One Anastomosis Gastric Bypass With Excluded Stomach Fundoplication: FundoRing vs Nissen vs OAGB Without Fundoplication

NCT ID: NCT04828733

Last Updated: 2025-01-03

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

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-03-29

Study Completion Date

2024-05-10

Brief Summary

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Background and study aims:

Currently, one anastomosis Gastric Bypass (OAGB) is a common bariatric procedure.

Obesity and gastroesophageal reflux disease (GERD) are steadily increasing world weight and antireflux surgery must be performed simultaneously with bariatric surgery in obese patients. In these cases, most often for GERD patients OAGB procedures only with hiatus cruroraphy is performed.

The goal of this randomized controlled clinical trial is to compare bariatric and antireflux results after OAGB plus suture cruroplasty with FundoRing (n=50) versus Nissen fundoplication (n=50) and versus without total fundoplication (n=50) for patients with morbid obesity and GERD.

The main questions it aims to answer are:

* What is the impact of wrapping the fundus of the excluded part of the stomach use FundoRing method in the experimental group against developing reflux esophagitis compare impact standard Nissen in OAGB?
* What is the impact of excluded stomach fundoplication on weight loss in FundoRing group versus standard Nissen group in OAGB?

Methods: Adult participants (n=150) are randomly allocated to one of three groups:

Experimental surgical bariatric procedure in the first (A) group: patients (n=50) undergo the laparoscopic one anastomosis gastric bypass with excluded stomach fundoplication: FundoRingOAGB and suture cruroplasty (OAGB + SCP + FundoRing); Active comparator surgical bariatric procedure in the second (B) group: patients (n=50) undergo the laparoscopic one anastomosis gastric bypass with excluded stomach Nissen fundoplication and suture cruroplasty (OAGB + SCP +NF).

Active comparator surgical bariatric procedure in the second (C) group: patients (n=50) undergo laparoscopic one anastomosis gastric bypass without excluded stomach fundoplication and only suture cruroplasty (OAGB + SCP). All patients are then followed up 12, 24, and 36 months after surgery where the changing body mass index and change of GERD symptoms (GERD-HRQL).

Detailed Description

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One anastomosis Gastric Bypass/Mini Gastric Bypass (OAGB/MGB) is gaining popularity as a primary surgical treatment for morbid obesity. The total fundoplication is the gold standard for treating GERD. Morbid obesity and GERD require simultaneous surgical treatment.

The aim study is to compare bariatric and antireflux results after OAGB/MGB plus suture cruroplasty (SCP) with FundoRing versus Nissen fundoplication and versus without total fundoplication.

Adult participants (n=150) are randomly allocated to one of three groups:

Experimental surgical bariatric procedure in the first (A) group: patients (n=50) undergo the laparoscopic one anastomosis gastric bypass with excluded stomach fundoplication: FundoRingOAGB and suture cruroplasty (OAGB + SCP + FundoRing); Active comparator surgical bariatric procedure in the second (B) group: patients (n=50) undergo the laparoscopic one anastomosis gastric bypass with excluded stomach Nissen fundoplication and suture cruroplasty (OAGB + SCP +NF).

Active comparator surgical bariatric procedure in the second (C) group: patients (n=50) undergo laparoscopic one anastomosis gastric bypass without excluded stomach fundoplication and only suture cruroplasty (OAGB + SCP). All patients are then followed up 12, 24, 36 months after surgery where record the changing body mass index and change of GERD symptoms (GERD-HRQL).

Conditions

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Obesity GERD

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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OAGB + SCP + FundoRing

laparoscopic one anastomosis gastric bypass with excluded stomach fundoplication: FundoRingOAGB and suture cruroplasty

Group Type EXPERIMENTAL

laparoscopic one anastomosis gastric bypass with excluded stomach fundoplication: FundoRingOAGB and suture cruroplasty

Intervention Type PROCEDURE

Laparoscopic gastric bypass with suture cruroplasty and excluded stomach fundoplication use FundoRing method.

OAGB + SCP + NF

laparoscopic one anastomosis gastric bypass with excluded stomach Nissen fundoplication and suture cruroplasty

Group Type ACTIVE_COMPARATOR

laparoscopic one anastomosis gastric bypass with excluded stomach Nissen fundoplication and suture cruroplasty

Intervention Type PROCEDURE

Laparoscopic gastric bypass with suture cruroplasty and excluded stomach fundoplication use the Nissen method.

OAGB + SCP

laparoscopic one anastomosis gastric bypass without excluded stomach fundoplication and only suture cruroplasty

Group Type ACTIVE_COMPARATOR

Standard laparoscopic one anastomosis gastric bypass with cruroplasty. Not used fundoplication.

Intervention Type PROCEDURE

Laparoscopic gastric bypass with only suture cruroplasty without fundoplication

Interventions

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laparoscopic one anastomosis gastric bypass with excluded stomach fundoplication: FundoRingOAGB and suture cruroplasty

Laparoscopic gastric bypass with suture cruroplasty and excluded stomach fundoplication use FundoRing method.

Intervention Type PROCEDURE

laparoscopic one anastomosis gastric bypass with excluded stomach Nissen fundoplication and suture cruroplasty

Laparoscopic gastric bypass with suture cruroplasty and excluded stomach fundoplication use the Nissen method.

Intervention Type PROCEDURE

Standard laparoscopic one anastomosis gastric bypass with cruroplasty. Not used fundoplication.

Laparoscopic gastric bypass with only suture cruroplasty without fundoplication

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Class I- III obesity (BMI 30.0-50.0 kg/m)
* Patients with GERD A or B grade of reflux esophagitis (LA grade) after treatment PPI
* Hiatal hernia (HH) \<5 cm
* ASA grading 1-2
* Age 18-60 years old.

Exclusion Criteria

* Giant hiatal hernia (HH) \>5 cm
* Esophageal shortening
* Patients with C or D grade of RE (reflux esophagitis)
* Previously surgery on the stomach or esophagus
* Psychiatric illness
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Society of Bariatric and Metabolic Surgeons of Kazakhstan

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Oral Ospanov, Professor

Role: PRINCIPAL_INVESTIGATOR

President of Society of Bariatric and Metabolic Surgeons of Kazakhstan" (SBMSK)

Locations

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Oral Ospanov

Astana, , Kazakhstan

Site Status

Countries

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Kazakhstan

References

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Ospanov O, Zharov N, Yelembayev B, Duysenov G, Volchkova I, Sultanov K, Mustafin A. A Three-Arm Randomized Controlled Trial of Primary One-Anastomosis Gastric Bypass: With FundoRing or Nissen Fundoplications vs. without Fundoplication for the Treatment of Obesity and Gastroesophageal Reflux Disease. Medicina (Kaunas). 2024 Feb 27;60(3):405. doi: 10.3390/medicina60030405.

Reference Type RESULT
PMID: 38541131 (View on PubMed)

Other Identifiers

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FundoRing vs Nissen

Identifier Type: -

Identifier Source: org_study_id

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