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

Abstract

BackgroundAppropriate 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/designThis 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, n = 60), Group B (double-tract reconstruction, n = 60), and Group C (tube-like stomach, n = 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.DiscussionThis 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 registrationThis study was approved by the Chinese Clinical Trial Registry and registered on April 30, 2021. The registration number is ChiCTR2100045975.

Study protocol for comparing the efficacy of left-open single-flap technique versus double-flap technique after proximal gastrectomy: A multicenter randomized controlled trial

“…As shown in Figure 3 , patients in the control group will receive the double-flap technique after proximal gastrectomy, which includes the following ( 21 ):…”

“… Schematic diagram of reconstruction after proximal gastrectomy with the double-flap technique: 1) Marking the “H”-shaped mucosal window (A) ; 2) Making the double-flap (B) ; 3) Fixing the esophagus and opening the gastric mucosal window (C) ; 4) Completing continuous hand suture (D, E) ; 5) Covering the double-flap and suturing with barbed wires (F) ( 21 ). …”

The clinical outcomes of laparoscopic proximal gastrectomy with double-tract reconstruction versus tube-like stomach reconstruction in patients with adenocarcinoma of the esophagogastric junction based on propensity score-matching: a multicenter cohort study

“…Surgery is still an important method for the treatment of AEG, and the focus of attention in the surgical field is mainly on the extent of resection and the choice of digestive tract reconstruction after tumor resection. After proximal gastrectomy, digestive tract reconstruction is mainly divided into two categories: esophagealgastric anastomosis and esophageal-jejunal anastomosis, with the former mainly represented by Kamikawa, Tube-like stomach, and Side overlap reconstruction, and the latter mainly represented by double-tract and interposition jejunal reconstruction (8)(9)(10).…”