ArticleObesity surgery2026
Sleeve Gastrectomy with Roux-en-y Transit Bipartition versus Sleeve Gastrectomy for the Treatment of Obesity and Reflux: A Multicenter Randomized Controlled Trial.
Article in Obesity surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLaparoscopic Sleeve Gastrectomy (SG) is associated with a significant risk of de novo or worsening Gastroesophageal Reflux Disease (GERD). Sleeve Gastrectomy with Roux- en-y Transit Bipartition (SG-TB) has been proposed as an alternative procedure to mitigate reflux. This study aims to compare the efficacy and safety of SG versus SG-TB in controlling GERD in patients with obesity.
methodsA multicenter, prospective, pilot randomized controlled trial (ID: researchregistry11842) was conducted in three high- volume bariatric centers. A total of 120 patients with obesity were randomized to either SG (n = 60) or SG-TB (n = 60). The methodological core was the assessment of GERD, based on 24- hour pH-impedance monitoring performed at baseline and at 12 months.
resultsAt 12 months, the SG-TB group showed a significantly lower incidence of de novo GERD compared to the SG group (3.3% vs. 28.3%; p < 0.001). At 12 months, mean Acid Exposure Time (AET) was significantly lower after SG-TB than after SG (1.9% vs. 7.5%, p < 0.001) and remained numerically unchanged from the SG-TB baseline value of 1.9%. The SG-TB group also demonstrated a higher % of total weight loss and % Excess Weight Loss (%TWL: p < 0.001; %EWL: p = 0.002).
conclusionsIn this multicenter pilot RCT, SG-TB was associated with a significantly lower incidence of de novo GERD compared to SG at 12 months in carefully selected patients without severe pre-existing GERD. These short-term findings are encouraging; however, definitive conclusions regarding the superiority of SG-TB cannot be drawn on the basis of 12- month data alone. Longer follow-up is required to assess the durability of reflux outcomes, late nutritional safety, and late GERD relapse.
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