Gastroesophageal-junction Cancer, Gastroesophagostomy, Proximal Gastrectomy
Conditions
Brief summary
1. To evaluate the safety, simplicity and effectiveness of the gastric function (anti-reflux) preservation of the innovative parachute-tunnel-style technique (PTST) in laparoscopic proximal gastrectomy. 2. To investigate the correlation between anastomotic stenosis and blood supply of serosa-muscle flap,suture after esophagogastric anastomosis.(obtain objective indexes such as blood supply, healing pattern and length change of serosa-muscle flap through animal experiments)
Interventions
PROCEDUREPTST(parachute-tunnel-style technique)for esophagogastrostomy
Suture the gastric remnant at the mark on the back wall of the esophagus.(Don't tighten the suture); Pull the esophageal stump out of the tunnel meanwhile tighten the suture and the gastric stump to close the back wall of the esophagus and the gastric stump together;Cut the back esophageal wall close to the esophageal stump,cut the front gastric wall along line B. Suture the back esophageal wall and the upper edge of the front gastric wall incision from right to left;Remove residual esophageal nail, and suture the back esophageal wall and the lower edge of the gastric incision from right to left. Suture the anterior wall of the stomach at the lower edge of the tunnel with the serosa layer at the lower edge of the front wall of the esophagus stomach anastomosis;Suture the upper edge of the tunnel with the front wall of the esophagus and the left and right lateral walls at the gastric stump suture of the original posterior wall of the esophagus. (all use 3-0 barbed suture continuously)
Sponsors
Tang-Du Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Gastric cancer was confirmed histopathologically; * Patients who may undergo proximal gastrectomy according to guidelines; * Early upper gastric cancer, more than 1/2 of the distal gastric remnant remained after resection; * Esophagogastric junction carcinoma with maximum diameter ≤4 cm; * Patients with advanced upper gastric cancer (MSI-H) achieved cCR by neoadjuvant immunochemotherapy.
Exclusion criteria
* Patients with systemic conditions that cannot tolerate laparoscopic surgery; * Distal gastric remnant was less than 1/2 after proximal gastrectomy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| occurrence rate of anastomotic stenosis | one month after surgery | morbidity(%) |
| occurrence rate of reflux esophagitis | three month after surgery; six month after surgery | * Visick score after surgery * Los Angeles rating |
Countries
China
Outcome results
None listed