Feasibility of Enhanced Recovery After Surgery Without Prophylactic Abdominal Drainage Tubes After Laparoscopic Distal Gastrectomy For Gastric Cancer

NCT ID: NCT07029269

Last Updated: 2025-12-17

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

454 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-06-16

Study Completion Date

2028-09-10

Brief Summary

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This study aims to compare the effects of using prophylactic abdominal drainage tubes during Enhanced Recovery After Surgery (ERAS) in patients undergoing Laparoscopic Distal Gastrectomy (LDG) for gastric cancer through a multicenter non-inferiority randomized trial. The study is divided into two groups: 1. ERAS-tubeless group: The ERAS protocol without nasogastric decompression, nasojejunal feeding or prophylactic abdominal drainage tubes. 2. ERAS-tube group: the ERAS protocol with prophylactic abdominal drainage tubes, along with no nasogastric decompression or nasojejunal feeding tubes. Patients will be randomly assigned to the two groups in a 1:1 ratio, with the primary analysis based on the modified intention-to-treat population (mITT) and secondary analysis on the per-protocol (PP) population. Perioperative management will adhere to ERAS guidelines, and postoperative quality of life will be assessed using the EORTC QLQ-C30 questionnaire and QoR-15 scores. Preliminary training on the standard ERAS protocol is administered to all members in the team before the initiation of the study, ensuring in-group members to fully master the requirements and other related contents in the study. Data collectors, analysts, and outcome evaluators will remain blinded to group allocation. The findings of this study are expected to provide high-quality evidence on the feasibility of omitting prophylactic abdominal drainage in the context of ERAS, thereby contributing to the optimization of postoperative management strategies for gastric cancer surgery.

Detailed Description

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Conditions

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Gastric Adenocarcinoma Laparoscopic Gastrectomy Complications

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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ERAS-tubeless group

Nasogastric decompression tube is not placed preoperatively; If necessary, nasogastric decompression tube is placed after anesthesia induction during surgery and removed when the reconstruction is performed; No abdominal drainage and nasojejunal feeding tubes were placed intraoperatively; None of these 3 tubes were present postoperatively.

Group Type EXPERIMENTAL

ERAS-tubeless group

Intervention Type PROCEDURE

Nasogastric decompression tube is not placed preoperatively; If necessary, nasogastric decompression tube is placed after anesthesia induction during surgery and removed when the reconstruction is performed; No abdominal drainage and nasojejunal feeding tubes were placed intraoperatively; None of these 3 tubes were present postoperatively.

ERAS-tube group

Nasogastric decompression tube is not placed preoperatively; If necessary, nasogastric decompression tube is placed after anesthesia induction during surgery and removed when the reconstruction is performed; Nasojejunal feeding tube is not placed intraoperatively; 1 prophylactic abdominal drainage tube is placed at the duodenal stump for LDG and retained postoperatively.

Group Type ACTIVE_COMPARATOR

ERAS-tube group

Intervention Type PROCEDURE

Nasogastric decompression tube is not placed preoperatively; If necessary, nasogastric decompression tube is placed after anesthesia induction during surgery and removed when the reconstruction is performed; Nasojejunal feeding tube is not placed intraoperatively; 1 prophylactic abdominal drainage tube is placed at the duodenal stump for LDG and retained postoperatively.

Interventions

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ERAS-tubeless group

Nasogastric decompression tube is not placed preoperatively; If necessary, nasogastric decompression tube is placed after anesthesia induction during surgery and removed when the reconstruction is performed; No abdominal drainage and nasojejunal feeding tubes were placed intraoperatively; None of these 3 tubes were present postoperatively.

Intervention Type PROCEDURE

ERAS-tube group

Nasogastric decompression tube is not placed preoperatively; If necessary, nasogastric decompression tube is placed after anesthesia induction during surgery and removed when the reconstruction is performed; Nasojejunal feeding tube is not placed intraoperatively; 1 prophylactic abdominal drainage tube is placed at the duodenal stump for LDG and retained postoperatively.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Patients' age from 18 to 80 years old;
2. Histopathologically confirmed gastric adenocarcinoma;
3. Clinical tumor stage of cT1-4N0-3M0;
4. Laparoscopic distal gastrectomy approach;
5. ECOG score of 0-1;
6. Written informed consent

Exclusion Criteria

1. Patients with severe concurrent illness or comorbid diseases;
2. Patients with severe pyloric obstruction, recurrent or remnant gastric cancer; 3. Patients with perforation, or undergoing emergency surgery;

4\. Patients with a history of radiotherapy; 5. Patients undergoing complex abdominal surgeries other than laparoscopic cholecystectomy or appendectomy; 6. Patients with peritoneal, hepatic or ovarian metastasis, or simultaneous tumors in other parts of the body preoperatively and intraoperatively; 7. Patients with diabetes and poor recent glycemic control; 8. Patients with autoimmune diseases who have received corticosteroid treatment; 9. Patients with a BMI ≥30 kg/m2 or \<18 kg/m2; 10. Patients with gastrointestinal hemorrhage and hemoglobin levels below 90 g/L; 11. Patients with hypoproteinemia and albumin levels below 30 g/L; 12. Patients with portal hypertension; 13. Patients with severe edema or dense fibrosis intraoperatively after neoadjuvant therapy; 14. Patients with intraoperative findings of duodenal invasion; 15. Patients with combined organ resection; 16. Reconstruction different from BillrothⅡand Braun anastomosis; 17. Patients with preoperative pathological examination inconsistent with postoperative result; 18. Declined to participate; 19. Patients with poor compliance and withdrew from the study halfway
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Zuoyi Jiao

OTHER

Sponsor Role lead

Responsible Party

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Zuoyi Jiao

Medical Professor

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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International Hospital of Pecking University

Beijing, Beijing Municipality, China

Site Status RECRUITING

Fujian Medical University Union Hospital

Fuzhou, Fujian, China

Site Status RECRUITING

Lanzhou University Second Hospital

Lanzhou, Gansu, China

Site Status RECRUITING

Sun Yat-sen University Cancer Center Gansu Hospital

Lanzhou, Gansu, China

Site Status RECRUITING

Zhejiang Cancer Hospital

Zhejiang, Hangzhou, China

Site Status RECRUITING

The First Affiliated Hospital of Xi'an Jiaotong University

Xi'an, Xi'an City, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Zuoyi Jiao, M.D.

Role: CONTACT

+86-0931-5190920

Facility Contacts

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Ning Ning, M.D.

Role: primary

+86-010-69006900

Jianxian Lin, M.D.

Role: primary

+86-591-83363366

Zuoyi Jiao, M.D.

Role: primary

+86-0931-5190920

Dengwen Wei

Role: primary

+86-13919916710

Zhiyuan Xu, M.D.

Role: primary

+86-0571-88122222

Lin Fan, M.D.

Role: primary

+86-029-85323874

Other Identifiers

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LanzhouU2H-2025A-540

Identifier Type: -

Identifier Source: org_study_id