Evidence mapPaperPMID 41554945Full record

Trial reportObesity surgery2026

Ring-Augmented Versus Non-Ring Augmented Sleeve Gastrectomy in Patients with BMI > 50 kg/m²: 3-Year Follow-up of a Randomized Controlled Trial.

Mohamed Hany, Walid El Ansari, Mohamed H Zidan, Anwar Ashraf Abouelnasr, Mohamed Ibrahim, Hazem Al Momani, Ala Wafa, Ehab Elmongui, Bart Torensma

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Obesity surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

9 authors.

Mohamed HanyDepartment of Surgery, Medical Research Institute, Alexandria University, Alexandria, Egypt. mohamed.ashour@alexu.edu.eg.ORCID http://orcid.org/0000-0001-6650-8112
Walid El AnsariCollege of Medicine, Ajman University, Ajman, United Arab Emirates.
Mohamed H ZidanMadina's Bariatric Center, Madina Women's Hospital, Alexandria, Egypt.ORCID http://orcid.org/0000-0001-7425-356X
Anwar Ashraf AbouelnasrDepartment of Surgery, Medical Research Institute, Alexandria University, Alexandria, Egypt.ORCID http://orcid.org/0009-0007-5718-994X
Mohamed IbrahimDepartment of Surgery, Medical Research Institute, Alexandria University, Alexandria, Egypt.ORCID http://orcid.org/0000-0003-4000-9520
Hazem Al MomaniNMC Royal Khalifa Hospital, Abu Dhabi, United Arab Emirates.ORCID http://orcid.org/0000-0001-8693-1364
Ala WafaDirector of Libyan Board of Metabolic and Bariatric Surgery Fellowship program, Assistant Professor of Surgery, Misurata University, Jamahiriya, Libya.
Ehab ElmonguiIndependent biostatistical consultant, Alexandria, Egypt.ORCID http://orcid.org/0009-0002-9497-8159
Bart TorensmaErasmus University Rotterdam, Rotterdam, Netherlands.ORCID http://orcid.org/0000-0003-0274-9608

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSleeve gastrectomy (SG) is effective but prone to late recurrent weight gain (RWG). Ring-augmented SG (Ra-SG) may preserve restriction and enhance long-term durability.

methodsIn this single-center, prospective, single-blind randomized trial, adults with a BMI > 50 kg/m² were randomized to SG or Ra-SG and followed for 36 months. The primary endpoint was percent total weight loss (%TWL) at 36 months. Secondary outcomes included RWG, gastric pouch volumetry, relapse of associated medical problems, complications, endoscopic findings, laboratory parameters, and patient-reported outcomes (SF-36, Suter).

resultsRa-SG produced significantly greater weight loss at 36 months (48.8 ± 8.3 vs. 45.5 ± 9.0%TWL; mean difference 3.25% points, 95% CI 0.86 to 5.63; p 0.008). Exploratory analyses showed lower rates of clinically significant RWG (≥ 30% regain: 5.9% vs. 16.3%; absolute risk difference - 10.4%, 95% CI - 19.6 to - 1.2; p = 0.033) and smaller pouch volumes (160.1 ± 8.9 vs. 194.2 ± 10.3 mL; p < 0.001). Perioperative complications were infrequent and comparable. At three years, the prevalence of endoscopic GERD was similar (17.3% vs. 19.6%). Food tolerance scores were consistently better after SG (all p < 0.05). HRQoL improved significantly in both groups, with no differences observed at 36 months. Two Ra-SG patients (1.8%) underwent ring removal.

conclusionsRa-SG enhanced weight-loss durability and lowered RWG compared to SG, with similar safety and GERD outcomes but decreased food tolerance at mid-term. Ra-SG may be considered in patients at higher risk of RWG, though multicenter studies with longer follow-up are needed to confirm these findings.

Indexed as

GastrectomyObesity, MorbidAdultBody Mass IndexFemaleFollow-Up StudiesHumansMaleMiddle AgedPostoperative ComplicationsProspective StudiesSingle-Blind MethodTreatment OutcomeWeight GainWeight LossBanded sleeveFood toleranceMetabolic and bariatric surgeryRecurrent weight gainRing-augmented sleeve gastrectomySleeve gastrectomy

Identifiers

PMID41554945
PMCPMC13038747

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.