Sleeve Gastrectomy with Roux-en-y Transit Bipartition versus Sleeve Gastrectomy for the Treatment of Obesity and Reflux: A Multicenter Randomized Controlled Trial.
Vincenzo Consalvo, Sofia Guadalupe Rodriguez, Federica Galli et al.
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In 30 seconds
This multicenter, prospective pilot randomized controlled trial compared sleeve gastrectomy with Roux-en-y transit bipartition (SG-TB) against sleeve gastrectomy (SG) in 120 patients with obesity. At 12 months, de novo GERD occurred less often after SG-TB than after SG (3.3% vs. 28.3%; p < 0.001). Mean acid exposure time was also lower with SG-TB (1.9% vs. 7.5%, p < 0.001), while weight-loss measures favored SG-TB. The findings apply to carefully selected patients without severe pre-existing GERD and do not establish long-term superiority.
Key findings
- At 12 months, de novo GERD incidence was 3.3% with SG-TB versus 28.3% with SG (p < 0.001).
- Mean acid exposure time at 12 months was 1.9% after SG-TB versus 7.5% after SG (p < 0.001).
- SG-TB was associated with higher % total weight loss (p < 0.001) and % excess weight loss (p = 0.002).
Why it matters
Reflux is a recognised concern after sleeve gastrectomy. This randomized comparison suggests that adding Roux-en-y transit bipartition may reduce short-term reflux outcomes while also improving weight-loss measures. The results may inform evaluation of surgical options for appropriately selected patients, but the pilot design and 12-month follow-up leave durability and later safety unresolved.
What to keep in mind
This was a pilot trial with 12-month follow-up; the authors state that longer follow-up is needed to assess durability, late nutritional safety, and GERD relapse. Findings concern carefully selected patients without severe pre-existing GERD.