Gastric CancerOGTNCT05442502
Safety and Efficacy of OGT Method Versus the Traditional Overlap Method
An observational study of Gastric Cancer, run by Nanfang Hospital, Southern Medical University at 1 site in China.
Trial summary
Introduction: The safety and efficiency of OGT-assisted method have not yet been compared with conventional overlap approach. Methods Retrospectively analyses the data of 155 gastric/gastroesophageal junction (G/GEJ) cancer patients who underwent laparoscopic total gastrectomy by conventional(conventional group, n=83)… Read more about this study
- Who is it for?
- Ages 18 to 85 years
- Conditions the study is for
- Gastric Cancer
- What is being tested?
- The overlap guiding tube(OGT) method and The conventional overlap method
- Type of treatment
- Surgery or procedure
- How many people
- 155 participants
- Where
- 1 siteChina
- Study dates
- 1 Jun 2018to 1 Mar 2022
- Phase
- Observational
- 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 to 85 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: All patients enrolled in our study underwent standard LTG with D2 lymphadenectomy according to the Japanese Gastric Cancer Association treatment guidelines
Who may be able to join
- (1)gastric cancer was confirmed by pathological examination; (2) tumor located in GEJ with involving esophagus no more than 2cm or the upper, upper to the middle, or entire stomach; (3) had no obvious operative contraindication; and (4) aged 18-85 years.
Who cannot join
- Null.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Safety and Efficacy of OGT-assisted Overlap Esophagojejunostomy Versus the Traditional Overlap Method in Laparoscopic Total Gastrectomy for Gastric/Gastroesophageal Junction (G/GEJ) Tumors
Introduction: The safety and efficiency of OGT-assisted method have not yet been compared with conventional overlap approach.
Methods Retrospectively analyses the data of 155 gastric/gastroesophageal junction (G/GEJ) cancer patients who underwent laparoscopic total gastrectomy by conventional(conventional group, n=83) or OGT-assisted (OGT group, n=72) overlap methods at Nanfang Hospital. The anastomotic efficiency and surgical outcomes were compared between two groups.
Read the detailed description
Although our previous multicenter randomized controlled trial (CLASS-01) has confirmed the safety and efficacy of laparoscopic distal gastrectomy for gastric cancer[1, 2], the feasibility of laparoscopic total gastrectomy (LTG) remains uncertain. The most challenging technical difficulty of LTG is esophagojejunostomy(ESJ)[3, 4]. At present, there is still no consensus on the ideal anastomosis method for EJ.
Since overlap esophagojejunostomy was first proposed in 2010[5], it has gradually gone mainstream because of its lower incidence of anastomotic-related complications and satisfactory short-term outcomes[6-10]. However, the overlap approach is technically-difficult and time-consuming, and might confront intraoperative construction complications, such as injuring esophagus caused by the repetition of inserting anvil fork into esophagus or developing esophageal submucosa pseudocanals(video 1 and 2). Therefore, we first designed an overlap guiding tube (OGT)-assisted method to overcame above limitations[11]. And the first reported about the application of OGT-assisted method preliminarily indicated that it is safe and feasible, with a satisfactory success rate of inserting anvil fork into esophageal lumen at first attempt and esophagojejunostomy time[11]. However, the safety and efficiency of OGT-assisted method have not yet been compared side-by-side with the conventional overlap approach. Therefore, this study aimed to compare the OGT-assisted and conventional overlap methods in terms of feasibility and safety in LTG for gastric/gastroesophageal junction (G/GEJ) tumors.
Methods Patients One hundred and fifty-five patients with G/GEJ cancer undergoing LTG via either the conventional overlap esophagojejunostomy(conventional group) or OGT-assisted overlap esophagojejunostomy (OGT group) in the Department of Gastrointestinal Surgery, Southern Medical University Nanfang Hospital, between June 2018 and February 2022 were initially eligible for the study. The inclusion criteria were as follows: (1)gastric cancer was confirmed by pathological examination; (2) tumor located in GEJ with involving esophagus no more than 2cm or the upper, upper to the middle, or entire stomach; (3) had no obvious operative contraindication; and (4) aged 18-85 years. The pathological staging was based on the TNM system of the 8th edition of the International Federation for the prevention and treatment of cancer[12]. This study meets the requirements of the Helsinki Declaration revised in 2013. Patients and their families signed informed consent forms before operation. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline. The data collection protocol was approved by the Ethics Committee of Nanfang Hospital, Southern Medical University. Written informed consent was obtained from all the patients in the study.
- Conditions
- Gastric Cancer
- Being tested
- The overlap guiding tube(OGT) method, The conventional overlap method
- Keywords
- Gastric/gastroesophageal junction (G/GEJ) tumors, Laparoscopy total gastrectomy, Overlap esophagojejunostomy, OGT
- Medical subject headings
- Stomach Neoplasms, Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
The overlap guiding tube(OGT) methodProcedure or surgery
The overlap guiding tube(OGT) is used to assist the anvil fork placed into the esophageal cavity.
The conventional overlap methodProcedure or surgery
After firing the stapler, two openings were converted into a single entry hole to create an end-to-side esophagojejunostomy, and the entry hole was closed with full-thickness running suture using barbed sutures intracorporeally.
| Study group | Role | What they receive |
|---|---|---|
| The conventional overlap group | In conventional overlap group, after firing the stapler, two openings were converted into a single entry hole to create an end-to-side esophagojejunostomy, and the entry hole was closed with full-thickness running suture using barbed sutures intracorporeally. Receives: Procedure: The conventional overlap method | |
| The OGT-assisted group | In OGT group, the anvil fork was inserted into the esophageal mucosa canal by movement of the connection of fork-OGT-gastric tube. Receives: Procedure: The overlap guiding tube(OGT) method |
What is being measured
The primary outcome is the main question the study is designed to answer.
The rate of early postoperative complications.
- Surgery-related complications: wound complications (infection, effusion, dehiscence,poor healing), intra-abdominal active bleeding,digestive tract active bleeding, anastomotic leakage, anastomotic stenosis, intestinal fistula, pancreatic fistula, chylous fistula, intra-abdominal abscess formation, gastroparesis, intestinal paralysis, intestinal obstruction, cholecystitis, pancreatitis, etc.
- System-related complications: pneumonia, pleural effusion, pulmonary embolism, cardiocerebrovascular complications, deep venous thrombosis, urinary tract complications, catheter-related complications, condition of pain,etc.;
Measured: 30 Days
Secondary outcomes (3)
The success rate of inserting anvil fork into esophageal lumen at first attempt
Inserting anvil fork into esophageal lumen at first attempt: when inserting the anvil fork into the esophageal hole, the anvil fork can be correctly placed in a satisfactory position and at a satisfactory angle into the esophageal mucosa canal to be fired for esophagojejunostomy by inserting it only once.
Measured: 1 Days
Attempts of inserting anvil fork into esophagus
The number of times required to try to insert the anvil fork in a satisfactory position and at a satisfactory angle into the esophageal mucosa canal to be fired for esophagojejunostomy.
Measured: 1 Days
Time of esophagojejunostomy
Time of esophagojejunostomy was defined as the time from making the entry hole for the anastomosis on the esophageal stump to the time the common entry hole was closed and reinforced using barbed threads
Measured: 1 Days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 Jul 2022
- Study start1 Jun 2018
- Primary completion1 Feb 2022
- Study completion1 Mar 2022
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Gastric CancerStudies of the same condition, open and under way.
- More trials run by Nanfang Hospital, Southern Medical UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Retrospective
- Enrolment
- 155 participants (actual)
Sponsor and investigators
- Lead sponsor
- Nanfang Hospital, Southern Medical University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Jiang Yu, Prof., Principal investigator, Nanfang Hospital, Southern Medical University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05442502
- Sponsor's protocol ID
- NFEC-202204-K17-01
- Acronym
- OGT
- Status last verified
- Mar 2022
- First submitted
- 19 Jun 2022
- Last updated
- 5 Jul 2022
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: One hundred and fifty-five patients with G/GEJ cancer undergoing LTG via either the conventional overlap esophagojejunostomy(conventional group) or OGT-assisted overlap esophagojejunostomy (OGT group) in the Department of Gastrointestinal Surgery, Southern Medical University Nanfang Hospital, between June 2018 and February 2022 were initially eligible for the study. The inclusion criteria were as follows: (1)gastric cancer was confirmed by pathological examination; (2) tumor located in GEJ with involving esophagus no more than 2cm or the upper, upper to the middle, or entire stomach; (3) had no obvious operative contraindication; and (4) aged 18-85 years.
Study at a glance
From the registry record, last updated by the sponsor on 5 Jul 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Safety and Efficacy of OGT-assisted Overlap Esophagojejunostomy Versus the Traditional Overlap Method in Laparoscopic Total Gastrectomy for Gastric/Gastroesophageal Junction (G/GEJ) Tumors
- ClinicalTrials.gov ID
- NCT05442502
- Acronym / sponsor ID
- OGT / NFEC-202204-K17-01
- Conditions
- Gastric Cancer
- Keywords
- Gastric/gastroesophageal junction (G/GEJ) tumors, Laparoscopy total gastrectomy, Overlap esophagojejunostomy, OGT
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 155 participants (actual)
- Lead sponsor
- Nanfang Hospital, Southern Medical UniversityUniversity, hospital or other
- Study start
- 1 Jun 2018 (actual)
- Primary completion
- 1 Feb 2022 (actual)
- Study completion
- 1 Mar 2022 (actual)
- First posted
- 5 Jul 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Introduction: The safety and efficiency of OGT-assisted method have not yet been compared with conventional overlap approach.
Methods Retrospectively analyses the data of 155 gastric/gastroesophageal junction (G/GEJ) cancer patients who underwent laparoscopic total gastrectomy by conventional(conventional group, n=83) or OGT-assisted (OGT group, n=72) overlap methods at Nanfang Hospital. The anastomotic efficiency and surgical outcomes were compared between two groups.
Detailed description
Although our previous multicenter randomized controlled trial (CLASS-01) has confirmed the safety and efficacy of laparoscopic distal gastrectomy for gastric cancer[1, 2], the feasibility of laparoscopic total gastrectomy (LTG) remains uncertain. The most challenging technical difficulty of LTG is esophagojejunostomy(ESJ)[3, 4]. At present, there is still no consensus on the ideal anastomosis method for EJ.
Since overlap esophagojejunostomy was first proposed in 2010[5], it has gradually gone mainstream because of its lower incidence of anastomotic-related complications and satisfactory short-term outcomes[6-10]. However, the overlap approach is technically-difficult and time-consuming, and might confront intraoperative construction complications, such as injuring esophagus caused by the repetition of inserting anvil fork into esophagus or developing esophageal submucosa pseudocanals(video 1 and 2). Therefore, we first designed an overlap guiding tube (OGT)-assisted method to overcame above limitations[11]. And the first reported about the application of OGT-assisted method preliminarily indicated that it is safe and feasible, with a satisfactory success rate of inserting anvil fork into esophageal lumen at first attempt and esophagojejunostomy time[11]. However, the safety and efficiency of OGT-assisted method have not yet been compared side-by-side with the conventional overlap approach. Therefore, this study aimed to compare the OGT-assisted and conventional overlap methods in terms of feasibility and safety in LTG for gastric/gastroesophageal junction (G/GEJ) tumors.
Methods Patients One hundred and fifty-five patients with G/GEJ cancer undergoing LTG via either the conventional overlap esophagojejunostomy(conventional group) or OGT-assisted overlap esophagojejunostomy (OGT group) in the Department of Gastrointestinal Surgery, Southern Medical University Nanfang Hospital, between June 2018 and February 2022 were initially eligible for the study. The inclusion criteria were as follows: (1)gastric cancer was confirmed by pathological examination; (2) tumor located in GEJ with involving esophagus no more than 2cm or the upper, upper to the middle, or entire stomach; (3) had no obvious operative contraindication; and (4) aged 18-85 years. The pathological staging was based on the TNM system of the 8th edition of the International Federation for the prevention and treatment of cancer[12]. This study meets the requirements of the Helsinki Declaration revised in 2013. Patients and their families signed informed consent forms before operation. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline. The data collection protocol was approved by the Ethics Committee of Nanfang Hospital, Southern Medical University. Written informed consent was obtained from all the patients in the study.
Study design
- Observational model
- Cohort
- Time perspective
- Retrospective
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| The conventional overlap group | – | Procedure: The conventional overlap methodIn conventional overlap group, after firing the stapler, two openings were converted into a single entry hole to create an end-to-side esophagojejunostomy, and the entry hole was closed with full-thickness running suture using barbed sutures intracorporeally. |
| The OGT-assisted group | – | Procedure: The overlap guiding tube(OGT) methodIn OGT group, the anvil fork was inserted into the esophageal mucosa canal by movement of the connection of fork-OGT-gastric tube. |
Who may qualify
- Ages
- 18 to 85 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- All patients enrolled in our study underwent standard LTG with D2 lymphadenectomy according to the Japanese Gastric Cancer Association treatment guidelines
Key inclusion criteria (1 listed)
- (1)gastric cancer was confirmed by pathological examination; (2) tumor located in GEJ with involving esophagus no more than 2cm or the upper, upper to the middle, or entire stomach; (3) had no obvious operative contraindication; and (4) aged 18-85 years.
Key exclusion criteria (1 listed)
- Null.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| The overlap guiding tube(OGT) methodThe overlap guiding tube(OGT) is used to assist the anvil fork placed into the esophageal cavity. | Procedure or surgery | The OGT-assisted group |
| The conventional overlap methodAfter firing the stapler, two openings were converted into a single entry hole to create an end-to-side esophagojejunostomy, and the entry hole was closed with full-thickness running suture using barbed sutures intracorporeally. | Procedure or surgery | The conventional overlap group |
Primary outcome
The rate of early postoperative complications.
Time frame: 30 Days
1. Surgery-related complications: wound complications (infection, effusion, dehiscence,poor healing), intra-abdominal active bleeding,digestive tract active bleeding, anastomotic leakage, anastomotic stenosis, intestinal fistula, pancreatic fistula, chylous fistula, intra-abdominal abscess formation, gastroparesis, intestinal paralysis, intestinal obstruction, cholecystitis, pancreatitis, etc. 2. System-related complications: pneumonia, pleural effusion, pulmonary embolism, cardiocerebrovascular complications, deep venous thrombosis, urinary tract complications, catheter-related complications, condition of pain,etc.;
3 secondary outcomes
The success rate of inserting anvil fork into esophageal lumen at first attempt
Time frame: 1 Days
Attempts of inserting anvil fork into esophagus
Time frame: 1 Days
Time of esophagojejunostomy
Time frame: 1 Days
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Jul 2022.
- Individual participant dataSharing planned: Yes. One hundred and fifty-five patients with G/GEJ cancer undergoing LTG via either the conventional overlap esophagojejunostomy(conventional group) or OGT-assisted overlap esophagojejunostomy (OGT group) in the Department of Gastrointestinal Surgery, Southern Medical University Nanfang Hospital, between June 2018 and February 2022 were initially eligible for the study. The inclusion criteria were as follows: (1)gastric cancer was confirmed by pathological examination; (2) tumor located in GEJ with involving esophagus no more than 2cm or the upper, upper to the middle, or entire stomach; (3) had no obvious operative contraindication; and (4) aged 18-85 years.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Jiang Yu, Prof. principal investigator
Nanfang Hospital, Southern Medical University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Gastric Cancer, run by Nanfang Hospital, Southern Medical University at 1 site in China.
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 1 inclusion and 1 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: finished, as of the sponsor's last update on 5 Jul 2022. 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 China. 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
The rate of early postoperative complications. (time frame: 30 Days). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 5 Jul 2022.