospective randomized trial is to compare the staple-line leak rate after LSG according to the use of a standard bougie calibre (34, 36 or 38 Fr) or 48-Fr, assuming that a higher diameter is correlated with a lower risk of leak, without lowering long-term weight loss.

Detailed Description

Laparoscopic sleeve gastrectomy (LSG) has become an increasing bariatric procedure. The most common complication is gastric leak from the staple line, observed in approximately 3% of cases, and can result in long and incapacitating treatment. The diameter of the bougie used to calibrate the remnant stomach could impact the rate of gastric leak, a higher diameter being correlated with a lower risk of leak, without lowering long-term weight loss.

The aim of this prospective randomized trial is to compare the outcomes of LSG according to the use of a standard care bougie calibre or 48-Fr on postoperative gastric leak and mid-term weight loss.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
1658
Inclusion Criteria
  • Patients between 18 and 70 years
  • Sleeve gastrectomy as a primary bariatric procedure
  • Body Mass Index (BMI) > 40 kg/m² or > 35 kg/m² associated with at least one comorbidity susceptible to improve after surgery (including arterial hypertension, obstructive sleep apnea syndrome and other severe respiratory disorders, severe metabolic disorders, particularly type 2 diabetes, incapacitating osteo-articular disorders, non alcoholic steatohepatitis)
  • Decision for intervention after multidisciplinary discussion
  • Written informed consent
Exclusion Criteria
  • Previous upper abdominal surgery (cholecystectomy excepted)
  • ASA (American Society of Anesthesiologists) score > 3
  • Ongoing pregnancy or breast feeding
  • Esophagus pathology or disorder (esophageal varices, esophageal diverticula, esophageal tumors, esophageal strictures)
  • Coagulation disorder
  • Patient not covered by social security service and patient on AME
  • Patient under legal guardianship and trusteeship
  • Patient with known silicon allergy (calibration bougie contains medical silicon)
  • More generally, all other contraindications to the use of esophageal bougie MID-TUBE that have been the subject of a scientific paper or have been identified by the practitioner or practitioners

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Laparoscopic sleeve gastrectomy using 48-Fr bougieLaparoscopic sleeve gastrectomy using 48-Fr bougiePatients will undergo laparoscopic sleeve gastrectomy with a 48-Fr (16 mm) bougie
Laparoscopic sleeve gastrectomy using standard care bougieLaparoscopic sleeve gastrectomy using standard care bougiePatients will undergo laparoscopic sleeve gastrectomy with a standard care bougie (34, 36 or 38-Fr)
Primary Outcome Measures
NameTimeMethod
Postoperative gastric leak rate30 days following the procedure

Postoperative gastric leak rate during the first month following the procedure will be proven either on:

* Morphologic examination (with contrast ingestion)

* Blue dye test during surgical reintervention or postoperative course

* Contrast opacification during endoscopy

Secondary Outcome Measures
NameTimeMethod
Postoperative morbidity rate90 days following the procedure

Postoperative morbidity rate will be calculated regarding any complication occurring 90 days following the procedure.

Short-term weight lossAt 3 and 6 months after the procedure

Short-term weight loss will be assessed by calculation of excess weight loss at 3 and 6 months after the procedure.

Mid-term weight lossAt 1 and 2 years after the procedure

Mid-term weight loss will be assessed by calculation of excess weight loss at 1 and 2 years after the procedure.

Quality of life related to healthAt 3 months, 6 months, 1 year and 2 years after the procedure

Quality of life related to health will be assessed at 3 months, 6 months, 1 year and 2 years after the procedure with the validated GIQLI scale (Gastro Intestinal Quality of Life Index)

Trial Locations

Locations (12)

Hôpital Ambroise Paré

🇫🇷

Boulogne-Billancourt, France

Hôpital Côte de Nacre CHU de Caen

🇫🇷

Caen, France

CHU Antoine Béclère

🇫🇷

Clamart, France

Centre hospitalier Intercommunal de Créteil

🇫🇷

Créteil, France

Hôpital MICHALLON, CHU de Grenoble

🇫🇷

La Tronche, France

Hôpital Dupuytren - Limoges

🇫🇷

Limoges, France

Clinique de l'Yvette

🇫🇷

Longjumeau, France

Service de chirurgie générale et digestive, œsogastrique et bariatrique - Hôpital Bichat

🇫🇷

Paris, France

CHI - Centre Hospitalier Poissy/Saint-Germain-en-Laye

🇫🇷

Poissy, France

CH Saint-Denis

🇫🇷

Saint-Denis, France

Clinique Mutualiste Chirurgicale

🇫🇷

Saint-Étienne, France

Hôpitaux de Brabois

🇫🇷

Vandœuvre-lès-Nancy, France

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