Three M Study (Malabsorption, Microbiota, Mini-Gastric Bypass)

NCT ID: NCT03412149

Last Updated: 2021-04-28

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

COMPLETED

Clinical Phase

NA

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-03-21

Study Completion Date

2020-11-19

Brief Summary

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Bariatric surgery represents the best therapeutic option to induce sustainable weight loss and to solve serious comorbidities improving the life-expectancy and the quality of life. Actually the choice of the procedure is based on the surgeon's and patients preference . Mini gastric bypass(MGB) is an emerging procedure offering excellent results in terms of weight loss and comorbidities (mainly metabolic) control. On the other hand, recent data indicated that the gut microbiota may mediate some of the beneficial effects of bariatric surgery and changes in the composition and diversity of the gut microbiota have been observed after RY Gastric Bypass (RYGB) in humans as well as in mice. However, there are no prospective investigations on Gut Microbiota changes after MGB, despite the procedure is described as "malabsorptive" and there are no studies comparing gut microbiota shift and malabsorption entity in humans after RYGB vs MGB. Thereafter prospective data on the incidence of bile reflux esophageal lesions after MGB are lacking.

The aim of the present multicentric prospective comparative study is to evaluate malabsorption and gut microbiota shift after laparoscopic RYGB vs MGB at 1 year.

Detailed Description

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Conditions

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Obesity (Disorder)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Mini Gastric Bypass

Mini Gastric Bypass: The gastric pouch will be performed starting below the incisura angularis (transverse resection 4 cm) on the lesser curvature (18).Then the stomach will be transected against a 36 Fr bougie up to the gastro-esophageal junction Then 1/3 of the small bowel will be excluded (approximately 200cms) and 3.5-4 cm gastro-jejunostomy will be performed by linear stapler.

Group Type ACTIVE_COMPARATOR

Mini Gastric Bypass

Intervention Type PROCEDURE

Standardization of the techniques will be guaranteed:

1. Mini Gastric Bypass Arm
2. Roux en Y Gastric Bypass arm All patients will have intraoperative measurement of the whole length of bowel from Treitz ligament to the ileocecal junction (expected range 6-8 m).The common limb will be therefore about 2/3 of total small bowel length.

Roux en Y Gastric Bypass

Roux en Y Gastric Bypass: The steps of the standard double loop RYGB technique will be followed (17). The gastric pouch will be created 7 cm from the gastro-esophageal junction to obtain a volume of 30-40 ml, and the length of the alimentary limb will be 150 cm and 3.5-4 cm gastro-jejunostomy will be performed by linear stapler. The length of the biliopancreatic limb will be from 65 to 75 cm beyond the ligament of Treitz. The lengths of both limbs should carefully measured with a graduated instrument. The mesenteric defects will be closed.

Group Type ACTIVE_COMPARATOR

Roux en Y Gastric Bypass

Intervention Type PROCEDURE

Standardization of the techniques will be guaranteed:

1. Mini Gastric Bypass Arm
2. Roux en Y Gastric Bypass arm All patients will have intraoperative measurement of the whole length of bowel from Treitz ligament to the ileocecal junction (expected range 6-8 m).The common limb will be therefore about 2/3 of total small bowel length.

Interventions

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Mini Gastric Bypass

Standardization of the techniques will be guaranteed:

1. Mini Gastric Bypass Arm
2. Roux en Y Gastric Bypass arm All patients will have intraoperative measurement of the whole length of bowel from Treitz ligament to the ileocecal junction (expected range 6-8 m).The common limb will be therefore about 2/3 of total small bowel length.

Intervention Type PROCEDURE

Roux en Y Gastric Bypass

Standardization of the techniques will be guaranteed:

1. Mini Gastric Bypass Arm
2. Roux en Y Gastric Bypass arm All patients will have intraoperative measurement of the whole length of bowel from Treitz ligament to the ileocecal junction (expected range 6-8 m).The common limb will be therefore about 2/3 of total small bowel length.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* BMI 40-55 kg/m2
* Non smokers
* Primary Mini Gastric Bypass or Roux en Y Gastric Bypass without any concomitant surgeries except hiatal hernia repair
* Enrollment in the two study groups will be on the basis of patient choice.

Exclusion Criteria

* Smokers
* Different bowel measurement (plus or minus 10%).
* Conversion to open surgery, reoperation
* Helicobacter Pylori positive previous or current
* Free PPI 4 weeks before 6th month (after surgery)
* Corticosteroids, vitamine E, fish oil treatment 2 months before surgery
* Anti or pre- biotics treatment 2 months before surgery
* Chronic gastrointestinal diseases or syndromes
* Previous bariatric surgery (intragastric balloon excluded)
* Previous resective bowel surgery
* Previous pancreatic surgery
* Previous Hepato BilioPancreatic surgery
* Gallbladder gallstones
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Roma La Sapienza

OTHER

Sponsor Role lead

Responsible Party

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Gianfranco Silecchia

MD PhD Prof. G. Silecchia

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Gianfranco Silecchia, MD PhD

Role: PRINCIPAL_INVESTIGATOR

University of Roma La Sapienza

Locations

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ICOT Hospital

Latina, , Italy

Site Status

Countries

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Italy

References

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Provided Documents

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Document Type: Study Protocol

View Document

Other Identifiers

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RG11715C7CE1AD8A

Identifier Type: -

Identifier Source: org_study_id

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