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Early Oral Nutrition After Total GastrectomyNCT03257280

Trial on Impact on the Hospital Stay, of an Early Oral Nutrition Protocol Applied to Patients After Total Gastrectomy. (DOPGT_2015)

A study testing Early oral nutrition in people with Early Oral Nutrition After Total Gastrectomy and Gastric Cancer, run by Hospital Universitari de Bellvitge at 1 site in Spain.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This is a prospective randomized controlled clinical trial to clarify the effect of early oral nutrition introduction after total gastrectomy in gastric cancer patients on the length of hospital stay, comparing an experimental group vs control group. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Early oral nutrition
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
84 participants
Where
1 siteSpain
Study dates
20 Oct 2017to Sep 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • All patients requiring radical total gastrectomy for gastric cancer.
  • 18 or above years old.
  • Acceptance and signing the full informed consent.

Who cannot join

  • Patient with poorly controlled diabetes mellitus (glycosylated hemoglobin levels greater than 7%)
  • Emergency surgery.
  • Total gastrectomy with esophagus-jejunal manual suture.
  • Early dehiscence of esophagus-jejunal anastomosis (first 24 hours).
  • Reintervention for abdominal complication in the first 24 hours.
  • Surgery involving large intestinal or colon resections.
  • Proximal resection margin affected requiring a esophagectomy and reconstruction with coloplasty.

Trial locations and contacts

1 site in 1 country.

Leandre Farran Teixidor, PhD, MD contact

+34-93-335-90-11 ext. 2316

lfarran@bellvitgehospital.cat

Spain1 site, 1 recruiting
  • Leandre Farran Teixidor

    L'Hospitalet de Llobregat, Barcelona, 08026

    Leandre Farran Teixidor, PhD, MD, +34-93-335-90-11 ext. 2316, lfarran@bellvitgehospital.cat

    Fernando Estremiana Garcia, MD, +34-93-335-90-11 ext. 2316, festremiana@bellvitgehospital.cat

    Recruiting

Other trials in Spain

About this study

Official title: Impact on the Hospital Stay, of an Early Oral Nutrition Protocol Applied to Gastric Cancer Patients After Total Gastrectomy: A Prospective Randomized Control Trial (DOPGT_2015)

This is a prospective randomized controlled clinical trial to clarify the effect of early oral nutrition introduction after total gastrectomy in gastric cancer patients on the length of hospital stay, comparing an experimental group vs control group.

Read the detailed description

The total gastrectomy is a high complexity surgery that involves a high morbid-mortality. In our center, the postoperative management consisted in 1 week period of non oral intake and total parenteral nutrition. At the 7 day, an oral contrast image is performed to prove the correct function of the anastomosis, in witch case, a progressive oral diet is begin.

In the late 90s, the Fast-track concept (or multimodal perioperative patient care) was introduced in the surgical patients attempting to improve their postoperative course. This new concept includes the preoperative advices related to the surgery, the intensive mobilization after surgery, the early oral diet, and to avoid the routinary use of the nasogastric tube. Some groups have been trying to apply this Fast-track program sporadically in patients submitted to an elective total gastrectomy for gastric cancer, even do, there is still no good evidence to sport these practice.

Based on the reasons exposed before, the investigators design a prospective randomized controlled trial in gastric cancer patients underwent on a total gastrectomy comparing two groups. 24 hours after gastrectomy the investigators will administer oral methylene blue and if no evidence of drainage leakage the participants will be randomized into two groups: one of them with our classical postoperative management, and the other one implements an early oral nutrition protocol, having in considerations its effectiveness, security, and impact on the hospital stay.

Being tested
Early oral nutrition
Medical subject headings
Stomach Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Early oral nutritionOther

    An early oral nutrition with supplements and increased progressively according to an established schedule, start 48 hours after total gastrectomy.

Study groups in NCT03257280
Study groupRoleWhat they receive
Early oral nutritionExperimentalAn early oral nutrition with supplements and increased progressively according to an established schedule, start 48 hours after total gastrectomy.
Receives: Other: Early oral nutrition
control groupNo interventionIn our center, the classical postoperative management consisted in one week period of non oral intake and total parenteral nutrition. At the 7 day, an oral contrast image is performed to prove the correct function of the anastomosis, in witch case, a three days progressive oral diet is begin.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Hospital stay

    Postoperatory hospital stay in days

    Measured: postoperative 1 day to discharge, up to 1 month after surgery

Secondary outcomes (13)
  1. Mortality

    Postoperative Mortality: Deaths occurring during admission and / or within 30 days after surgery or during surgical admission if it lasts longer than 30 days.

    Measured: During the admission, two weeks and one month after surgery

  2. Hospital readmissions

    It will be considered the income produced within 30 days after the surgical intervention in which the cause of the admission is attributed to a complication in relation to the surgical intervention.

    Measured: Two weeks and one month after surgery

  3. Weight

    weight shall be measured in kilograms

    Measured: First day of hospital admission, two weeks and one month after surgery

  4. Anastomotic dehiscence

    Anastomotic dehiscence: If the intra-abdominal drainage presents a purulent appearance or an amylase determination> 30, suspicion of anastomosis dehiscence will be made; In this situation, a clinical test (intake of methylene blue) radiological test (with oral contrast) or endoscopy will be requested to confirm the diagnosis. Anastomosis dehiscence will be confirmed if any of the following occurs:

    • Exit of methylene blue through intra-abdominal drainage
    • Contrast leakage in a radiological test performed for sepsis
    • Evidence of dehiscence in a fibrogastroscopy
    • Evidence of anastomotic dehiscence during a reintervention

    Measured: postoperative 1 day to discharge, up to 1 month after surgery

  5. Duodenal stump leak

    Intra-abdominal drainage presents a purulent appearance with amylase determination> 30 and a bilirubin value higher than plasmatic bilirubin.

    Measured: postoperative 1 day to discharge, up to 1 month after surgery

  6. Paralytic ileus

    When three of the following criteria are met.

    Oral intolerance after the fourth postoperative day Abdominal distention and tympanism No bowel motions or flatus Compatible abdominal x-ray

    Measured: postoperative 1 day to discharge, up to 1 month after surgery

  7. Intra-Abdominal abscesses

    1. Radiological criteria: Air inside the collection Collection with heterogeneous and irregular pickup or wall pickup Collection with heterogeneous content
    2. Isolation of one or more microorganisms in culture after percutaneous collection

    Measured: postoperative 1 day to discharge, up to 1 month after surgery

  8. Postoperative Hemoperitoneum

    Presence of blood in the abdominal cavity after gastrectomy that needs any kind of treatments

    Measured: postoperative 1 day to discharge, up to 1 month after surgery

  9. Evisceration

    Extrusion of viscera outside the body through a surgical incision

    Measured: postoperative 1 day to discharge, up to 1 month after surgery

  10. Superficial Incisional Surgical Site Infection

    Superficial Incisional Surgical Site Infection

    Infection within 30 days after the operation and only involves skin and subcutaneous tissue of the incision and at least one of the following:

    Purulent drainage with or without laboratory confirmation, from the superficial incision.

    Organisms isolated from an aseptically obtained culture of fluid or tissue from the superficial incision.

    At least one of the following signs or symptoms of infection: pain or tenderness, localised swelling, redness, or heat and superficial incision is deliberately opened by surgeon, unless incision is culture-negative.

    Diagnosis of superficial incisional surgical site infection made by a surgeon or attending physician.

    Measured: postoperative 1 day to discharge, up to 1 month after surgery

  11. Height

    Height shall be measured in meters

    Measured: First day of hospital admission, two weeks and one month after surgery

  12. Percentage of weight lost

    Percentage of weight lost shall be measured in percentage

    Measured: First day of hospital admission, two weeks and one month after surgery

  13. Impedancemetry

    The impedanciometry will record:

    Phase-angle Na / K ratio Basal metabolism (Kcal) Fat mass percentage Muscle mass percentage Cell mass percentage Extracellular mass percentage

    Measured: First day of hospital admission, two weeks and one month after surgery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Aug 2017
  2. Study start20 Oct 2017
  3. Primary completionOct 2022 (estimated)
  4. Study completionSep 2023 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
84 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03257280
Sponsor's protocol ID
DOPGT_2015
Status last verified
Feb 2021
First submitted
7 Jul 2017
Last updated
17 Feb 2021
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Gonzalez CA, Agudo A. Carcinogenesis, prevention and early detection of gastric cancer: where we are and where we should go. Int J Cancer. 2012 Feb 15;130(4):745-53. doi: 10.1002/ijc.26430. Epub 2011 Oct 20.

    PubMed 21918974
  • Allum WH, Blazeby JM, Griffin SM, Cunningham D, Jankowski JA, Wong R; Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland, the British Society of Gastroenterology and the British Association of Surgical Oncology. Guidelines for the management of oesophageal and gastric cancer. Gut. 2011 Nov;60(11):1449-72. doi: 10.1136/gut.2010.228254. Epub 2011 Jun 24. No abstract available.

    PubMed 21705456
  • Van Cutsem E, Dicato M, Geva R, Arber N, Bang Y, Benson A, Cervantes A, Diaz-Rubio E, Ducreux M, Glynne-Jones R, Grothey A, Haller D, Haustermans K, Kerr D, Nordlinger B, Marshall J, Minsky BD, Kang YK, Labianca R, Lordick F, Ohtsu A, Pavlidis N, Roth A, Rougier P, Schmoll HJ, Sobrero A, Tabernero J, Van de Velde C, Zalcberg J. The diagnosis and management of gastric cancer: expert discussion and recommendations from the 12th ESMO/World Congress on Gastrointestinal Cancer, Barcelona, 2010. Ann Oncol. 2011 Jun;22 Suppl 5:v1-9. doi: 10.1093/annonc/mdr284.

    PubMed 21633049
  • Viudez-Berral A, Miranda-Murua C, Arias-de-la-Vega F, Hernandez-Garcia I, Artajona-Rosino A, Diaz-de-Liano A, Vera-Garcia R. Current management of gastric cancer. Rev Esp Enferm Dig. 2012 Mar;104(3):134-41. doi: 10.4321/s1130-01082012000300006.

    PubMed 22449155
  • Okines A, Verheij M, Allum W, Cunningham D, Cervantes A; ESMO Guidelines Working Group. Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2010 May;21 Suppl 5:v50-4. doi: 10.1093/annonc/mdq164. No abstract available.

    PubMed 20555102
  • Wong J, Kelly KJ, Mittra A, Gonen M, Allen P, Fong Y, Coit D. Rt-PCR increases detection of submicroscopic peritoneal metastases in gastric cancer and has prognostic significance. J Gastrointest Surg. 2012 May;16(5):889-96; discussion 896. doi: 10.1007/s11605-012-1845-2. Epub 2012 Feb 24.

    PubMed 22362071
  • Takata A, Kurokawa Y, Fujiwara Y, Nakamura Y, Takahashi T, Yamasaki M, Miyata H, Nakajima K, Takiguchi S, Mori M, Doki Y. Prognostic value of CEA and CK20 mRNA in the peritoneal lavage fluid of patients undergoing curative surgery for gastric cancer. World J Surg. 2014 May;38(5):1107-11. doi: 10.1007/s00268-013-2385-y.

    PubMed 24305936
  • Washington K. 7th edition of the AJCC cancer staging manual: stomach. Ann Surg Oncol. 2010 Dec;17(12):3077-9. doi: 10.1245/s10434-010-1362-z. No abstract available.

    PubMed 20882416
  • Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer. 2011 Jun;14(2):113-23. doi: 10.1007/s10120-011-0042-4. No abstract available.

    PubMed 21573742
  • Feng F, Ji G, Li JP, Li XH, Shi H, Zhao ZW, Wu GS, Liu XN, Zhao QC. Fast-track surgery could improve postoperative recovery in radical total gastrectomy patients. World J Gastroenterol. 2013 Jun 21;19(23):3642-8. doi: 10.3748/wjg.v19.i23.3642.

    PubMed 23801867
  • Deguchi Y, Fukagawa T, Morita S, Ohashi M, Saka M, Katai H. Identification of risk factors for esophagojejunal anastomotic leakage after gastric surgery. World J Surg. 2012 Jul;36(7):1617-22. doi: 10.1007/s00268-012-1559-3.

    PubMed 22415758
  • Schietroma M, Cecilia EM, Carlei F, Sista F, De Santis G, Piccione F, Amicucci G. Prevention of anastomotic leakage after total gastrectomy with perioperative supplemental oxygen administration: a prospective randomized, double-blind, controlled, single-center trial. Ann Surg Oncol. 2013 May;20(5):1584-90. doi: 10.1245/s10434-012-2714-7. Epub 2012 Oct 26.

    PubMed 23099730
  • Kucukay F, Okten RS, Parlak E, Disibeyaz S, Ozogul Y, Bostanci EB, Olcer T. Self-expanding covered metallic stent treatment of esophagojejunostomy fistulas. Abdom Imaging. 2013 Apr;38(2):244-8. doi: 10.1007/s00261-012-9895-1.

    PubMed 22527158
  • Lang H, Piso P, Stukenborg C, Raab R, Jahne J. Management and results of proximal anastomotic leaks in a series of 1114 total gastrectomies for gastric carcinoma. Eur J Surg Oncol. 2000 Mar;26(2):168-71. doi: 10.1053/ejso.1999.0764.

    PubMed 10744938
  • Langer FB, Wenzl E, Prager G, Salat A, Miholic J, Mang T, Zacherl J. Management of postoperative esophageal leaks with the Polyflex self-expanding covered plastic stent. Ann Thorac Surg. 2005 Feb;79(2):398-403; discussion 404. doi: 10.1016/j.athoracsur.2004.07.006.

    PubMed 15680802

Questions about this trial

What is this clinical trial studying?

A study testing Early oral nutrition in people with Early Oral Nutrition After Total Gastrectomy and Gastric Cancer, run by Hospital Universitari de Bellvitge at 1 site in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 17 Feb 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Leandre Farran Teixidor, PhD, MD (+34-93-335-90-11 ext. 2316, lfarran@bellvitgehospital.cat), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Hospital stay (time frame: postoperative 1 day to discharge, up to 1 month after surgery). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03257280, which also lists 36 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Feb 2021.

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