Comparison of Billroth-I and Roux-en-Y Reconstruction After Distal Subtotal Gastrectomy

NCT ID: NCT01142271

Last Updated: 2011-11-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-06-30

Study Completion Date

2012-05-31

Brief Summary

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The purpose of this trial is to compare the degree of reflux, operative outcomes and quality of life between Roux en Y and Billroth-I reconstructions after distal subtotal gastrectomy for gastric cancer

Detailed Description

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Most common procedure for the resection of gastric cancers located in middle or lower stomach is distal subtotal gastrectomy. However, the optimal reconstruction procedure after that has still not to be established. Although B-I reconstruction is most common method due to the safety and simplicity, the duodenal fluid may reflux into the remnant stomach which may contribute to the mucosal injury to remnant stomach and esophagus. Roux en Y reconstruction may reduce the reflux to remnant stomach due to the length of Roux en Y limb, although it is more complicated procedure.

Therefore, we plan to collect 120 patients to compare the degree of reflux between Roux en Y and Billroth-I reconstructions after distal subtotal gastrectomy for gastric cancer. In addition, we compare the surgical outcome and quality of life between two groups.

Conditions

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Gastrectomy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

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Billroth-I

Patients in this group should be underwent gastroduodenostomy as reconstruction procedure after standard distal subtotal gastrectomy with lymph node dissection.

Group Type EXPERIMENTAL

Billroth-I

Intervention Type PROCEDURE

Standard distal gastrectomy with D1 plus beta or D2 lymph node dissection would be performed for distal gastric cancer. After that, gastroduodenostomy should be performed by circular stapler. In addition, stapler sites were re-enforced.

Roux en Y

Patients in this group should be underwent jejunojejunostomy and gastrojejunostomy as reconstruction procedure after standard distal gastrectomy.

Group Type EXPERIMENTAL

Roux en Y

Intervention Type PROCEDURE

Standard distal gastrectomy with D1 plus beta or D2 lymph node dissection would be performed for distal gastric cancer. After that, jejunojejunostomy and gastrojejunostomy should be performed by circular staplers. In addition, stapler sites were re-enforced.

Interventions

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Billroth-I

Standard distal gastrectomy with D1 plus beta or D2 lymph node dissection would be performed for distal gastric cancer. After that, gastroduodenostomy should be performed by circular stapler. In addition, stapler sites were re-enforced.

Intervention Type PROCEDURE

Roux en Y

Standard distal gastrectomy with D1 plus beta or D2 lymph node dissection would be performed for distal gastric cancer. After that, jejunojejunostomy and gastrojejunostomy should be performed by circular staplers. In addition, stapler sites were re-enforced.

Intervention Type PROCEDURE

Other Intervention Names

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Gastroduodenostomy Gastrojejunostomy and jejunojejunostomy

Eligibility Criteria

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Inclusion Criteria

* Patients diagnosed with adenocarcinoma at the endoscopic biopsy
* Patients who are possible to be performed curative resection in imaging study
* Patients with tumor which not involved in pylorus and are located in mid or distal portion of the stomach
* Patients with informed consent
* Patients with three or less American Society Anesthesiology Score 3

Exclusion Criteria

* Patients who are or become pregnant
* Patients with uncontrolled disease
* Patient s with synchronous other malignancy
* Patients participated in other clinical trial
Minimum Eligible Age

20 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ajou University School of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Sang-Uk Han

Department of Surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sang-Uk Han, M.D., Ph D.

Role: PRINCIPAL_INVESTIGATOR

Department of Surgery, Ajou University School of Medicine

Hoon Hur, M.D.

Role: STUDY_DIRECTOR

Department of Surgery, Ajou University School of Medicine

Locations

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Ajou University Hospital

Suwon, , South Korea

Site Status RECRUITING

Countries

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South Korea

Central Contacts

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Hoon Hur, M.D.

Role: CONTACT

+82-31-219-2507

Sang-Uk Han, M.D.

Role: CONTACT

+82-31-219-6320

Facility Contacts

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Hoon Hur, M.D.

Role: primary

+82-31-219-5207

Jun Young Kim, M.D.

Role: backup

+82-31-219-5206

References

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Chan DC, Fan YM, Lin CK, Chen CJ, Chen CY, Chao YC. Roux-en-Y reconstruction after distal gastrectomy to reduce enterogastric reflux and Helicobacter pylori infection. J Gastrointest Surg. 2007 Dec;11(12):1732-40. doi: 10.1007/s11605-007-0302-0. Epub 2007 Sep 18.

Reference Type BACKGROUND
PMID: 17876675 (View on PubMed)

Ishikawa M, Kitayama J, Kaizaki S, Nakayama H, Ishigami H, Fujii S, Suzuki H, Inoue T, Sako A, Asakage M, Yamashita H, Hatono K, Nagawa H. Prospective randomized trial comparing Billroth I and Roux-en-Y procedures after distal gastrectomy for gastric carcinoma. World J Surg. 2005 Nov;29(11):1415-20; discussion 1421. doi: 10.1007/s00268-005-7830-0.

Reference Type BACKGROUND
PMID: 16240061 (View on PubMed)

Nishizaki D, Ganeko R, Hoshino N, Hida K, Obama K, Furukawa TA, Sakai Y, Watanabe N. Roux-en-Y versus Billroth-I reconstruction after distal gastrectomy for gastric cancer. Cochrane Database Syst Rev. 2021 Sep 15;9(9):CD012998. doi: 10.1002/14651858.CD012998.pub2.

Reference Type DERIVED
PMID: 34523717 (View on PubMed)

Hur H, Ahn CW, Byun CS, Shin HJ, Kim YB, Son SY, Han SU. A Novel Roux-en-Y Reconstruction Involving the Use of Two Circular Staplers after Distal Subtotal Gastrectomy for Gastric Cancer. J Gastric Cancer. 2017 Sep;17(3):255-266. doi: 10.5230/jgc.2017.17.e32. Epub 2017 Sep 26.

Reference Type DERIVED
PMID: 28970956 (View on PubMed)

Other Identifiers

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AJIRB-MED-DEO-09-297

Identifier Type: -

Identifier Source: org_study_id