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临床试验/NCT03601234
NCT03601234Unknown不适用

Application of Laparoscopy Combined With Endoscopy Surgery in the Treatment of Gastric Stromal Tumors

First Affiliated Hospital Xi'an Jiaotong University1 个研究点 分布在 1 个国家目标入组 80 人开始时间: 2018年4月16日最近更新:
适应症
干预措施

试验速览

阶段
不适用
入组人数
80
试验地点
1
主要终点
operation time

研究概览

简要总结

Gastrointestinal stromal tumor (GIST) is a kind of mesenchymal tumor with malignant differentiation potential. It originated from mesenchymal stem cells of gastrointestinal tract.The most common is that gastric stromal tumors(GST) make up 60-70% of gastrointestinal stromal tumors.The first choice for the treatment of non-metastatic gastric stromal tumors is to ensure the integrity of the tumor and obtain the negative surgical margin.At present, the common surgical methods of resection of gastric stromal tumors include laparotomy and laparoscopy, most of them are partial gastrectomy, wedge-shaped resection, proximal subtotal gastrectomy, distal subtotal gastrectomy and total gastrectomy, etc.There was no significant difference between open surgery and laparoscopic surgery.With the rapid development of endoscopic technology in recent years, endoscopes have been continuously explored in practice.Laparoscopic endoscopic cooperative surgery(LECS) is different from the past technology. It is a new radical resection of GIST presented by Japanese scholars. LECS resects the tumor completely by laparoscopy with the help of the precise positioning and guidance of endoscopy .This method conforms to the idea of the modern minimally invasive surgery, and avoids many problems,such as incomplete resection and disorders of digestion caused by excessive tissue resection. Investigators will observe the diffenrence of LECS and traditional laparoscopic surgeries.Firstly,the investigators will collect 80 cases of GST patients, randomly assigned for the laparoscopic group, the LECS surgical treatment. Secondly, to analyzing the basic treatment and follow-up data, including the operation time, blood loss, the number of transfer laparotomy or laparoscopy, the number of cut edge positive, the distances of cut edge away from the tumor edge, the cases of anastomotic fistula bleeding, stenosis, average such confinement, the meal time, cost of treatment, tumor recurrence rate, the presence of residual stomach, upset stomach and frequency, reflux esophagitis, bile reflux gastritis and other indicators.The purpose of this subject is to observe the effectivity and safety of LECS , invent serval LECS equipment patents and provide some references for LECS applying to the minimally invasive surgery of the digestive tract tumor and multidisciplinary treatment mode.It also provides reference for gastrointestinal stromal tumors, leiomyomas, ectopic pancreas, carcinoid, early carcinomas, giant adenomas and polyps.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Treatment
盲法
Single (Outcomes Assessor)

入排标准

性别
All
接受健康志愿者

入选标准

  • Patients without contraindications gastroscope,surgery and anesthesia;
  • Gastroscope found submucosal lesions, qualitative hard;Endoscopic ultrasonography (EUS) confirmed the lesions come from the muscularis propria;
  • Tumors diameter > 2 cm;Or tumors had < 2 cm, but the position is located in the stomach wall, after nearly cardia and it is a difficult position for gastroscope ;
  • Tumors diameter < 5 cm, the tumors had complete, no broken feed and bleeding;
  • Not found the tumor metastasis;
  • There is no history of abdominal surgery, no severe abdominal cavity adhesion
  • Normal coagulation function;
  • There is no history of anticoagulant drugs, or who take aspirin, salvia miltiorrhiza, etc., should stop taking drugs for more than one week;
  • Patients and their families volunteered choice the surgical procedure and signed informed consent.

排除标准

  • Patients with preoperative assessment of distant metastasis;
  • Patients with preoperative radiation and chemotherapy or hormone therapy;
  • Patients with acute obstruction, bleeding or perforation of the emergency surgery;
  • Patients with a history of abdominal trauma or abdominal surgery;
  • Patients with contraindications gastroscope,surgery and anesthesia.

研究组 & 干预措施

laparoscopic surgery

Experimental

This is a kind of traditional surgical method.only use laparoscopy to resect the GIST.

干预措施: laparoscopic surgery (Procedure)

laparoscopic and endoscopic combined surgery

Experimental

LECS resects the GIST completely by laparoscopy with the help of the precise positioning and guidance of endoscopy.

干预措施: laparoscopic and endoscopic cooperative surgery (Procedure)

结局指标

主要结局

operation time

时间窗: 1 hours to 6 hours through the surgery completion

record in minutes,from the beginning of anesthesia to the end

次要结局

  • blood loss(1 hours to 6 hours through the surgery completion)
  • time in bed(from two days to two weeks after surgery)
  • time to take food(from two days to two weeks after surgery)
  • postoperative complication rate(from two weeks to one year after surgery)
  • tumor recurrence rate(from one month to two years after surgery)
  • success rate(after the pathological report, up to 2 weeks)
  • hospitalization expenses(one month)

研究者

申办方类型
Other
责任方
Sponsor

研究点 (1)

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