Advanced gastric cancer
Conditions
Interventions
Control group:Patients with advanced gastric cancer underwent conventional D2 radical gastrectomy and lymph node dissection in group 12 (D2-12 group).
Experimental group:Mesohepatic dissection via right subcostal approach (RSA-HHMD group)
Sponsors
The First Affiliated Hospital of University of Science and Technology of China
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: Patients aged between 18 and 80, who have a preoperative pathological diagnosis of malignant gastric tumor, and meet at least one of the following: (1) Preoperative imaging shows enlarged lymph nodes at the hepatic portal; (2) Tumor in the lower stomach is =5 cm in diameter; (3) Preoperative tumor markers CEA, CA125, CA199, CA724 are elevated; (4) Intraoperative exploration finds enlarged lymph nodes or involvement at the hepatic portal; (5) Even after neoadjuvant therapy, preoperative check still shows enlarged lymph nodes at the hepatic portal.
Exclusion criteria
Exclusion criteria: 1. Patients with abnormal liver function before operation, including abnormal transaminase and bilirubin; 2. Patients with contraindications to laparoscopic surgery, such as severe cardiopulmonary dysfunction; 3. Patients who have undergone abdominopelvic surgery or extensive abdominal adhesions several times in the past; 4. Patients with pyloric obstruction, gastric perforation, gastric bleeding and other emergency surgery; 5. Preoperative imaging suggests peritoneal cancer nodular implantation and metastasis; 6. ASA grade >= IV and/or ECOG performance status score >= 2; 7. Patients with severe cardiopulmonary function, coagulation dysfunction or combined with severe underlying diseases cannot tolerate surgery; 8. Having a history of severe mental illness; 9. Pregnant or lactating women; 10. Patients with uncontrolled infection before surgery; 11. Other clinical and laboratory abnormalities considered by the investigator should not participate in the trial; 12. Patients and their families refused to sign informed consent.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Number and positive rate of lymph node harvest in group 12 of postoperative pathology;Five-year survival, survival, and disease-free recurrence;Short-term complications (intraoperative vascular and bile duct injury; bilirubin and transaminase levels; laparoscopic conversion rate; second operation rate, etc.);Long-term postoperative hilar recurrence rate; | — |
Countries
China
Contacts
Public ContactYao Hanhui
The First Affiliated Hospital of University of Science and Technology of China
Outcome results
None listed