Laparoscopic roux-en-Y gastric bypass versus sleeve gastrectomy for teenagers with severe obesity - TEEN-BEST: study protocol of a multicenter randomized controlled trial

• Published in: BMC surgery Vol. 20; no. 1; p. 117
• Main Authors: Bonouvrie, Daniëlle S, Beamish, Andrew J, Leclercq, Wouter K G, van Mil, Edgar G A H, Luijten, Arijan A P M, Hazebroek, Eric J, Vreugdenhil, Anita C E, Olbers, Torsten, van Dielen, François M H
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 03-06-2020; BioMed Central; BMC
• Subjects: Adolescent; Adolescent obesity; Adolescents; Bariatric surgery; Body composition; Body mass; Body Mass Index; Body size; Body weight; Body weight loss; bypass; children; Clinical trials; Comorbidity; Control methods; Fractures; Gastrectomy; Gastrectomy - methods; Gastric bypass; Gastric Bypass - methods; Gastroenterologi; Gastroenterology and Hepatology; Gastrointestinal surgery; Humans; Informed consent; Laparoscopy; Laparoscopy - methods; Multicenter Studies as Topic; Netherlands; Obesity; Obesity, Morbid - surgery; Patient Satisfaction; Protocol (computers); Quality of Life; Randomization; Randomized Controlled Trials as Topic; Risk analysis; Risk Factors; Roux-en-Y gastric; Roux-en-Y gastric bypass; Severe obesity; Sleeve gastrectomy; Study Protocol; Surgery; Teenagers; united-states; Weight loss; Weight reduction; Netherlands; Roux-en-Y gastric bypass; Adolescents; Severe obesity; Bariatric surgery; Sleeve gastrectomy
• ISSN: 1471-2482; 1471-2482
• DOI: 10.1186/s12893-020-00778-9

Recent data support the use of bariatric surgery in adolescents with severe obesity following unsuccessful non-surgical treatments. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) have demonstrated reasonably similar weight loss and reduction of obesity related comorbidities in randomized trials in adults. SG has internationally become the most commonly used procedure in adolescents, yet long-term outcome data are lacking. No randomized controlled trial comparing SG and RYGB has been performed in adolescents.
Determine whether SG is non-inferior to RYGB in terms of total body weight (TBW) loss in adolescents with severe obesity.
A multicenter randomized controlled non-inferiority trial. Two hundred sixty-four adolescents aged 13-17 (Tanner stage ≥IV) with severe obesity (corrected for age and sex) will be included. Adolescents agreeing to participate will be randomized to either RYGB or SG. The primary outcome is the proportion of participants achieving 20% TBW loss at 3 years postoperatively. Secondary outcomes include (i) change in body weight, body mass index (BMI) and BMI standard deviation score, (ii) incidence of adverse health events and need for additional surgical intervention, (iii) resolution of obesity-related comorbidities, (iv) prevalence of cardio metabolic risk factor measures, (v) bone health measures and incidence of bone fractures, (vi) quality of life including psychosocial health, patient satisfaction and educational attainment and (vii) body composition. Follow-up will extend into the long term.
Not applicable.
This study will, to our knowledge, be the first randomized controlled trial comparing SG and RYGB in adolescents with severe obesity.
The trial is registered at the Netherlands Trial Register on July 26th, 2018 - NTR7191 - https://www.trialregister.nl/trial/7191 (protocol version 5.0 - February 3th 2020).