Feasibility and Safety of Robotic Assisted Proximal Gastrectomy With Double-flap Technique for Proximal Early Gastric Cancer: a Phase II, Multi-center, Single-arm Clinical Study

Status: Recruiting
Location: See location...
Intervention Type: Procedure
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Proximal early gastric cancer can choose radical total gastrectomy or proximal gastrectomy. The patients have poor nutritional status and quality of life after total gastrectomy. Compare to total gastrectomy, the nutritional status can improve after proximal gastrectomy . But if use simple esophagogastric anastomosis for proximal gastrectomy, the incidence of postoperative reflux esophagitis is high, which seriously affects the quality of life, and the short-term outcome is poorer than the total gastrectomy. If the incidence of postoperative reflux esophagitis can be reduced, proximal gastrectomy would be the treatment choice for proximal early gastric cancer, which may more improve both quality of life and nutritional condition than total gastrectomy. Double-flap technique is a new surgical reconstruction procedure between esophagus and remnant stomach. It can reduce the occurrence of reflux oesophagitis through reconstruction a simulative cardia. At present, the technique has been carried out in some hospitals in China but still lack large-scale prospective studies and evidence of evidence-based medicine. At present, some retrospective studies have shown that robotic assisted proximal gastrectomy with double-flap technique is safe and effective, and the learning curve is shorter than laparoscopic surgery. The applicant have finished two robotic assisted proximal gastrectomy with double-flap technique cases. Two patients recovered well after surgery, with no occurrence of anastomotic leakage or stenosis and the postoperative quality of life was good. Now we plan to conduct a multi-center, single arm study on proximal early gastric cancer patients(T1N0-1M0 and T2N0M0) to evaluate the feasibility of robotic assisted proximal gastrectomy with double-flap technique , and to evaluate the surgical and oncological safety of this surgical method. Aim to provide initial evidence of evidence-based medicine for its clinical application..

Eligibility
Participation Requirements
Sex: All
Minimum Age: 20
Maximum Age: 80
Healthy Volunteers: f
View:

• 20 years ≤ age ≤ 80 years

• The primary gastric lesions were located in the proximal third of the stomach

• histologically proven gastric adenocarcinoma (by preoperative gastrofiberscopy)

• clinical stage IA (T1N0M0) or IB (T1N1M0 / T2N0M0) according to the 8th edition of the American Joint Committee on Cancer System(Clinical stage was determined based on the finding of endoscopic ultrasonography and/or thoraco-abdominal contrast-enhanced computed tomography)

• scheduled for robotic assisted proximal gastrectomy with D1+/D2 lymphadenectomy, and possible for R0 surgery by this procedures (Lymphadenectomy is performed on the basis of the criteria of the Japanese Gastric Cancer Treatment Guidelines 2021 (6th edition).).

• The preoperative American Society of Anesthesiologists (ASA) physical status was I-III;

• The patient's cardiopulmonary function can tolerate robotic assisted surgery;

• The subjects have signed the informed consent form.

Locations
Other Locations
China
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
RECRUITING
Guangzhou
Contact Information
Primary
Yang bin, associate professor
yyzsu@163.com
13798163278
Time Frame
Start Date: 2024-06-10
Estimated Completion Date: 2026-12-10
Participants
Target number of participants: 42
Treatments
Experimental: Robotic assisted proximal gastrectomy with double-flap technique
Sponsors
Collaborators: Liaoning Cancer Hospital & Institute, Qinghai Province Cancer Hospital, Sichuan Provincial People's Hospital, First Affiliated Hospital of Kunming Medical University, First Hospital of China Medical University, Third Affiliated Hospital, Sun Yat-Sen University, Gansu Provincial Hospital, Sichuan Cancer Hospital and Research Institute, Qilu Hospital of Shandong University, The First Affiliated Hospital of Zhengzhou University, LanZhou University, Zunyi Medical College, Tianjin Medical University Cancer Institute and Hospital, First Affiliated Hospital of Guangxi Medical University, Shandong Provincial Hospital
Leads: Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University

This content was sourced from clinicaltrials.gov