Comparing Nissen-Sleeve Gastrectomy and Roux-en-Y Gastric Bypass in Adults with Obesity and GERD to Improve Treatment Outcomes

What this Trial Is About

Researchers are investigating two surgical methods for treating obesity in patients who also experience symptoms of gastroesophageal reflux disease GERD. This study compares the newer Nissen-Sleeve Gastrectomy N-SG, which combines sleeve gastrectomy with an anti-reflux procedure, to the standard Roux-en-Y Gastric Bypass RYGB. The goal is to determine if N-SG is not worse than RYGB in reducing GERD symptoms one year after surgery, while also examining weight loss, quality of life, surgical complications, and hormone changes related to appetite. Participants will be randomly assigned to receive either N-SG, which preserves the gastrointestinal tracts natural pathway and includes a 360-degree wrap around the esophagus, or RYGB, which reroutes parts of the stomach and small intestine to help reduce reflux and promote weight loss. Additionally, a separate group of patients without GERD will undergo standard sleeve gastrectomy to serve as a control for comparison. All surgical procedures are laparoscopic and follow specific technical steps as described. During the year-long follow-up, participants will have blood samples collected at surgery, the day after, one week after discharge, and at 12 months to measure serum ghrelin levels. GERD symptoms will be assessed with a validated questionnaire before and after surgery, alongside weight loss and quality of life evaluations. The study also monitors surgical complications and the need for proton pump inhibitor therapy. This comprehensive data collection aims to improve bariatric treatment personalized for patients with obesity and reflux.

Comparison of Nissen-Sleeve and Gastric Bypass for GERD in Obese Patients