ClinicalTrials.gg
Not yet recruitingNCT05418920Updated Jul 5, 2022

Clinical Trial of Reconstruction After Proximal Gastrectomy

An interventional study of left-opening single-flap technique and double-flap group technique in Esophagitis, Reflux, sponsored by Oncogastroenterology Committee of Chinese. Not yet recruiting. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2022-07-05.

Sponsored by Oncogastroenterology Committee of Chinese · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Jul 2024, 2 years 3 months ago, but the record still lists the study as not yet recruiting.
Phase
Not applicable
Study type
Interventional
Enrollment
250
Allocation
Randomized
Ages
18 Years to 80 Years
Sex
All
01

Study summary

  1. To explore a simple, safe, post-proximal gastrectomy reconstruction method with good absorption and digestive function in order to improve patients' postoperative quality of life; 2) To fill the gap in the comparison of clinical efficacy between left-open single-flap technique and double-flap technique in this specialized field in China; 3) To utilize the experience and foundation of gastrointestinal surgery in the treatment of gastric cancer and integrate the advantageous resources in China; 4) To establish a large-sample, multicenter randomized clinical study in order to promote the establishment and improvement of relevant norms of gastrointestinal reconstruction
Read the detailed description

Gastric cancer is the fifth most common cancer worldwide and the third leading cause of cancer-related deaths each year. Although the incidence of gastric cancer has decreased worldwide compared to the past, the incidence of esophagogastric junction cancer and upper 1/3 gastric cancer is gradually increasing. Currently, the main treatment for esophagogastric junction cancer and upper gastric cancer is surgery. However, there is no clinical consensus on the choice of surgical approach for these patients. Compared with total gastrectomy, proximal gastrectomy can preserve the physiological function of the stomach and has great advantages in nutrient absorption, thus it has been widely accepted in Asian countries.

However, the risk of developing reflux esophagitis after proximal gastrectomy is high, which seriously affects patients' postoperative quality of life. In order to reduce the occurrence of postoperative complications, clinicians continue to improve the methods of GI reconstruction. Currently, the common methods of GI reconstruction after proximal gastrectomy include esophagogastrostomy (EG), jejunal intubation (JI), jejunal pouch intubation (JPI), and dual-tract reconstruction (DTR). However, the choice of the optimal reconstruction method after proximal gastrectomy remains controversial, and there is no standard approach to GI reconstruction. In 2016, Kuroda et al. reported a new surgical approach with a double-flap technique after proximal gastrectomy and showed satisfactory short-term outcomes compared with conventional esophagogastric anastomosis. At the 1-year postoperative follow-up, no reflux esophagitis was detected in all patients. At the same time, the rate of anastomotic stenosis was noteworthy.

This study will be the first attempt at a left-open single-flap technique, which was modified from the double-flap technique. The short-term outcome was satisfactory in all patients. This study will establish a large sample, multicenter randomized clinical study. By exploring a simple, safe, good absorption and digestive function method of post-proximal gastrectomy reconstruction to improve patients' postoperative quality of life and fill the gap in the comparison of clinical efficacy between left-open single-flap technique and double-flap technique in this specialized field. This will promote the establishment and improvement of the specifications related to gastrointestinal reconstruction.

02

Conditions studied

  • Esophagitis, Reflux

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Keywords

  • left open single-flap technique, proximal gastrectomy
03

In context

Esophagitis, Peptic

83 studies on the registry are indexed under Esophagitis, Peptic; 16 are open to participants now.

This study's planned enrollment of 250 is above the median of 135 across 60 interventional studies indexed under Esophagitis, Peptic.

Browse Esophagitis, Peptic studies →

Lead sponsor

This is the only study on the registry with Oncogastroenterology Committee of Chinese as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Patients aged 18-80 years, regardless of gender;
  2. Siewert III of the esophagogastric junction adenocarcinoma: Stage Ⅰ(cT1-2N0M0) or adenocarcinoma of the upper part of the stomach: Stage Ⅰ(cT1-2N0M0), Stage II( cT1-2N1-3M0 / cT3-4N0M0), Stage III(cT3-4aN1-3M0); patients who are suitable for surgery according to the 8th AJCC clinical staging of gastric cancer;
  3. Primary lesion diagnosed by preoperative endoscopic end pathology: tumor diameter \<4 cm and located in the upper part of the stomach (including the esophagogastric junction), confirmed adenocarcinoma;
  4. Preoperative : I, II, or III;
  5. Preoperative physical status score: ≥ 70%; or preoperative physical status score: ≤ 2;
  6. No distant (confirmed by preoperative chest X-ray, abdominal ultrasound, and upper abdominal CT); no peritoneal implant metastases (confirmed by laparoscopic exploration surgery);
  7. R0 surgical outcome is expected to be obtained with radical gastrectomy of D2 proximal gastric cancer;
  8. Patients and their families voluntarily participate in this study and sign the form after understanding the study content.

Exclusion criteria

Exclusion Criteria

  1. Patients received any preoperative treatment, such as chemotherapy, radiotherapy, targeted therapy or immunotherapy; preoperative chemotherapy recipients;
  2. Patients with clinical stage exceeding Siewert III of the esophagogastric junction adenocarcinoma: Stage Ⅰ(cT1-2N0M0) or more than adenocarcinoma of the upper part of the stomach: Stage Ⅰ(cT1-2N0M0), Stage II(cT1-2N1-3M0/cT3-4N0M0), Stage III(cT3-4aN1-3M0);
  3. Patients with acute infections, especially biliary tract infections;
  4. Patients with complications of gastric cancer (bleeding, perforation, obstruction) requiring emergency surgery;
  5. Patients with uncorrectable coagulation dysfunction;
  6. Patients with vital organ failure, such as heart, lung, liver, brain, kidney, etc.
  7. Severe central nervous system disease, mental disorders, or impaired consciousness;
  8. Pregnant or lactating women;
  9. Patients with distant ;
  10. Patients with a primary tumor at another site diagnosed within the past 5 years;
  11. Preoperative : ≥ IV;
  12. Preoperative physical status score: ≥ 2;
  13. History of continuous systemic therapy within the past 1 month;
  14. History of unstable angina, myocardial infarction, cerebral infarction, or cerebral hemorrhage within the past 6 months;
  15. Patients with concurrent surgical treatment of other diseases;
  16. Patients with immunodeficiency, , or diseases (organ transplant requiring immunosuppressive therapy within the past 5 years, bone marrow transplant patients, taking immunosuppressive drugs, etc.);
  17. Patients with concurrent participation in other clinical studies;
  18. Patients refusing to sign an form to participate in this study;
  19. Preoperative imaging: regional fusion of enlarged lymph nodes (maximal diameter > 3 cm).
Terms in these criteria, in plain language(11)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

ASA physical status

The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.

Karnofsky performance status (KPS)

A 0–100 scale of how well someone can carry out everyday activities. 100 is no complaints and no signs of illness; 70 is able to look after yourself but not to work or keep up normal activity; 50 is needing considerable help and frequent medical care.

Studies often ask for 60 or 70 and above. Your doctor gives the score.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Adjuvant and neoadjuvant

Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
250 participants (estimated)

Study arms

  • Experimental
    the trial group (left-opening single-flap group)

    left-opening single-flap group

    Procedure: left-opening single-flap technique

  • Active comparator
    the control group (double-flap group)

    double-flap group

    Procedure: double-flap group technique

Interventions

  • Procedureleft-opening single-flap technique

    left-opening single-flap technique

  • Proceduredouble-flap group technique

    double-flap group technique

06

What researchers measure

Primary outcomes

  1. Incidence of reflux esophagitis

    Incidence of reflux esophagitis

    Time frame: 12 months

Secondary outcomes

  1. Overall postoperative complication rate

    Overall postoperative complication rate

    Time frame: 30 days

  2. Incidence of anastomotic fistula

    Incidence of anastomotic fistula

    Time frame: 30 days

  3. Operation time

    Operation time

    Time frame: intraoperative

  4. Bleeding loss volume

    Bleeding loss volume

    Time frame: intraoperative

  5. incidence of anastomotic stricture

    incidence of anastomotic stricture

    Time frame: 30 days

  6. Incidence of reflux esophagitis

    Incidence of reflux esophagitis

    Time frame: 6 days

07

Study locations

No study locations are listed for this record.

08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 5, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT05418920
Lead sponsor
Oncogastroenterology Committee of Chinese
Collaborators
Tang-Du Hospital, First Affiliated Hospital Xi'an Jiaotong University, General Hospital of Ningxia Medical University, Henan Provincial People's Hospital, The First Affiliated Hospital of Shanxi Medical University
Responsible party
Sponsor
First posted
Jun 14, 2022
Start date
Aug 1, 2022 (estimated)
Primary completion
Jul 31, 2024 (estimated)
Completion
Jul 31, 2027 (estimated)
Last update
Jul 5, 2022

Study contacts

Xiaohua Li, MD
Contact
xjyylixiaohua@163.com
+8613474299901
Gang Ji, MD
Contact
xijingweichang@163.com
+8613572152581
Nan Wang, MD
study chair · Tang-Du Hospital
Chao Zhang, MD
study chair · Henan Provincial People's Hospital
Lei Wang, MD
study chair · General Hospital of Ningxia Medical University
Renwei Chang, MD
study chair · The First Affiliated Hospital of Shanxi Medical University
Junjun She, MD
study chair · First Affiliated Hospital Xi'an Jiaotong University

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Jun 2022. You cannot join it, but the record below documents what was studied.

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