Weight Loss Clinical Trial
Official title:
Laparoscopic Gastric Bypass Versus Laparoscopic Banded Gastric Bypass, a Randomized Prospective Clinical Trial
This study try to identify differences in length of operation, weight loss and complications,
between two different bariatric surgical techniques, the laparoscopic Roux-en-Y gastric
bypass and the laparoscopic Roux-en-Y banded gastric bypass. The study will be conducted in a
Spanish public health system hospital. The patients of the trial will have the preoperative
studies, hospital treatment during the admission, postoperative treatment and follow up as
any other patient included in the hospital bariatric surgery program. The study cases will
have placed around the gastric pouch a band of polypropylene mesh, and will be randomly
choose between the participants.
Patients will be randomized in a 5/3 (study/control) ratio.
One group of patients of the study will have done the simplified laparoscopic gastric bypass,
with a vertical gastric pouch of about 20 ml, a 150 cm Roux-en-Y limb constructed in an
antegastric antecolic fashion, and a biliary limb of 100 cm. Anastomosis will be done with
endoscopic surgical linear stapler, closing the apertures with continuous absorbable running
sutures. The Petersen space and the mesenteric defect will be closed with non-absorbable
sutures.
The other group of patients will have performed the laparoscopic Roux-en-Y banded gastric
bypass. This technique is identical to the one performed in the other group, but differs in
that a polypropylene mesh (10x65 mm) is placed 15 mm proximal to the anastomosis around the
gastric pouch, and the gastric pouch is about 15 mm longer.
The investigators randomly assigned 50 patients to the study group (Laparoscopic Roux-en-Y
banded gastric bypass) and 30 to the control group (Laparoscopic Roux-en-Y gastric bypass) ,
n=80, and were also blinded to the surgeon until surgery.
One of the methods is basically the same than the other, but for the placement of the
polypropylene mesh around the gastric pouch above the anastomosis, and patient series with
Laparoscopic Roux-en-Y banded gastric bypass showed long term better weight loss than other
series with not banded gastric bypass, thus it is expected a difference in long term weight
loss between groups.
Fisher Test will be used for the statistical analysis, assuming a risk of 0.05 and a
statistical power of 90%.
Sample size is calculated considering bibliographic long term weight loss in both groups,
which is 82% in the banded group versus 63% in the not banded group. Thus sample size (n):
67, and adjust by loss sample size: 79 (10% expected loss ratio), not being necessary a 1: 1
ratio between cases and controls and requiring no more than 25 controls, A sample size of 50
cases and 30 controls, total n = 80, will be used.
The method of randomization was concealed envelopes.
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