Obesity, Morbid Clinical Trial
Official title:
Impact of the Preservation of the Gastric Antrum in the Technique of Sleeve Gastrectomy for the Treatment of the Morbid Obesity: a Prospective,Controlled, Randomized, Multicentrique Study.
The bariatric surgery is recognized, at present, as the only effective therapeutic for the
patients with morbid obesity. Two surgical procedures (said restrictive) are considered as
consensual: the adjustable calibrated horizontal gastroplasty under laparoscopy (ring
périgastric) and Gastric Bypass under laparoscopy (LGBP). The longitudinal gastrectomy
(sleeve gastrectomy) is a technique of bariatric surgery recently validated (HAS on 2008). It
consists of the realization of a partial gastrectomy of 2/3 (Fundus, gastric Body +/-
antrum). However, lot of technical disagreements are brought back by expert teams. The most
important disagreement concerns the conservation or the exeresis of the gastric antrum. In
fact, the conservation of gastric antrum could facilitate the gastric emptying and to
decrease the RGO (main complication) and act on the regulations of hormones modulators of the
insulino-secretion.
A prospective,randomized study comparing these both techniques is necessary to determine a
unique consensual technique
The main objective of this study is to compare the frequency of post-operative gastronomic
appearance of gastroesophageal reflux(RGO) between two techniques of longitudinal gastrectomy
under laparoscopy (gastrectomy coupling sleeve with antrum conservation or without antrum
conservation) at patients with morbid obesity.
There are lot of secondary outcomes assessed in this study. In fact, one of secondary
objectives is to compare between both techniques of longitudinal gastrectomy under
laparoscopy described in the literature the efficiency on the loss of weight and global
post-operative morbidity.
This study assess the impact of these surgery techniques on the comorbidity of the obesity
and their treatments (type 2 diabetes, arterial hypertension, sleep apnea syndrome,
arthralgia, dyslipemia).
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