Evidence map›Paper›PMID 38935261›Full record

ArticleObesity surgery2024

Modified One Anastomosis Gastric Bypass Following Sleeve Gastrectomy for Severe Reflux and Delayed Gastric Emptying: A Prospective Trial with Clinical and Physiological Outcome Measures.

Anagi C Wickremasinghe, Yit J Leang, Yazmin Johari, Cheryl Laurie, David Nadebaum, Helen Yue, Kenneth S Yap, Geoffrey S Hebbard, Wendy A Brown, Paul R Burton

Abstract read
In one paragraph

Article in Obesity surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Anagi C WickremasingheMonash University Department of Surgery, Central Clinical School, Monash University, Level 6, Alfred Centre, 99 Commercial Rd, Melbourne, 3004 VIC, Australia. anagi.wickremasinghe@monash.edu.ORCID 0000-0001-9876-7792
Yit J LeangMonash University Department of Surgery, Central Clinical School, Monash University, Level 6, Alfred Centre, 99 Commercial Rd, Melbourne, 3004 VIC, Australia.
Yazmin JohariMonash University Department of Surgery, Central Clinical School, Monash University, Level 6, Alfred Centre, 99 Commercial Rd, Melbourne, 3004 VIC, Australia.
Cheryl LaurieMonash University Department of Surgery, Central Clinical School, Monash University, Level 6, Alfred Centre, 99 Commercial Rd, Melbourne, 3004 VIC, Australia.
David NadebaumDepartment of Nuclear Medicine and PET, The Alfred Hospital, Melbourne, Australia.
Helen YueDepartment of Nuclear Medicine and PET, The Alfred Hospital, Melbourne, Australia.
Kenneth S YapDepartment of Nuclear Medicine and PET, The Alfred Hospital, Melbourne, Australia.
Geoffrey S HebbardDepartment of Gastroenterology, Royal Melbourne Hospital and University of Melbourne, Melbourne, Australia.
Wendy A BrownMonash University Department of Surgery, Central Clinical School, Monash University, Level 6, Alfred Centre, 99 Commercial Rd, Melbourne, 3004 VIC, Australia.
Paul R BurtonMonash University Department of Surgery, Central Clinical School, Monash University, Level 6, Alfred Centre, 99 Commercial Rd, Melbourne, 3004 VIC, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGastro-esophageal reflux (GORD) following sleeve gastrectomy (SG) is a central challenge, and precise indications for revisional surgery or the physiology have not been precisely defined. We aimed to determine whether OAGB performed for reflux post-SG (1) accelerates gastric emptying half-time, (2) reduces the frequency and severity of reflux events, and (3) improves reflux symptoms.

methodsWe undertook a prospective trial (ACTRN12616001089426). There were 22 participants who underwent measurement before and after revisional surgery with 29 optimal SG (patients with optimal outcome from their primary surgery) as controls. All participants underwent a protocolized nuclear scintigraphy, 24-h pH monitoring, and gastroscopy and completed objective questionnaires.

resultsTrial patients were 90.9% female, age 44.4 years. Conversion from SG to OAGB was at a median of 45.2 ± 19.6 months. Scintigraphy showed an increased rate of gastric emptying post-OAGB 34 (IQR 14) vs 24 (IQR 10.3) min, p-value 0.008, with decreased number of reflux events post-prandially (39 (IQR 13) vs 26 (IQR 7), p-value 0.001). This data correlated with the pH analysis; total acid events substantially reduced post-OAGB 58.5 (IQR 88) vs 12 (IQR 9.4) events, p-value 0.017. Endoscopic findings indicated a reduction in incidence of bile stasis 72.7% vs 40.9% post-OAGB, p-value < 0.00010. Post-OAGB, patients experienced less frequent regurgitation (12 ± 4.1 vs. 5.5 ± 3, p-value 0.012) and reflux (37.1 ± 15.7 vs. 16.8 ± 12.6, p-value 0.003).

conclusionsWe found OAGB is an effective treatment for reflux associated with delayed gastric emptying post-SG. The likely mechanisms is by, an increase in the rate of gastric clearance and reduced reflux events and overall esophageal acid exposure. This suggests that some forms of post-SG reflux are driven by slower emptying of the residual stomach and are amenable to treatment with drainage above the incisura.

Indexed as

GastrectomyGastric BypassGastric EmptyingGastroesophageal RefluxObesity, MorbidAdultEsophageal pH MonitoringFemaleGastroparesisHumansMaleMiddle AgedProspective StudiesReoperationTreatment OutcomeBariatric outcomeBariatric surgery mechanismClinical trialDelayed gastric emptyingOne anastomosis gastric bypassPhysiologyRefluxSleeve gastrectomy

Identifiers

PMID38935261
PMCPMC11289068

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.