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Obese Patients (BMI ≥ 30 kg/m²)NCT07070908

Modifications to Gastric Sleeve: Implications for GRED and Quality of Life

A study testing Antrum calibration, Fudus calibration and No antrum calibration in people with Obese Patients (BMI ≥ 30 kg/m²) and Obese Patients, run by Hospital San Juan de Dios Tenerife at 1 site in Spain.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

This is a prospective randomized clinical trial evaluating the impact of antrum and fundus calibration during laparoscopic vertical gastrectomy (VG) on postoperative gastroesophageal reflux disease (GERD), quality of life, and surgical costs. Read more about this study

Who is it for?
Ages 18 to 65 years
What is being tested?
Antrum calibration, Fudus calibration and No antrum calibration
Could I receive a placebo?
No, everyone receives an active treatment
How many people
120 participants
Where
1 siteSpain
Study dates
6 Apr 2020to 31 Dec 2025
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients with morbid obesity on the waiting list for bariatric surgery.
  • Both male and female participants.
  • Age between 18 and 65 years.
  • BMI > 35 kg/m².
  • Availability to attend scheduled follow-up visits.
  • Indication for sleeve gastrectomy as the first bariatric procedure.

Who cannot join

  • Obesity of endocrine origin.
  • Preoperative GERD (diagnosed by pH-metry or upper endoscopy following a positive GERD-HRQL test).
  • Active gastrointestinal disease (such as esophagitis, peptic ulcer, cancer, or esophageal motility disorder), diagnosed by endoscopy or manometry.
  • History of previous gastric surgery.
  • Patients not meeting the inclusion criteria

Trial locations and contacts

1 site in 1 country.

Spain1 site
  • Regional University Hospital of Málaga

    Málaga, Malaga, 29010

Other trials in Spain

About this study

Official title: Modifications to Gastric Tube Construction in Vertical Gastrectomy: Implications for Gastroesophageal Reflux Disease and Patient Quality of Life

This is a prospective randomized clinical trial evaluating the impact of antrum and fundus calibration during laparoscopic vertical gastrectomy (VG) on postoperative gastroesophageal reflux disease (GERD), quality of life, and surgical costs. Eligible participants are adults with morbid obesity (BMI ≥35 kg/m²) undergoing LSG. Patients are randomized into four groups based on whether antral and/or fundal calibration is performed. Primary outcomes include the incidence of de novo GERD at 12 months. Secondary outcomes include postoperative quality of life, vomiting , surgical complications, weight loss, and operative costs. The study aims to optimize the LSG technique by identifying anatomical modifications that minimize GERD while improving clinical outcomes

Read the detailed description

This is a prospective, randomized clinical trial conducted at the Regional University Hospital of Málaga. The objective is to evaluate the effect of antrum and fundus calibration during vertical gastrectomy (VG) on the incidence of gastroesophageal reflux disease (GERD), quality of life, weight loss, and surgical costs.

Eligibility Criteria:

Inclusion criteria include adults with an indication for VG, a body mass index (BMI) ≥ 35 kg/m², and provision of written informed consent.

Exclusion criteria include endocrine-related obesity, active gastrointestinal disease (such as GERD, esophagitis, peptic ulcer, or motility disorders), or a history of gastric surgery.

Randomization and Study Arms:

Patients are randomized to one of four groups:

Group A: No antrum or fundus calibration Group B: Fundus calibration only Group C: Antrum and fundus calibration Group D: Antrum calibration only

Surgical Protocol:

All patients receive a 36 Fr bougie to shape the gastric tube. In cases with antrum calibration, a 50 cc balloon catheter (MidSleeve®) guides the staple line. For fundus calibration, transection is performed 1 cm from the anatomical fat pad. Stapler height is adjusted according to tissue thickness, and the staple line is reinforced.

GERD Assessment:

De novo GERD is defined by endoscopic findings (esophagitis), pathological pH monitoring (DeMeester index > 14.72 or acid exposure > 4%), or clinically significant reflux symptoms with a GERD-HRQL score ≥ 12. Preoperative GERD is ruled out by endoscopy and questionnaire, followed by pH monitoring if symptoms are present.

Follow-Up and Monitoring:

Patients are followed at 2 weeks, 3, 6, and 12 months. In those reporting symptoms postoperatively, endoscopy and pHmetry are repeated.

Variables Collected:

Data include age, sex, BMI, comorbidities, operative details (e.g., number of stapler cartridges), complications (Clavien-Dindo classification), weight loss (%EWL), quality of life metrics (vomiting, regurgitation, satiety, food tolerance), and presence of GERD.

Statistical Analysis:

Comparisons are made across the four study groups, as well as pooled analyses for fundus calibration (yes vs. no) and antrum calibration (yes vs. no). Quantitative data are analyzed using Student's t-test or Mann-Whitney U test, and categorical variables by chi-square or Kruskal-Wallis test as appropriate. Spearman's correlation is used for association between variables. A p-value < 0.05 is considered statistically significant.

Being tested
Antrum calibration, Fudus calibration, No antrum calibration, No fundus calibration
Keywords
Obesity, Vertical gastrectomy, Gastroesophageal reflux disease, Quality of life
Medical subject headings
Obesity, Gastroesophageal Reflux

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Antrum calibrationDevice

    Also called Antrum section

    For antral calibration, a 50 cc balloon catheter was used to guide the staple line.

  • Fudus calibrationProcedure or surgery

    Also called fundus section

    Fundus transection was performed 1 cm from the "fat pad" in calibrated cases (an anatomically constant area near the short gastric vessels that contains minimal fat and facilitates dissection toward the diaphragmatic crus).

  • No antrum calibrationProcedure or surgery

    In patients without antrum calibration, gastric transection was performed 5 cm from the pylorus.

  • No fundus calibrationProcedure or surgery

    Fundus transection was performed adjacent to the "fat pad" in no calibrated cases.

Study groups in NCT07070908
Study groupRoleWhat they receive
No antrum or fundus calibrationExperimentalNo antrum or fundus calibration
Receives: Procedure: No antrum calibration; Procedure: No fundus calibration
Fundus calibrationExperimentalFundus calibration only
Receives: Procedure: Fudus calibration; Procedure: No antrum calibration
Antrum and fundus calibrationExperimentalAntrum and fundus calibration
Receives: Device: Antrum calibration; Procedure: Fudus calibration
Antrum calibrationExperimentalAntrum calibration only
Receives: Device: Antrum calibration; Procedure: No fundus calibration

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Incidence of de novo Gastroesophageal Reflux Disease (GERD)

    De novo GERD will be diagnosed if any of the following criteria are met:

    Presence of esophagitis according to the Los Angeles classification DeMeester index > 14.72 Acid exposure time > 4% on 24-hour pH-metry GERD-HRQL questionnaire score ≥ 12

    Measured: 12 months postoperatively

Secondary outcomes (18)
  1. Incidence of Postoperative Vomiting

    Postoperative vomiting will be assessed during follow-up visits at 2 weeks, 3 months, 6 months, and 12 months. Patients will self-report the presence, frequency, and severity of vomiting episodes related to food intake.

    Measured: 12 months postoperatively

  2. Incidence of Postoperative Regurgitation

    Postoperative regurgitation will be assessed during follow-up visits at 2 weeks, 3 months, 6 months, and 12 months. Patients will self-report the presence, frequency, and severity of regurgitation related to food intake. In addition, regurgitation will be evaluated using the specific item in the GERD-Health-Related Quality of Life (GERD-HRQL) questionnaire.

    Measured: 12 months postoperatively

  3. Food intake volume per meal

    Food intake volume will be assessed during follow-up visits at 2 weeks, 3 months, 6 months, and 12 months.

    Measured: 12 months postoperatively

  4. Percentage of excess weight loss (%EWL)

    The percentage of excess weight loss (%EWL) will be calculated at 12 months postoperatively. %EWL is defined as:

    Ideal weight will be based on a BMI of 25 kg/m². This measure evaluates the effectiveness of the procedure in achieving weight reduction

    Measured: 12 months postoperatively

  5. Change in Hypertension Status from Baseline to 12 Months Post-Surgery

    Hypertension improvement or resolution will be determined by comparing preoperative and postoperative clinical records, and antihypertensive medication usage.

    Measured: Baseline and within 12 months after surgery

  6. Postoperative BMI

    The Body Mass Index (BMI) will be calculated at each postoperative follow-up visit (2 weeks, 3 months, 6 months, and 12 months) to assess the evolution of weight loss. BMI is calculated as weight in kilograms divided by the square of height in meters (kg/m²)

    Measured: Within 12 months after surgery

  7. Weight loss

    Weight loss will be calculated at each postoperative follow-up visit (2 weeks, 3 months, 6 months, and 12 months)

    Measured: Within 12 months after surgery

  8. Postoperative Morbidity

    Postoperative complications will be assessed and classified according to the Clavien-Dindo classification system. All adverse events occurring within 30 days of surgery will be recorded and categorized by severity.

    Measured: Up to 30 days after surgery

  9. Number of stapler cartridges used

    The total number of stapler cartridges used during vertical gastrectomy will be recorded for each patient.

    Measured: During the surgical procedure

  10. Intraoperative complications

    All adverse events occurring during surgery will be recorded, including bleeding, injury to adjacent organs, anesthetic incidents, or other unforeseen technical difficulties

    Measured: During the surgical procedure

  11. Change in Type 2 Diabetes Mellitus Status from Baseline to 12 Months Post-Surgery

    Improvement or resolution of Type 2 Diabetes Mellitus will be assessed through levels, HbA1c, and antidiabetic medication requirements

    Measured: Baseline and within 12 months after surgery

  12. Change in Hypercholesterolemia Status from Baseline to 12 Months Post-Surgery

    Evaluated through serum cholesterol levels and lipid-lowering medication usage before and after surgery.

    Measured: Baseline and within 12 months after surgery

  13. Change in Obstructive Sleep Apnea Syndrome (OSAS) Status from Baseline to 12 Months Post-Surgery

    Improvement or resolution based on patient-reported symptoms, CPAP usage, and clinical evaluation

    Measured: Baseline and within 12 months after surgery

  14. Change in Hypertriglyceridemia Status from Baseline to 12 Months Post-Surgery

    Improvement or resolution of hypertriglyceridemia will be assessed by comparing preoperative and postoperative triglyceride levels and the need for lipid-lowering therapy

    Measured: Baseline and within 12 months after surgery

  15. Change in Postoperative Satiety Over Time

    Satiety will be assessed through patient self-reported feedback during postoperative visits at 2 weeks, 3 months, 6 months, and 12 months. The evaluation includes perceived fullness after meals and the volume of food tolerated per intake.

    Measured: 2 weeks, 3 months, 6 months, and 12 months postoperatively

  16. Tolerance to Oral Liquid Intake After Surgery

    Tolerance to oral liquid intake will be assessed at 2 weeks, 3 months, 6 months, and 12 months after surgery. This variable evaluates the patient's ability to ingest and retain clear liquids without nausea, vomiting, or discomfort. Data will be collected through clinical interviews, patient-reported outcomes, and medical records during scheduled follow-up visits.

    Measured: 2 weeks, 3 months, 6 months, and 12 months postoperatively

  17. Tolerance to Oral Solid Intake After Surgery

    Assessment of the patient's ability to tolerate solid food intake following vertical gastrectomy. Tolerance will be evaluated based on patient self-reported ability to consume solid foods without discomfort, vomiting, or regurgitation.

    Measured: 2 weeks, 3 months, 6 months, and 12 months postoperatively

  18. Tolerance to Oral Meat Intake After Surgery

    Patient-reported ability to consume and tolerate meat (solid protein) without nausea, vomiting, regurgitation, or abdominal discomfort. Data will be collected via clinical interviews at each postoperative visit

    Measured: 2 weeks, 3 months, 6 months, and 12 months postoperatively

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Jul 2025
  2. Study start6 Apr 2020
  3. Primary completion31 Dec 2025 (estimated)
  4. Study completion31 Dec 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Screening
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
120 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07070908
Sponsor's protocol ID
25-00101
Status last verified
Jul 2025
First submitted
27 Jun 2025
Last updated
17 Jul 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No: The data presented in this study are available on request from the corresponding author, in accordance with the informed consent provided by study participants and subject to patient confidentiality and data protection policies

Questions about this trial

What is this clinical trial studying?

A study testing Antrum calibration, Fudus calibration and No antrum calibration in people with Obese Patients (BMI ≥ 30 kg/m²) and Obese Patients, run by Hospital San Juan de Dios Tenerife at 1 site in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 17 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Incidence of de novo Gastroesophageal Reflux Disease (GERD) (time frame: 12 months postoperatively). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Jul 2025.

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