The effect of 30 and 45 mm gasterojejunal anastomosis size with fixed 125 cm biliopancreatic limb and 75 cm alimentary limb on Excess Body Mass Index Loss (EBMIL) and Roux-en-Y bypass outcomes in the patients with morbid obesity; a double- blinded clinical trial
Investigating the effect of 30 and 45 mm gasterojejunal anastomosis size with fixed 125 cm biliopancreatic limb and 75 cm alimentary limb on Excess Body Mass Index Loss (EBMIL) and Roux-en-Y bypass outcomes in the patients with morbid obesity; a double- blinded clinical trial
Design
A clinical trial with parallel, double-blind, randomized by permuted block randomization, performed on 124patients in the two equal groups.
Settings and conduct
This study will be carried out on 124 patients who are candidates for bariatric surgery by Roux-en-Y method in Hazrat-e-Rasoul Akram and Atiyeh hospitals in Tehran. The two groups with gasterojejunal anastomosis sizes of 30 and 45 mm will be randomly assigned to the study groups. The randomization method is permuted block randomization.
Participants/Inclusion and exclusion criteria
Inclusion criteria: Candidate for Roux-en Y surgery, satisfaction to participate in the study, age over 18 years, body mass index more or equal to 40 and less or equal to 50. Exclusion criteria: History of major gastrointestinal surgery, having general conditions that prevent surgery under general anesthesia, age over 75 years, having Crohn's inflammatory disease, family history of gastric cancer , severe intestinal adhesions
Intervention groups
Intervention group 1 (second surgical technique): Recipient of gasterojejunal anastomosis with a size of 45mm: Intervention group 2 (second surgical technique): Recipient of gasterojejunal anastomosis with a size of 30 mm
Main outcome variables
Excess Body Mass Index Loss (EBMIL), diabetes remission, HOMA-IR, FBS, 2HPP, C-Peptide, HbA1C, lipid profile, liver profile, systolic and diastolic blood pressure, dumping, hemoglobin and albumin
General information
Reason for update
Acronym
IRCT registration information
IRCT registration number:IRCT20180507039572N1
Registration date:2021-02-13, 1399/11/25
Registration timing:prospective
Last update:2021-02-13, 1399/11/25
Update count:2
Registration date
2021-02-13, 1399/11/25
Registrant information
Name
Rohollah Valizadeh
Name of organization / entity
Country
Iran (Islamic Republic of)
Phone
+98 21 8670 5512
Email address
rohvali4@gmail.com
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2021-03-05, 1399/12/15
Expected recruitment end date
2021-08-21, 1400/05/30
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
The effect of 30 and 45 mm gasterojejunal anastomosis size with fixed 125 cm biliopancreatic limb and 75 cm alimentary limb on Excess Body Mass Index Loss (EBMIL) and Roux-en-Y bypass outcomes in the patients with morbid obesity; a double- blinded clinical trial
Public title
The effect of gasterojejunal anastomosis size on Excess Body Mass Index Loss (EBMIL) and Roux-en-Y bypass outcomes
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
Candidate for Roux-en Y surgery
Satisfaction to participate in the study
Age over 18 years
Body mass index more or equal to 40 and less or equal to 50
Exclusion criteria:
History of major gastrointestinal surgery
Having general conditions that prevent surgery under general anesthesia
Age over 75 years
Having Crohn's inflammatory disease
Family history of gastric cancer
Severe intestinal adhesions
Age
From 18 years old to 75 years old
Gender
Both
Phase
N/A
Groups that have been masked
Participant
Outcome assessor
Sample size
Target sample size:
123
Randomization (investigator's opinion)
Randomized
Randomization description
First, we will create random numbers in a column, so the Rand () function in Excel will be used. Then we will consider the random numbers below the half as 4 blocks and the numbers above the half as 6 blocks. For this purpose, the symbols O30 and O45 have been used for 30 and 45 mm interventions. The procedure is as follows: in block 4, two O30 interventions and two O45 interventions will be written in a column first. More column will then be assigned 4 random numbers using the Rand () function. The order of the assigned random numbers will then be sorted from small to large to change the order of our intervention codes. The same thing will be repeated for a block of 6. This process continues until we reach an equal number of control and intervention groups. After generating random numbers without repetition, a number is assigned to each assigned sequence along with the type of intervention, and will be placed in a sealed envelope whose contents are not known, so that the operating room nurse will pick up one of the 124 envelopes for qualified patient and will inform the type of group to surgeon after tearing the sealed envelope.
Blinding (investigator's opinion)
Double blinded
Blinding description
Patients and outcome assessors will be unaware of the allocated study groups. Due to the fact that the intervention is necessarily performed by the surgeon, so there is no possibility of blinding the surgeon and the surgeon is aware of the group type.
Placebo
Not used
Assignment
Parallel
Other design features
Secondary Ids
empty
Ethics committees
1
Ethics committee
Name of ethics committee
Ethics committee of Iran University of Medical Sciences
Street address
Iran University of Medical Sciences., next to Milad tower., Hemmat highway
City
Tehran
Province
Tehran
Postal code
1449614535
Approval date
2021-02-09, 1399/11/21
Ethics committee reference number
IR.IUMS.REC.1399.1227
Health conditions studied
1
Description of health condition studied
Diabetes
ICD-10 code
E08
ICD-10 code description
Diabetes mellitus due to underlying condition
2
Description of health condition studied
Morbid obesity
ICD-10 code
E66.01
ICD-10 code description
Morbid (severe) obesity due to excess calories
Primary outcomes
1
Description
Excess Body Mass Index Loss (EBMIL)
Timepoint
Before the intervention, one, three and six months after the intervention
Method of measurement
Using the following formula obtained from the body mass index: (Pre-operative BMI – Current BMI) / (Pre-operative BMI – 25) × 100
Secondary outcomes
1
Description
Diabetes remission
Timepoint
Before the intervention, one, three and six months after the intervention
Method of measurement
Using Buchwald criteria (FPG <100 mg/dl or A1C <6 %)
2
Description
Insulin
Timepoint
Before the intervention, one, three and six months after the intervention
Method of measurement
Blood sampling
3
Description
Fasting blood sugar
Timepoint
Before the intervention, one, three and six months after the intervention
Method of measurement
Blood sampling
4
Description
Glocuse, 2 hour Post Prandial
Timepoint
Before the intervention, one, three and six months after the intervention
Method of measurement
Blood sampling
5
Description
C-Peptide
Timepoint
Before the intervention, one, three and six months after the intervention
Method of measurement
Blood sampling
6
Description
HbA1C
Timepoint
Before the intervention, one, three and six months after the intervention
Method of measurement
Blood sampling
7
Description
Lipid profile
Timepoint
Before the intervention, one, three and six months after the intervention
Method of measurement
Blood sampling
8
Description
Systolic blood presser
Timepoint
Before the intervention, one, three and six months after the intervention
Method of measurement
Barometer
9
Description
Diastolic blood pressure
Timepoint
Before the intervention, one, three and six months after the intervention
Method of measurement
Barometer
10
Description
Dumping
Timepoint
Before the intervention, one, three and six months after the intervention
Method of measurement
Physical examination
11
Description
Hemoglobin
Timepoint
Before the intervention, one, three and six months after the intervention
Method of measurement
Blood sampling
12
Description
Liver porfile
Timepoint
Before the intervention, one, three and six months after the intervention
Method of measurement
Blood sampling
Intervention groups
1
Description
Intervention 1 "Receiving 45 mm gasterojejunal anastomosis": Patients in this group will be placed in French (Y-shaped) surgical position after general anesthesia so that the surgeon can stand between the patient's legs. Five trocas will be used to perform Roux-en Y bariatric laparoscopy. The first optical troca (with camera) is placed 10 cm from the xiphoid process in the medline line, and then the other two trocas will be placed to the right (10 mm) and left (5 mm) of the medline line. Also, two 5 mm trocas will be placed at the bottom of the umbilicus at a distance of approximately 20 cm from each other. The "Angle of His" between the stomach and esophagus is released. After implanting a gastric pouch that is 6 cm long with an approximate volume of 30 to 60 ml, 125 cm from the proximal part of the small intestine will be calculated to prepare it for anastomosis with a 45 mm gastric linear stapler and then 75 cm from the distal part to the gasterojejunostomy site, a hole will be made to make a gasterojejunal anastomosis.
Category
Treatment - Surgery
2
Description
Intervention 2 "Receiving 30 mm gasterojejunal anastomosis": Patients in this group will be placed in French (Y-shaped) surgical position after general anesthesia so that the surgeon can stand between the patient's legs. Five trocas will be used to perform Roux-en Y bariatric laparoscopy. The first optical troca (with camera) is placed 10 cm from the xiphoid process in the medline line, and then the other two trocas will be placed to the right (10 mm) and left (5 mm) of the medline line. Also, two 5 mm trocas will be placed at the bottom of the umbilicus at a distance of approximately 20 cm from each other. The "Angle of His" between the stomach and esophagus is released. After implanting a gastric pouch that is 6 cm long with an approximate volume of 30 to 60 ml, 125 cm from the proximal part of the small intestine will be calculated to prepare it for anastomosis with a 30 mm gastric linear stapler and then 75 cm from the distal part to the gasterojejunostomy site, a hole will be made to make a gasterojejunal anastomosis.
Category
Treatment - Surgery
Recruitment centers
1
Recruitment center
Name of recruitment center
Rasool Akram Hospital
Full name of responsible person
Masoud Solaymani-Dodaran
Street address
Hazrat-E-Rasool Hospital, Iran University of Medical Sciences, Niayesh “St.”,Sattarkahn “Ave.”, Tehran
City
Tehran
Province
Tehran
Postal code
1445613131
Phone
+98 21 6651 5001
Email
msdodran@gmail.com
Sponsors / Funding sources
1
Sponsor
Name of organization / entity
Iran University of Medical Sciences
Full name of responsible person
Seyyed Abas Motavalian
Street address
Fifth floor, Central staff, Iran University of Medical Sciences, Hemmat Highway
City
Tehran
Province
Tehran
Postal code
1433933111
Phone
+98 21 6650 9059
Email
amotevalian@yahoo.com
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Iran University of Medical Sciences
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic
Person responsible for general inquiries
Contact
Name of organization / entity
Iran University of Medical Sciences
Full name of responsible person
Rohollah Valizadeh
Position
PhD student
Latest degree
Master
Other areas of specialty/work
Epidemiology
Street address
Hazrat-e-Rasoul Hospital, Sattar Khan Ave.
City
Tehran
Province
West Azarbaijan
Postal code
1916737183
Phone
+98 21 8670 5512
Fax
Email
rohvali4@gmail.com
Person responsible for scientific inquiries
Contact
Name of organization / entity
Iran University of Medical Sciences
Full name of responsible person
Rohollah Valizadeh
Position
PhD student
Latest degree
Master
Other areas of specialty/work
Epidemiology
Street address
Hazrat-e-Rasoul hospital, Sattar Khan Ave.
City
Tehran
Province
West Azarbaijan
Postal code
1916737183
Phone
+98 21 8670 5512
Fax
Email
rohvali4@gmail.com
Person responsible for updating data
Contact
Name of organization / entity
Iran University of Medical Sciences
Full name of responsible person
Rohollah Valizadeh
Position
PhD student
Latest degree
Master
Other areas of specialty/work
Epidemiology
Street address
Hazrat-e-Rasoul hospital, Sattar Khan Ave.
City
Tehran
Province
West Azarbaijan
Postal code
1916737183
Phone
+98 21 8670 5512
Fax
Email
rohvali4@gmail.com
Sharing plan
Deidentified Individual Participant Data Set (IPD)
Yes - There is a plan to make this available
Study Protocol
Yes - There is a plan to make this available
Statistical Analysis Plan
Yes - There is a plan to make this available
Informed Consent Form
Yes - There is a plan to make this available
Clinical Study Report
Yes - There is a plan to make this available
Analytic Code
Yes - There is a plan to make this available
Data Dictionary
Yes - There is a plan to make this available
Title and more details about the data/document
All patient's data will be provided anonymously to researchers. The findings of the study will be presented publicly.
When the data will become available and for how long
Immediately after the publication of the article
To whom data/document is available
Academic researchers and faculty members
Under which criteria data/document could be used
For research purposes only
From where data/document is obtainable
ٍEmail must be sent to the responsible for scientific inquiries (msdodran@gmail.com)
What processes are involved for a request to access data/document
ٍEmail must be sent to the responsible for scientific inquiries (msdodran@gmail.com)