Randomised controlled trialindependent cross-checkabstract checked I-BAR-145 standard review

Trial follow-up: Barrett changes 7 years after sleeve or bypass

Long-term effect of Roux-en-Y gastric bypass versus sleeve gastrectomy on reflux and Barrett's oesophagus: a randomized controlled trial.

Overview

Lee et al.. ANZ J Surg 2025 · PMID 39829211 · DOI 10.1111/ans.19369

Barrett changes were found in 8 of 26 examined sleeve patients and 3 of 22 bypass patients; the difference was not statistically certain.

Does the study support the specific claim? Partly · Methodological quality: low

Study explained simply

What did the researchers want to find out?: BE after LSG vs LRYGB
How was the study done?: RCT follow-up
How many people, animals or samples were studied?: 48
What was actually found?: 30.8% vs 13.6%
How large was the observed effect?: P=0.19
What do the results mean in everyday life?: Endoscopy checks may be useful
What are the study's limitations?: Small, selected
What does it say about Elawady's specific claim?: Partly supports Barrett concern
Do the results apply to Germany and Europe?: Applicable
What can explicitly not be concluded from this study?: Cancer risk

Authors: Lee et al.
Journal: ANZ J Surg
Year: 2025
Identifier: PMID 39829211 DOI 10.1111/ans.19369
Verification: verified – PubMed efetch 2026-10-26 + Crossref API
Retracted: no
Corrections: none
Extent checked: abstract only
Conflicts of interest and funding: Grants: Johnson & Johnson Innovative Medicine, Medtronic Foundation, Auckland Medical Research Foundation (PubMed record).

Do long-term Barrett oesophagus and GORD differ after LSG and LRYGB?

Study design: Randomised controlled trial – Long-term endoscopic follow-up of a double-blind RCT (banded RYGB vs SG for T2D)
Population: Participants of an RCT for T2D remission; 48 of 109 took part
Country: New Zealand
Period: Mean follow-up 7.5 y
Sample size: 48 (26 LSG, 22 LRYGB)
Inclusion and exclusion criteria: Trial participants agreeing to gastroscopy

Exposure / intervention: LSG
Comparator: Banded LRYGB
Endpoints: Barrett (endoscopic and histologic), reflux scores, oesophagitis, PPI use, %EWL
Statistical methods: Group comparisons

Results: Barrett 8/26 (30.8%) LSG vs 3/22 (13.6%) LRYGB, P=0.19. Reflux and regurgitation scores not different. PPI use rose from 23.1% to 50.0% (LSG) and from 36.4% to 54.5% (LRYGB). %EWL 49.7% vs 74.8%.
Absolute risks: Barrett in about 3 in 10 sleeve participants examined.
Authors' conclusion: Long-term BO incidence trended higher but not significantly after LSG; routine endoscopic surveillance supported.

30.8% vs 13.6%, P=0.19: imprecise; compatible with no difference or a large excess.

Highest Barrett frequency in a randomised population; supports concern but underpowered; also shows half of sleeve patients used PPIs (not all).

Non-significant; selection.

New Zealand data.

Weak evidence; signal for Barrett after sleeve.

Multidimensional assessment
Multidimensional assessment
Authenticity of the source	verified
Methodological quality	low
Risk of bias	high
Precision of results	low
Directness	direct
Reproducibility	unknown
Consistency with the overall evidence	mixed
Regional transferability	moderate
Adequacy of the interpretation (by the archive)	not applicable

Adequately powered endoscopic RCT follow-up.