Gastroesophageal reflux disease, hiatal hernia
Conditions
Interventions
Experimental group:Surgical treatment was performed using an abdominal endoscopic surgical system
Sponsors
Harbin Medical University Affiliated Cancer Hospital
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Inclusion criteria
Inclusion criteria: 1.Age range: 18-75 years old (inclusive), gender not limited; 2.Can cooperate and complete follow-up and related examinations; 3.Voluntarily participate in this experiment and sign the informed consent form. 4.Gastric cancer surgery: 1) Histologically confirmed as gastric cancer 2) Patients confirmed suitable for laparoscopic gastric cancer surgery by researchers 3) TNM clinical staging as stage I, II, and III; 5.Gastric weight-loss surgery: 1) The duration of type 2 diabetes is less than or equal to 15 years, and the islets still have some insulin secretion function, and the fasting serum C-peptide is more than or equal to 1/2 of the lower limit of normal value; 2) BMI >= 32.5 kg/m2 or BMI >= 27.5 kg/m2, and with type 2 diabetes, it is difficult to control blood sugar through lifestyle changes and drug treatment, and at least conforms to two additional components of metabolic syndrome or has complications 3) There is a clear metabolic disorder related to obesity, and it is predicted that weight loss can effectively improve related metabolic diseases; 6.Gastroesophageal reflux disease: 1) Typical symptoms of gastroesophageal reflux such as acid reflux (acid reflux and/or food reflux), heartburn, and belching, with or without cough, asthma, and pharyngitis for more than 6 months, and relying on proton pump inhibitors for cumulative treatment for more than 3 months; 2) Long term maintenance therapy or unsatisfactory efficacy of proton pump inhibitors; 3) Clear esophagitis with or without hiatal hernia detected during upper gastrointestinal endoscopy within 6 months; 7.Esophageal hiatal hernia: 1) Relevant examinations show that esophageal hiatal hernia (type II/III/IV) is accompanied by GERD; 2) The patient has reflux symptoms such as reflux, acid reflux, and burning pain in the chest area, and after regular conservative treatment in internal medicine, the symptoms have not improved significantly;
Exclusion criteria
Exclusion criteria: 1. Accompanied by severe abdominal adhesions. 2. Acute severe uncontrolled infection. 3. Accompanied by important organ failure, can not tolerate general anesthesia. 4. Gastric cancer complicated with perforation, bleeding, obstruction and other emergency operations. 5. Severe coagulopathy and obvious bleeding tendency. 6. Combined with severe mental disorder, unable to cooperate. 7. Pregnant or lactating women. 8. The investigator did not consider him appropriate to participate in the trial. 9. Gastric cancer surgery: clinical and imaging examination showed extensive metastasis in the abdominal cavity or other organs, or lymph node metastasis was fused and wrapped around important blood vessels. 10. Gastric bariatric surgery: 1) confirmed diagnosis of non-obese type 1 diabetes mellitus; 2) islet B cell function has been basically lost, serum C-peptide level is low or C-peptide release curve is low under glucose load; 3) patients with gestational diabetes mellitus and some special types of diabetes mellitus; 4) unable to cooperate with postoperative changes in diet and living habits, poor compliance; 5) the presence of well-defined obesity-related metabolic disorders that are predicted to be ameliorated by weight loss; 11. Gastroesophageal reflux disease: 1) history of other abdominal surgery or malignant tumor; 2) achalasia, nutcracker esophagus and esophageal outflow obstruction 3) dysphagia due to mental factors; 4) It is difficult to perform minimally invasive fundoplication or secondary surgery. 12. Hiatal hernia: 1) secondary esophageal motility disorders due to systemic diseases or primary esophageal motility disorders other than hiatal hernia; 2) previous history of gastric or esophageal surgery;
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Untransmission rate during surgery; | — |
Secondary
| Measure | Time frame |
|---|---|
| Gastric cancer surgery: number of lymph node dissections;Gastric weight loss surgery (preoperative and postoperative): Weight BMI Waist circumference, hip circumference, waist to hip ratio, percentage of excess weight loss (EWL; | — |
Countries
China
Contacts
Public ContactWang Kuan
Harbin Medical University Affiliated Cancer Hospital
Outcome results
None listed