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Which type of obesity surgery is best?

Press release issued: 27 February 2012

The BY-BAND study, led by the University of Bristol, will assess which surgical approach is best to treat obesity – the gastric band or the gastric bypass?

There are two very commonly performed operations to treat morbid obesity in the UK but it is unclear which is the most effective and provides the greatest benefit for patients and the NHS.

The BY-BAND study led by the University of Bristol and funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme will compare the outcomes of stomach bypass and stomach band operations.

Professor Jane Blazeby, Consultant Upper GI Surgeon in the School of Social and Community Medicine at the University of Bristol, who is leading the study, said: “Obesity is an increasing health problem in the UK, which is predicted to worsen. Current national guidelines recommend that surgery should be considered for morbidly obese people or for those remaining obese after trying other options.

“The BY-BAND study will compare two types of operation, gastric bypass and gastric banding, to find out which one has the greater benefits.”

BY-BAND will compare weight changes over three years between the two types of surgery and test specifically whether better overall quality of life is achieved with bypass surgery.

Due to the way surgery is organised BY-BAND will have a short preliminary phase in two hospitals to work out the best ways to involve patients, surgeons, and other health professionals before including more centres across the country.

The research team plan to study over 700 very over weight patients in a randomised trial. BY-BAND will also document differences in surgical complications, both at the time of surgery and for up to three years, and value for money for the NHS between the operations.

Obese adults who are referred for obesity surgery under current government guidelines can participate in the study. Half of patients who take part will be treated with gastric band surgery and the other half with gastric bypass surgery. Both operations are currently in use and neither operation is new or experimental. The type of operation will be decided by randomisation.

Participants will also be asked to complete a series of questionnaires about their quality of life, and some participants will be interviewed about their experiences of treatment decisions.  Researchers will also ask participants to provide two blood samples in addition to the samples they would give as part of their normal care, for future research into obesity.

There will be two centres (Taunton and the University of Southampton) taking part in the trial in phase one and eight centres taking part in phase two. The study will be co-ordinated from the Clinical Trials and Evaluation Unit at the University of Bristol.

The study is expected to start recruitment in April 2012 and will run for approximately eight years, until the last recruited patient is followed-up. The trial will be recruiting patients until 2015 and the findings will be published in 2018.

 

Further information

The National Institute for Health Research Health Technology Assessment (NIHR HTA) programme funds research about the effectiveness, costs, and broader impact of health technologies for those who use, manage and provide care in the NHS. It is the largest NIHR programme and publishes the results of its research in the Health Technology Assessment journal, with over 600 issues published to date. The journal’s 2010 Impact Factor (4.197) ranked it in the top ten per cent of medical and health-related journals. All issues are available for download free of charge from the website, www.hta.ac.uk.

The National Institute for Health Research provides the framework through which the research staff and research infrastructure of the NHS in England is positioned, maintained and managed as a national research facility. The NIHR provides the NHS with the support and infrastructure it needs to conduct first-class research funded by the Government and its partners alongside high-quality patient care, education and training. Its aim is to support outstanding individuals (both leaders and collaborators), working in world-class facilities (both NHS and university), conducting leading edge research focused on the needs of patients. www.nihr.ac.uk

The University of Southampton is a leading UK teaching and research institution with a global reputation for leading-edge research and scholarship across a wide range of subjects in engineering, science, social sciences, health and humanities.

With over 23,000 students, around 5000 staff, and an annual turnover well in excess of £435 million, the University of Southampton is acknowledged as one of the country’s top institutions for engineering, computer science and medicine. We combine academic excellence with an innovative and entrepreneurial approach to research, supporting a culture that engages and challenges students and staff in their pursuit of learning.

The University is also home to a number of world-leading research centres including the Institute of Sound and Vibration Research, the Optoelectronics Research Centre, the Web Science Trust and Doctoral training Centre, the Centre for the Developmental Origins of Health and Disease, the Southampton Statistical Sciences Research Institute and is a partner of the National Oceanography Centre at the Southampton waterfront campus.

Please contact joanne.fryer@bristol.ac.uk for further information.