Impact of GEA Simultaneous to VSG on Post-operative GERD
Impact of Gastroenteroanastomosis Simultaneous to Vertical Gastrectomy on Post-operative Gastroesophageal Reflux
The goal of this clinical trial is to evaluate the effect of GEA on GERD in patients undergoing VSG. The main question it aims to answer is:
• Does adoption of GEA to VSG reduce the occurrence of GERD? Participants will complete a symptom questionnaire during follow-up visits. All exams are already part of the surgical or GERD follow-up routine.
Researchers will compare with GEA (Group A) and Without GEA (Group B) to see if adopting GEA during VSG reduces the occurrence of GERD.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Rio Grande do Sul
-
Passo Fundo, Rio Grande do Sul, Brazil, 99020000
- Gastrobese Clinic
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- All VSG candidate patients aged >18 and <65 years and BMI≥ 35 and BMI≤50 who agree to participate in the study
Exclusion Criteria:
- Presence of reflux esophagitis according to the Lyon Consensus
- Previous gastric surgery
- Esophagus' motor diseases
- Development of chronic diseases associated with the use of medications such as chemotherapy, anti-rheumatics, etc.
- Patients who fail to undergo the study exams during follow-up or who withdraw the informed consent form (TCLE) at any time during the study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Group A
adoption of GEA to VSG
|
GEA will be held after completion of GV.
The small intestine is then measured every 5 cm, measured with the aid of markings on the laparoscopic clamps, and at 280 cm the manual laterolateral gastroileal anastomosis is performed between 4 and 5 cm in an isoperistaltic direction and 3 cm proximally to the pylorus.
Then, 40 cm distally to the gastroileoanastomosis, the Roux-en-Y is constructed with a 2-cm diameter lateral-to-side manual anastomosis followed by the transection of the ileal limb segment interposed with the anastomoses.
Other Names:
VSG will be performed as primary surgery.
The greater curvature is released up to the angle of His in order to perform an ascending stapling from 5 cm proximal to the pylorus to 1 cm from the angle of His and guided by a 32 French Fouchet probe.
Stapling starts 5 cm from the pylorus and extends to 1 cm from the angle of His.
The result is a tube of approximately 150 ml as adapted in consensus.
Other Names:
|
|
Sham Comparator: Group B
Without GEA to VSG
|
VSG will be performed as primary surgery.
The greater curvature is released up to the angle of His in order to perform an ascending stapling from 5 cm proximal to the pylorus to 1 cm from the angle of His and guided by a 32 French Fouchet probe.
Stapling starts 5 cm from the pylorus and extends to 1 cm from the angle of His.
The result is a tube of approximately 150 ml as adapted in consensus.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
GERD in endoscopy
Time Frame: until 60 months
|
decrease or absence of esophagitis, detected by endoscopy (Los Angeles classification), and esophageal acid exposure, detected by pH monitoring, in the group with GEA
|
until 60 months
|
|
GERD symptoms
Time Frame: until 60 months
|
improvement or absence of GERD symptoms reported by the patient in consultation and QS-GERD.
The QS-GERD (Gastroesophageal Reflux Disease Symptom Questionnaire) is a self-administered tool designed to diagnose and quantify the intensity of GERD symptoms.
It consists of approximately 11 questions (including self-perceived health), assessing typical and atypical symptoms, with scores ranging from 0 to 50 or 55, indicating the severity of reflux.
|
until 60 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
weight loss
Time Frame: until 60 months
|
Better weight loss with the combination of techniques during the postoperative period, measured through body mass index (BMI), bioelectrical impedance analysis (fat mass/lean mass), body weight, and percent excess BMI loss (% excess BMI loss).
|
until 60 months
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Glycated Hemoglobin (HbA1c) Levels
Time Frame: until 60 months
|
significant improvement in metabolic profile for diabetic patients, measured by change in HbA1c levels from baseline to postoperative follow-up.
|
until 60 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Carlos Madalosso, PhD, Clinica Gastrobese
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Nutrition Disorders
- Overnutrition
- Body Weight
- Digestive System Diseases
- Gastrointestinal Diseases
- Esophageal Diseases
- Overweight
- Esophageal Motility Disorders
- Deglutition Disorders
- Pathological Conditions, Signs and Symptoms
- Nutritional and Metabolic Diseases
- Signs and Symptoms
- Obesity
- Gastroesophageal Reflux
Other Study ID Numbers
Other Study ID Numbers
- GEA+VSG on GERD
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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