Journal Article

Prospective randomized controlled trial comparing the efficacy and safety of Roux-en-Y gastric bypass and one-anastomosis gastric bypass (the RYSA trial): trial protocol and interim analysis

Saarinen, Tuure, Meriläinen, Sanna, Koivukangas, Vesa, Juuti, Anne, Pietiläinen, Kirsi Hannele

2019

Overview

Introduction There is a lack of prospective studies comparing Roux-en-Y gastric bypass (RYGB) and one-anastomosis gastric bypass (OAGB). Also, the effects of bariatric surgery and weight loss need a deeper understanding through metabolic studies. We describe the trial protocol and interim analysis of a prospective randomized controlled study comparing RYGB and OAGB: the RYSA trial. Materials and methods In total, 120 bariatric patients will be randomized between RYGB and OAGB in two academic centers. All patients will be followed up for 10 years with analysis and measurements of weight, comorbidities, blood tests, body composition and questionnaires. Extensive metabolic analyses (mixed meal tests, energy expenditure, biopsies of muscle and subcutaneous fat, urine, saliva and fecal samples) will be carried out in the Obesity Research Unit, University of Helsinki, for all patients treated at the Helsinki University Hospital (80 patients) at baseline, 6 months and 12 months. Bile reflux will be studied for the OAGB group at the Helsinki University Hospital at 6 months with gastroscopy and scintigraphy. Results At an interim analysis at 3 months (half-way) through recruitment (30 RYGB and 30 OAGB patients) there have been no deaths and no intensive care unit admittances. One patient in both groups required additional gastroscopy, with anastomosis dilatation in the RYGB group but with no additional intervention in the OAGB group. Conclusion The trial can be safely carried out. Recruitment is estimated to be complete by the end of 2019. Trial registration Clinical Trials Identifier NCT02882685 . Registered on August 30th 2016.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Aged / Aged, 80 and over / Analysis / Anastomosis, Roux-en-Y - methods / Bariatric surgery / Bile / Biomedicine / Blood tests / Body composition / Body fat / Body mass index / Clinical trials / Comorbidity / Diabetes / Esophagus / Female / Follow-Up Studies / Gastric bypass / Gastric Bypass - adverse effects / Gastric Bypass - methods / Gastrointestinal surgery / Glucose / Health Sciences / Hemoglobin / Humans / Liver / Magnetic resonance imaging / Male / Medicine / Medicine & Public Health / Metabolic surgery / Metabolism / Microbiota / Middle Aged / Obesity / Obesity, Morbid - surgery / One-anastomosis gastric bypass / Performance evaluation / Physiological aspects / Prospective Studies / Quality of life / Randomized Controlled Trials as Topic / Roux-en-Y gastric bypass / Statistics for Life Sciences / Stomach - surgery / Study Protocol / Surgery / Surveys and Questionnaires / Treatment Outcome / Type 2 diabetes / Weight control / Weight Loss