High Resolution Manometry After Partial Fundoplication for Gastro-oesophageal Reflux

NCT ID: NCT05132816

Last Updated: 2025-05-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-01-24

Study Completion Date

2027-12-31

Brief Summary

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This is a combined retro- and prospective, monocentric study. All patients who underwent or are planned for laparoscopic partial fundoplication (180° anterior or 270° posterior) between 2020-2023 are assessed for preoperative ineffective esophageal motility (IEM).

The main hypothesis is, that preoperative oesophageal motility disorders, especially hypo-contractility or failed peristalsis, are caused by gastro-oesophageal reflux. Therefore, postoperative manometry after partial wrap fundoplication (270° posterior, 180° anterior) shows a decrease in comparison to preoperative motility disorders.

The primary objective of this study is to examine the postoperative esophageal motility in patients with known preoperative motility disorders.

Secondary endpoints are the presence of other oesophageal motility disorders pre- vs. postoperatively (including new onset disorders), the assessment of the Gastrointestinal Symptom Rating Scale (GSRS) pre- vs. postoperatively, and more.

If IEM is present preoperatively, patients are contacted at least 1 year after surgery and will be informed about the study and asked to participate. In case of agreement, they are invited to the study site. They undergo high-resolution manometry 18-24 months postoperatively (study intervention).

Detailed Description

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Conditions

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Gastroesophageal Reflux Esophageal Motility Disorders Upper Gastrointestinal Disorder

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Main arm

Group Type EXPERIMENTAL

high-resolution manometry

Intervention Type DIAGNOSTIC_TEST

High-resolution manometry is an outpatient examination and part of our routine diagnostic or pre-operative evaluation in GERD.

A thin catheter is placed through the nose into the esophagus, local anaesthesia can be used if the patient experiences a discomfort. Once the tip of the manometry catheter is placed below the esophagogastric junction, the patient is asked to take in water and bread. In rest and during deglutition, pressure measurements are registered with the manometry catheter, allowing the investigator to detect IEM. The examination takes about 1.5 hours. The manometry is a standard and routine intervention being performed for over 30 years with minimal risks.

The GSRS questionnaire pre- and postoperatively is part of our standard workup, no additional assessment for this study is needed.

Interventions

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high-resolution manometry

High-resolution manometry is an outpatient examination and part of our routine diagnostic or pre-operative evaluation in GERD.

A thin catheter is placed through the nose into the esophagus, local anaesthesia can be used if the patient experiences a discomfort. Once the tip of the manometry catheter is placed below the esophagogastric junction, the patient is asked to take in water and bread. In rest and during deglutition, pressure measurements are registered with the manometry catheter, allowing the investigator to detect IEM. The examination takes about 1.5 hours. The manometry is a standard and routine intervention being performed for over 30 years with minimal risks.

The GSRS questionnaire pre- and postoperatively is part of our standard workup, no additional assessment for this study is needed.

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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Gastrointestinal Symptom Rating Scale (GSRS) - questionnaire

Eligibility Criteria

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Inclusion Criteria

* Age older than 18 years
* Ineffective esophageal motility disorder according the Chicago classification (7), defined as ≥ 7/10 (70%) of swallows with weak contraction (distal contraction interval (DCI) between 100mmHg/s/cm and less than 450 mmHg/s/cm) or ≥ 5/10 (50%) of swallows with failed peristalsis (DCI \<100mgHg/s/cm)Performance of partial fundoplication (180° anterior or 270° posterior) at Spital Limmattal
* Informed Consent as documented by signature

Exclusion Criteria

* Age under 18 years
* Pregnancy
* Normal preoperative esophageal motility
* Other specifically defined esophageal motility disorders such as Nutcracker or Jackhammer esophagus
* Preoperative presence of a hiatal hernia with migration of \>20% of stomach in the chest
* Revisional surgery (after other procedures for reflux or at the hiatus)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Prof Urs Zingg

OTHER

Sponsor Role lead

Responsible Party

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Prof Urs Zingg

Prof. Dr.

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Spital Limmattal

Schlieren, Canton of Zurich, Switzerland

Site Status RECRUITING

Countries

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Switzerland

Facility Contacts

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Urs Zingg, PD Dr. med.

Role: primary

+41 733 21 26

Patrizia Heeb

Role: backup

+41 733 11 11

Other Identifiers

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2021-01536

Identifier Type: -

Identifier Source: org_study_id

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