Effect of sleeve gastrectomy on patients with or without preoperative gastroesophageal reflux disease

ISRCTN ISRCTN15208502
DOI https://doi.org/10.1186/ISRCTN15208502
Secondary identifying numbers N/A
Submission date
24/03/2015
Registration date
15/04/2015
Last edited
24/07/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Nutritional, Metabolic, Endocrine
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Gastroesophageal reflux disease (GERD) is a common condition where stomach acids leak out into the oesophagus (gullet). Symptoms include heartburn, acid reflux (acid coming back up into the mouth), and difficulty and pain when swallowing. People who are overweight or obese are at high risk of developing GERD. In some cases, 24-hour pH monitoring is recommended to help diagnose the condition. This measures pH levels around the oesophagus to test for excess acid. Laparoscopic sleeve gastrectomy (LSG), where the stomach is made smaller to restrict the amount of food that can be eaten, has been found to work well in treating morbid (life-endangering) obesity based on both short and mid-term studies. However, there are concerns that LSG may lead to GERD or worsen existing GERD. There has not yet been any rigorous large studies investigating this using 24-hour pH monitoring. The aim of this study is to observe pH levels in the oesophagus in people having LSG using 24-hour pH monitoring.

Who can participate?
Adults who are obese and scheduled to have LSG surgery.

What does the study involve?
Each participant undergoes 24-hour pH monitoring just before they have their LSG surgery. Six months following surgery, they then have a usual full clinical and biological examination and are invited to undergo 24-h pH monitoring again to test for GORD.

What are the possible benefits and risks of participating?
Participants enjoy the benefit of a gold standard test to test for GERD in clinical practice. No major adverse outcomes have been reported with such a test.

Where is the study run from?
The University Nutrition Department at Ambroise Paré University Hospital, West Paris (France)

When is the study starting and how long is it expected to run for?
January 2012 to April 2015

Who is funding the study?
Investigator initiated and funded

Who is the main contact?
Dr Sébastien Czernichow

Contact information

Dr Sébastien Czernichow
Scientific

Departement of Nutrition
CHU Ambrosie Paré
Boulogne-Billancourt
92100
France

Dr Jérémie Thereaux
Public

Departement of Nutrition
CHU Ambrosie Paré
Boulogne-Billancourt
92100
France

ORCiD logoORCID ID 0000-0002-7361-9811

Study information

Study designPatients scheduled for sleeve gastrectomy were offered to undergo 24-h pH monitoring in the preoperative time and 6 months after surgery.
Primary study designObservational
Secondary study design
Study setting(s)Hospital
Study typeQuality of life
Scientific titleEffect of sleeve gastrectomy on patients with or without preoperative gastroesophageal reflux disease: a pH-metry based study
Study objectivesGastroesophageal reflux disease is a frequent obesity-related co-morbidity which is objectively assessed by 24-h pH monitoring. Sleeve gastrectomy (LSG) has been found as an effective treatment for morbid obesity based on short and mid term studies. However, some concerns have been raised on LSG with the unpredictable risk of de novo or worsening GERD. Rigorous large studies using 24-h pH monitoring are lacking. The aim of our study was to assess post operative influence of sleeve gastrectomy (LSG) on GERD in obese morbid patients with or without preoperative GERD.
Ethics approval(s)Observational study
Health condition(s) or problem(s) studiedGrade 3 obesity
InterventionLaparoscopic sleeve gastrectomy:
The aim of our study is to determine whether sleeve gastrectomy leads to de novo gastroesophageal reflux disease or exacerbates preoperative GERD in morbidly obese patients.
Ambulatory esophageal pH monitoring is the gold standard for the diagnosis of gastroesophageal reflux disease. The nasoesophageal catheter was placed 5 cm above upper border of the lower esophageal sphincter. Esophageal pH monitoring was performed for 24 hours. There were recorded total, supine and upright time with esophageal pH<4. Patients were offered to undergo the 24-h pH monitoring preoperatively and 6 months after the bariatric procedure.
Intervention typeProcedure/Surgery
Primary outcome measurePercentage with esophageal pH<4 for total time ≥4.2%.
Secondary outcome measuresPercentage with esophageal pH<4 for upright and supine time ≥4.2%.
Overall study start date01/01/2012
Completion date01/04/2015

Eligibility

Participant type(s)Patient
Age groupAdult
SexBoth
Target number of participants90
Total final enrolment89
Key inclusion criteria1. Adults patients
2. Body Mass Index >35 kg/m²
3. Eligible for bariatric surgery
4. Preoperative medical management > 6 months
5. According to NIH/HAS criteria for bariatric surgery
Key exclusion criteria1. Refusal
2. Huge Hiatal Hernia
3. History of hiatal surgery
4. Pregnancy
Date of first enrolment01/07/2012
Date of final enrolment15/09/2014

Locations

Countries of recruitment

  • France

Study participating centre

CHU Ambroise Paré
Boulogne-Billancourt
92100
France

Sponsor information

CHU Ambroise Paré
Hospital/treatment centre

Avenue Charles de Gaulle
Boulogne-billancourt
92100
France

ROR logo "ROR" https://ror.org/03j6rvb05

Funders

Funder type

Not defined

Investigator initiated and funded

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination planThe results of the study will be published in a peer-reviewed scientific journals and presented at conferences (years 2015-2016)
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/03/2016 24/07/2020 Yes No

Editorial Notes

24/07/2020: Publication reference and total final enrolment number added.