Bariatric surgery represents the best therapeutic option to induce sustainable weight loss and to solve serious comorbidities improving the life-expectancy and the quality of life. Actually the choice of the procedure is based on the surgeon's and patients preference . Mini gastric bypass(MGB) is an emerging procedure offering excellent results in terms of weight loss and comorbidities (mainly metabolic) control. On the other hand, recent data indicated that the gut microbiota may mediate some of the beneficial effects of bariatric surgery and changes in the composition and diversity of the gut microbiota have been observed after RY Gastric Bypass (GBP) in humans as well as in mice. However, there are no prospective investigations on Gut Microbiota changes after MGB, despite the procedure is described as "malabsorbitive" and there are no studies comparing gut microbiota shift and malabsorption entity in humans after GBP vs MGB.Thereafter prospective data on the incidence of bile reflux esophageal lesions after MGB are lacking.
The aim of the present multicentric prospective comparative study is to evaluate malabsorption and gut microbiota shift after laparoscopic RYGB vs MGB at 1 year.
Study draft: Three european accademic center of excellence for laparoscopic metabolic surgery will be involved. 90 consecutive morbid obese patients (BMI 36-59) (30 for each center) candidate to primary bariatric surgery will be enrolled in 12 months: 45 MGB group and 45 GBP group. Blood tests (Hemoglobin, glucose, HbA1c, cholesterol, triglycerides, T3, T4, TSH, Glp-1 and micronutrient) and stool analysis (gut microbiota, blie acids, macronutrient) before surgery and after 6 and 12 months after will be carried out. Upper GI endoscopy will be performed before and 12 months after surgery.
. The insights on the metabolic and microbiota changes will support post.op. optimal medical treatment and will provide data for the developing of new probiotic drugs.
