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Trials Comparing of HD Versus 4K Laparoscopy for Gastric Cancer

Not Applicable
Conditions
Stomach Neoplasms
Interventions
Procedure: 4K Laparoscopic Surgery
Procedure: HD Laparoscopic Surgery
Registration Number
NCT04010006
Lead Sponsor
Fujian Medical University
Brief Summary

The purpose of this study is to explore the feasibility of 4K Laparoscopic Surgery for Gastric Cancer.

Detailed Description

A prospective randomized comparison of HD and 4K laparoscopic surgery for gastric cancer will be performed, to evaluate the clinical value and provide theoretical basis and clinical experience for the extensive application of the 4K laparoscopic technique. The evaluation parameters are perioperative clinical efficacy, postoperative life quality, immune function and 3-year survival and recurrence rates.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
502
Inclusion Criteria
  • (1)Age from over 19 to under 74 years
  • (2)cT 1-4a(clinical stage tumor), N0-3, M0 at preoperative evaluation according to the American Joint Committee on Cancer (AJCC) Cancer Staging Manual Seventh Edition
  • (3)Heart, lungs, kidneys and other vital organs function well, with no obvious surgical contraindications
  • (4)Preoperative examination with no distant metastasis, no significantly enlarged lymph nodes around abdominal main artery, and tumor not a direct violation of the pancreas, spleen and other surrounding organs
  • (5)American Society of Anesthesiology (ASA) score class I, II, or III
  • (6)Written informed consent
Exclusion Criteria
  • (1)Women during pregnancy or breast-feeding
  • (2)Severe mental disorder
  • (3)History of previous upper abdominal surgery (except laparoscopic cholecystectomy)
  • (4)Enlarged splenic hilar lymph nodes with integration into a mass and surrounding the blood vessels
  • (5)History of unstable angina or myocardial infarction within past six months
  • (6)History of cerebrovascular accident within past six months
  • (7)History of continuous systematic administration of corticosteroids within one month
  • (8)History of previous neoadjuvant chemotherapy or radiotherapy
  • (9)T4b tumors
  • (10)Emergency surgery due to complication (bleeding, obstruction or perforation) caused by gastric cancer
  • (11)FEV1(Forced expiratory volume in one second)#50% of predicted values

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
4K Laparoscopic Surgery4K Laparoscopic Surgery4K Laparoscopic Surgery will be performed for the treatment of patients assigned to this group.
HD Laparoscopic SurgeryHD Laparoscopic SurgeryHD Laparoscopic Surgery will be performed for the treatment of patients assigned to this group.
Primary Outcome Measures
NameTimeMethod
operating time1 day

day

Secondary Outcome Measures
NameTimeMethod
Time to first ambulation10 days

Time to first ambulation

intracavitary anastomosis time1 day

(patients who undergo totally laparoscopic surgery are analyzed)

the number of positive lymph nodes1 day

the number of positive lymph nodes

intraoperative lymph node dissection time1 day

(regional analysis:infrapyloric area lymph node,suprapancreatic area lymph node,splenic hilar area lymph node,cardial area lymph node)

intraoperative blood loss1 day

ml

the amount of use of titanium clip1 day

the amount of use of titanium clip

duration of postoperative hospital stay10 days

duration of postoperative hospital stay

3-year overall survival rate36 months

month

Time to first flatus10 days

Time to first flatus

Complication30 days;36 months

(early complications occurred within 30 days after operation): pulmonary infection, incision complication, intestinal obstruction, abdominal infection, anastomotic bleeding, anastomotic fistula, gastric emptying; long term complications (30 days later after operation): anastomotic stenosis, intestinal obstruction, dumping syndrome

The number of lymph node dissection1 day

number

intraoperative injury1 day

intraoperative injury

Hospitalization expenses1 months

dolloars

the rate of conversion to laparotomy1 day

the rate of conversion to laparotomy

The daily highest body temperature before discharge7 days

The daily highest body temperature before discharge

Time to first liquid diet10 days

Time to first liquid diet

Time to first soft diet10 days

Time to first soft diet

Overall postoperative morbidity and mortality rates30 days

The number of all patients treated with surgery as the denominator and the number of the patients with any intraoperative and postoperative morbidity and mortality as the numerator are used to calculate the proportions.

Postoperative morbidities are divided into short-term and long-term complications after surgery.

Short-term is defined as within 30 days of surgery or the first discharge if the hospital stay is \> 30 days.

Long-term is defined as the period from 30 days or more after the operation or the period between first discharge (the hospital days after surgery \>30 days) and 3 years after the operation.

Postoperative mortality: patients whose death was identified according to documented intraoperative observation items, including patients who die within 30 days after surgery (including the 30th day) regardless of the causality between death and surgery, and patients who die more than 30 days after surgery.

3-year disease free survival rate36 months

month

Trial Locations

Locations (1)

Fujian Medical University Union Hospital

🇨🇳

Fuzhou, Fujian, China

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