NCT05334173

Brief Summary

Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) has been the most performed bariatric surgical intervention until a few years ago, due to its good results in terms of weight loss and remission of comorbidities such as hypertension, type 2 diabetes mellitus, dyslipidemia and obstructive sleep apnea syndrome. However, more than 25% of patients do not obtain the expected result. There is no uniform technique to perform a LRYGB, but traditionally it was constructed using a long alimentary limb (AL) and a short biliopancreatic limb (BPL). There is no current consensus on the ideal length of the LRYGB limbs. The distal gastric bypass at the expense of a longer biliopancreatic limb (LBPL-GB) could induce more excess of weight loss (EWL%), but with possible protein malnutrition depending on the length of the remaining common limb. The aim of this study is compare a LBPL-GB (BPL 150cm, AL 70cm) with LAL-GB (BPL 70cm, AL 150cm). PRIMARY OUTCOME: to evaluate if there are differences in weight loss. SECONDARY OUTCOME: to assess whether there are differences in both groups in remission of the most common comorbidities and in quality of life. DESIGN: multicenter, prospective, randomized study in blocks (1:1), blinded for the patient and to the surgeon up to the time of intervention, in patients with indication of RYGB for obesity (BMI\>35 with associated comorbidity or BMI\>40 with or without comorbidity, excluding those of BMI\>50). Intervention: LRYGB type 1 (LAL-GB: 150cm ALand 70cm BPL) or type 2 (LBPL-GB: 70cm AL and 150cm BPL). The expected result is that the patients with LBPL-GB present better EWL%, and higher remission of their comorbidities than the comparison group

Trial Health

75
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
94

participants targeted

Target at P50-P75 for not_applicable

Timeline
4mo left

Started Jan 2019

Longer than P75 for not_applicable

Geographic Reach
1 country

3 active sites

Status
active not recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Progress95%
Jan 2019Sep 2026

Study Start

First participant enrolled

January 29, 2019

Completed
3.1 years until next milestone

First Submitted

Initial submission to the registry

March 19, 2022

Completed
1 month until next milestone

First Posted

Study publicly available on registry

April 19, 2022

Completed
2.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 11, 2024

Completed
1.9 years until next milestone

Study Completion

Last participant's last visit for all outcomes

September 21, 2026

Expected
Last Updated

October 17, 2023

Status Verified

October 1, 2023

Enrollment Period

5.7 years

First QC Date

March 19, 2022

Last Update Submit

October 16, 2023

Conditions

Keywords

Diabetes Mellitus, Type 2HypertensionDyslipidemiaObstructive Sleep Apnea SyndromeQuality of lifeNutritional deficitLaparoscopic-Roux-en-Y-Gastric-BypassBiliopancreatic limbAlimentary limbCommon limb

Outcome Measures

Primary Outcomes (1)

  • Excess Weight Loss (%EWL)

    The Excess Weight Loss (%EWL) after surgery. (Preoperatory weight in kilograms - current weight in kilograms) / (preoperatory weight in kilograms) x 100

    From baseline to five years after surgery

Secondary Outcomes (4)

  • Remission or improvement of Type 2 Diabetes Mellitus

    From baseline to five years after surgery

  • Remission or improvement of Hypertension

    From baseline to five years after surgery

  • Remission of improvement of Dyslipidemia

    From baseline to five years after surgery

  • Remission or improvement of Obstructive Sleep Apnea Syndrome

    From baseline to five years after surgery

Other Outcomes (1)

  • Quality of life after surgery

    From baseline to five years after surgery

Study Arms (2)

RYGB TYPE 1 - LONGER ALIMENTARY LIMB (LAL-GB)

ACTIVE COMPARATOR

150 cm alimentary limb and 70 cm biliopancreatic limb

Procedure: Roux-en-Y Gastric Bypass (RYGB) measuring the lengh of the common limb

RYGB TYPE 2 - LONGER BILIOPANCREATIC LIMB (LBPL-GB)

ACTIVE COMPARATOR

70 cm alimentary limb and 150 cm biliopancreatic limb

Procedure: Roux-en-Y Gastric Bypass (RYGB) measuring the lengh of the common limb

Interventions

The patients are randomized to Type 1 laparoscopic RYGB (150cm alimentary limb and 70cm biliopancreatic limb) or type 2 laparoscopic RYGB (70cm alimentary limb and 150cm biliopancreatic limb). In both groups, the total intestinal length is measured to determine the size of the common limb. We introduce a 10 cm ruler into the abdominal cavity to measure the bowel and then extract it. LRYGB is made with linear stapler anastomosis.

Also known as: Biliopancreatic and alimentary limbs of 150cm / 70cm, Biliopancreatic and alimentary limbs of 70cm / 150cm
RYGB TYPE 1 - LONGER ALIMENTARY LIMB (LAL-GB)RYGB TYPE 2 - LONGER BILIOPANCREATIC LIMB (LBPL-GB)

Eligibility Criteria

Age18 Years - 65 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients with BMI 35-40 kg/m2 with associated medical problems (Diabetes Mellitus, Hipertension, Dyslipidemia, Obstructive Sleep Apnea Syndrome) or 40-50 kg/m2 with or without associated medical problems, who comply with the regulatory rules for bariatric surgery in Spain (SECO and AEC)

You may not qualify if:

  • General contraindications to kind of surgery
  • BMI \> 50 kg/m2
  • Known drug or alcohol abuse
  • ASA (American Society of Anesthesiology) physical status classification \> III
  • Inability to follow the procedures of the study

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (3)

Juan José Arroyo Martín

Denia, Alicante, 03700, Spain

Location

Esther Mans Muntwyler

Mataró, Barcelona, 08301, Spain

Location

Débora Acín Gándara

Fuenlabrada, Madrid, 28942, Spain

Location

MeSH Terms

Conditions

ObesityDiabetes Mellitus, Type 2HypertensionDyslipidemiasSleep Apnea SyndromesSleep Apnea, Obstructive

Interventions

Gastric Bypass

Condition Hierarchy (Ancestors)

OverweightOvernutritionNutrition DisordersNutritional and Metabolic DiseasesBody WeightSigns and SymptomsPathological Conditions, Signs and SymptomsDiabetes MellitusGlucose Metabolism DisordersMetabolic DiseasesEndocrine System DiseasesVascular DiseasesCardiovascular DiseasesLipid Metabolism DisordersApneaRespiration DisordersRespiratory Tract DiseasesSleep Disorders, IntrinsicDyssomniasSleep Wake DisordersNervous System Diseases

Intervention Hierarchy (Ancestors)

Bariatric SurgeryBariatricsObesity ManagementTherapeuticsGastroenterostomyAnastomosis, SurgicalSurgical Procedures, OperativeDigestive System Surgical Procedures

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Masking Details
Blinded for the patient and to the surgeon up to the time of intervention
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Randomized trial in blocks (1:1). Type 1 laparoscopic Gastric Bypass (150cm alimentary limb and 70cm biliopancreatic limb) or type 2 laparoscopic Gastric Bypass (70cm alimentary limb and 150cm biliopancreatic limb)
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
MD, PhD, Bariatric Surgeon

Study Record Dates

First Submitted

March 19, 2022

First Posted

April 19, 2022

Study Start

January 29, 2019

Primary Completion

October 11, 2024

Study Completion (Estimated)

September 21, 2026

Last Updated

October 17, 2023

Record last verified: 2023-10

Data Sharing

IPD Sharing
Will not share

Locations