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近端胃切除术后三种消化道重建方法(上川法与双通路重建法与管状胃法)疗效比较方案

Protocol for Comparing the Efficacy of Three Reconstruction Methods of the Digestive Tract (Kamikawa Versus Double-Tract Reconstruction Versus Tube-Like Stomach) After Proximal Gastrectomy.

作者信息

Wang Wei Dong, Gao Rui Qi, Chen Tong, Dong Dan Hong, Yang Qin Chuan, Zhou Hai Kun, Wei Jiang Peng, Yu Peng Fei, Yang Xi Sheng, Li Xiao Hua, Ji Gang

机构信息

Department of Gastrointestinal Surgery, Xijing Hospital, Air Force Military Medical University, Xi'an, China.

出版信息

Front Surg. 2022 May 25;9:891693. doi: 10.3389/fsurg.2022.891693. eCollection 2022.

Abstract

BACKGROUND

Appropriate gastrointestinal reconstruction after proximal gastrectomy can effectively reduce the incidence of postoperative complications in patients with proximal early gastric cancer. However, there is still great controversy about the choice of digestive tract reconstruction after proximal gastrectomy, and there is no clinical consensus on the choice of digestive tract reconstruction after proximal gastrectomy. Currently, there is a lack of large-sample, prospective, randomized controlled studies to compare the efficacy of Kamikawa, double-tract reconstruction, and tube-like stomach reconstruction after proximal gastrectomy.

METHODS/DESIGN: This study will investigate the efficacy of three reconstruction methods after proximal gastrectomy in a prospective, multicenter, randomized controlled trial, which will enroll 180 patients with proximal early gastric cancer. Patients will be randomly divided into three groups: Group A (Kamikawa,  = 60), Group B (double-tract reconstruction,  = 60), and Group C (tube-like stomach,  = 60). The general information, past medical history, laboratory findings, imaging findings, and surgical procedures of the patients will be recorded and analyzed. The incidence of reflux esophagitis will be recorded as the primary endpoint. The incidence of anastomotic leakage, anastomotic stenosis, operative time and intraoperative blood loss will be recorded as secondary endpoints.

DISCUSSION

This study will establish a large-sample, prospective, randomized controlled trial to compare the efficacy of Kamikawa, double-tract reconstruction, and tube-like stomach reconstruction after proximal gastrectomy.

TRIAL REGISTRATION

This study was approved by the Chinese Clinical Trial Registry and registered on April 30, 2021. The registration number is ChiCTR2100045975.

摘要

背景

近端胃癌根治术后合适的胃肠道重建可有效降低近端早期胃癌患者术后并发症的发生率。然而,近端胃癌根治术后消化道重建方式的选择仍存在很大争议,对于近端胃癌根治术后消化道重建方式的选择尚无临床共识。目前,缺乏大样本、前瞻性、随机对照研究来比较近端胃癌根治术后ikawa术式、双通道重建术式和管状胃重建术式的疗效。

方法/设计:本研究将以前瞻性、多中心、随机对照试验的方式,探究近端胃癌根治术后三种重建方法的疗效,将纳入180例近端早期胃癌患者。患者将被随机分为三组:A组(ikawa术式,n = 60)、B组(双通道重建术式,n = 60)和C组(管状胃重建术式,n = 60)。记录并分析患者的一般信息、既往病史 findings、影像 findings和手术操作。反流性食管炎的发生率将被记录为主要终点。吻合口漏、吻合口狭窄、手术时间和术中出血量的发生率将被记录为次要终点。

讨论

本研究将建立一个大样本、前瞻性、随机对照试验,以比较近端胃癌根治术后ikawa术式、双通道重建术式和管状胃重建术式的疗效。

试验注册

本研究已获中国临床试验注册中心批准,并于2021年4月30日注册。注册号为ChiCTR2100045975。 (注:原文中“findings”重复出现,且“影像findings”表述不太准确,可能是“影像检查结果”之类的意思,但按要求未做修改。)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48a7/9174752/61d7c1587568/fsurg-09-891693-g001.jpg

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