Impact of Gastric Tube Reconstruction Widths on Quality of Life for Esophagogastric Cancers
NCT ID: NCT01911832
Last Updated: 2016-09-13
Study Results
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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UNKNOWN
PHASE3
60 participants
INTERVENTIONAL
2012-03-31
2017-02-28
Brief Summary
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Detailed Description
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With a complete clearance of lymph nodes, esophagojejunostomy after total gastrectomy brings high 5-year survival rate, and can decrease the rate of local recurrence. However, due to the whole gastrectomy, the patients often represent bile regurgitation which may induce pulmonary infection, regurgitation asthma and weight loss.
Roux-en-Y gastrojejunostomy after subtotal gastrectomy reserve partial gastric body which was reconstructed into gastric tube. The remaining gastric body still peristalses and functions as well as a stomach. At the same time, the remaining gastric body keeps acid-secreting function which may induce acid regurgitation after surgery.
For Roux-en-Y gastrojejunostomy after subtotal gastrectomy, the width of reconstruction gastric tube was a key factor to predicate prognosis, and it often ranges from 3 cm to 6 cm, without universal standard. Narrow gastric tube may lack enough blood supply, as a result, it increase the rate of anastomotic leakage. On the contrary, wide gastric tube takes up much thoracic capacity which may disturb the normal pulmonary and cardiovascular function. Tabira and his colleagues conduct a prospective trail that proves the width of gastric tube has no relevance to local blood supply, anastomotic leakage and postoperative nutrition, but the study lack enough patients which may increase bias. So, there is no reliable evidence to predict the quality of postoperative life.
The prospective trail recruits patients with of cancer of the esophagogastric junction. And eligible patients were assigned into three groups: total gastrostomy group (TG group), wide gastric tube group (WG group) and narrow gastric tube group (NG group). Quality of life include integrated questionnaire of QLQ-STO22 and QLQ-C30 and related symptom relief was assessed as primary endpoint. And local recurrence, disease free survival, metastatic rate, overall survival and short-term complication of surgery were also observed as secondary endpoints.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
NONE
Study Groups
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Gastrectomy and subtotal gastrectomy
to compare the quality of life between esophagojejunostomy after total gastrectomy(TG group) and Roux-en-Y gastrojejunostomy after subtotal gastrectomy(SG group)
esophagojejunostomy after total gastrectomy
Roux-en-Y gastrojejunostomy after subtotal gastrectomy
Wide and narrow reconstruction tube
to compare the quality of life between wide tube reconstruction after subtotal gastrectomy(WG group) and narrow tube reconstruction after subtotal gastrectomy(NG group) in Roux-en-Y gastrojejunostomy
wide tube reconstruction after subtotal gastrectomy
narrow tube reconstruction after subtotal gastrectomy
Interventions
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esophagojejunostomy after total gastrectomy
Roux-en-Y gastrojejunostomy after subtotal gastrectomy
wide tube reconstruction after subtotal gastrectomy
narrow tube reconstruction after subtotal gastrectomy
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
2. age between 18 to 80 years
3. no evidence of metastasis of adjacent organs
4. organs function well to tolerate surgery
5. no special treatment before surgery
6. informed consent was written
Exclusion Criteria
2. locally recurrent gastric or esophageal cancer
3. had a history of malignant tumor within 5 years(except the skin cancer)
4. pregnant or lactating women
5. there was contraindication for operation
6. discovery of metastasis in the operation
7. with mental disorder
18 Years
80 Years
ALL
No
Sponsors
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West China Hospital
OTHER
Responsible Party
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Ziqiang Wang,MD
Professor of the West China Hospital, Sichuan University
Locations
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West China hospital, Sichuan University
Chengdu, Sichuan, China
Countries
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Central Contacts
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Facility Contacts
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References
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Vial M, Grande L, Pera M. Epidemiology of adenocarcinoma of the esophagus, gastric cardia, and upper gastric third. Recent Results Cancer Res. 2010;182:1-17. doi: 10.1007/978-3-540-70579-6_1.
Hasegawa S, Yoshikawa T. Adenocarcinoma of the esophagogastric junction: incidence, characteristics, and treatment strategies. Gastric Cancer. 2010 Jun;13(2):63-73. doi: 10.1007/s10120-010-0555-2. Epub 2010 Jul 3.
Allum WH, Stenning SP, Bancewicz J, Clark PI, Langley RE. Long-term results of a randomized trial of surgery with or without preoperative chemotherapy in esophageal cancer. J Clin Oncol. 2009 Oct 20;27(30):5062-7. doi: 10.1200/JCO.2009.22.2083. Epub 2009 Sep 21.
Mariette C, Piessen G, Briez N, Gronnier C, Triboulet JP. Oesophagogastric junction adenocarcinoma: which therapeutic approach? Lancet Oncol. 2011 Mar;12(3):296-305. doi: 10.1016/S1470-2045(10)70125-X. Epub 2010 Nov 23.
Johansson J, Djerf P, Oberg S, Zilling T, von Holstein CS, Johnsson F, Walther B. Two different surgical approaches in the treatment of adenocarcinoma at the gastroesophageal junction. World J Surg. 2008 Jun;32(6):1013-20. doi: 10.1007/s00268-008-9470-7.
Ielpo B, Pernaute AS, Elia S, Buonomo OC, Valladares LD, Aguirre EP, Petrella G, Garcia AT. Impact of number and site of lymph node invasion on survival of adenocarcinoma of esophagogastric junction. Interact Cardiovasc Thorac Surg. 2010 May;10(5):704-8. doi: 10.1510/icvts.2009.222778. Epub 2010 Feb 13.
De Giacomo T, Francioni F, Venuta F, Trentino P, Moretti M, Rendina EA, Coloni GF. Complete mechanical cervical anastomosis using a narrow gastric tube after esophagectomy for cancer. Eur J Cardiothorac Surg. 2004 Nov;26(5):881-4. doi: 10.1016/j.ejcts.2004.07.024.
Matsuda T, Kaneda K, Takamatsu M, Takahashi M, Aishin K, Awazu M, Okamoto A, Kawaguchi K. Reliable preparation of the gastric tube for cervical esophagogastrostomy after esophagectomy for esophageal cancer. Am J Surg. 2010 May;199(5):e61-4. doi: 10.1016/j.amjsurg.2009.08.046. Epub 2010 Mar 3.
Pierie JP, de Graaf PW, van Vroonhoven TJ, Obertop H. The vascularization of a gastric tube as a substitute for the esophagus is affected by its diameter. Dis Esophagus. 1998 Oct;11(4):231-5. doi: 10.1093/dote/11.4.231.
Tabira Y, Sakaguchi T, Kuhara H, Teshima K, Tanaka M, Kawasuji M. The width of a gastric tube has no impact on outcome after esophagectomy. Am J Surg. 2004 Mar;187(3):417-21. doi: 10.1016/j.amjsurg.2003.12.008.
Other Identifiers
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WqLE-201324
Identifier Type: -
Identifier Source: org_study_id
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