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The PREBA Study: Effect of Preoperative Weight Loss With a 14-day Low-calorie Diet on Surgical Procedure and Outcomes in Patients Undergoing RYGB Surgery

Not Applicable
Active, not recruiting
Conditions
Bariatric Surgery
Morbid Obesity
Interventions
Other: 14-day Low Calorie Diet
Registration Number
NCT04433338
Lead Sponsor
Rijnstate Hospital
Brief Summary

Bariatric guidelines recommend preoperative weight loss of 5% to reduce the risk of surgical complications. However, results in the literature on the improvement of surgical procedure and outcomes are still conflicting.

This study aims to evaluate the effect of preoperative weight loss by means of a 14-day low-calorie diet in bariatric patients on operative time, the ease of the Roux-en-Y gastric bypass (RYGB) procedure and long-term weight loss in a real-life experimental setting.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
80
Inclusion Criteria
  • Undergoing primary RYGB surgery (meeting all criteria + approval of surgeon)
  • Able to prepare the meal replacements at home
Exclusion Criteria
  • Undergoing another bariatric procedure than primary RYGB.

  • Diabetes Mellitus

  • Contraindication for the usage of Modifast meal replacements:

    • Allergy or intolerance to any substance in the used meal replacements (Soy, milk, gluten, egg, peanuts, nuts and seeds)
    • Veganism
    • Kidney failure (GFR < 90 ml/min/1.73m2), liver failure or cardiac insufficiency
    • A heart attack (myocardial infarct) in the past twelve months
    • Cancer
    • Hypokalaemia: serum potassium level <3.4 mmol/l
    • Phenylketonuria & Porphyria

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Intervention group14-day Low Calorie DietParticipants in the intervention group will follow a low-calorie diet during 14 days before undergoing surgery. The diet will consist of both meal replacements and regular foods. For women, the diet provides ± 900 kcal, 50 grams of carbohydrates, 85 grams of protein, 30 grams of fat and 25 grams of fibres. For men, the diet provides ± 1000 kcal, 55 grams of carbohydrates, 100 grams of protein, 30 grams of fat and 30 grams of fibres.
Primary Outcome Measures
NameTimeMethod
Operative time of the RYGB proceduresurgery

Duration of the surgical procedure, retrieved from the electronic medical record

Secondary Outcome Measures
NameTimeMethod
Appearance of the patient's liversurgery

Includes four images of the liver in different stages (1= healthy, 2= fatty liver, 3= fatty liver with inflammation, 4= liver cirrhosis). Surgeons will be asked to choose the image that best matches the appearance of the patient's liver.

Ease of the RYGB proceduresurgery

Ten aspects of the RYGB procedure will be scored on a 5-point Likert scale. The total score can range from 10 to 50, with 10 being the easiest.

The ten aspects include:

* Exerting force on instruments (1=very low, 5= very high)

* Difficulty of moving the liver (1=very easy, 5=very difficult)

* Size of the liver (1=very small, 5= very large)

* Size of omentum (1=very small, 5= very large)

* Difficulty of approaching pouch (1=very easy, 5=very difficult)

* Accessibility of Treitz ligament (1=very easy, 5=very difficult)

* Difficulty of creating pouch (1=very easy, 5=very difficult)

* Difficulty of measuring small intestine (1=very easy, 5=very difficult)

* Difficulty of entero-entero connection (1=very easy, 5=very difficult)

* Difficulty of abdominal wall hernia repair (1=very easy, 5=very difficult)

Post-operative weight loss4 weeks, 3, 6 months and 1, 2, 3, 4, 5 years after surgery

Body weight measurements to assess weight loss after surgery

Trial Locations

Locations (1)

Rijnstate Hospital

🇳🇱

Arnhem, Gelderland, Netherlands

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