Splenic hilum remains challenging during total gastrectomy with D2 lymphadenectomy.The application of minimally invasive surgery for advanced gastric cancer is gaining popularity. The investigators aim to compare the safety and feasibility of LTG and OTG for advanced proximal gastric cancer.
Total gastrectomy with D2 lymphadenectomy remains the standard surgical therapy for patients with advanced proximal gastric cancer. Although lymph nodes dissection along with the splenic hilum (No.10) is recommended by the Japanese Gastric Cancer Treatment Guidelines, however, complete removal of the No. 10 is technically challenging due to the tortuous splenic vessels and the high possibility of injury to the parenchyma of the spleen and pancreas. Recently, the application of minimally invasive surgery for advanced gastric cancer is gaining popularity. However, laparoscopic total gastrectomy (LTG) with standard D2 lymphadenectomy was still not widely performed, because pancreas- and spleen-preserving splenic hilum lymph node dissection were mainly challenging manipulations for laparoscopic surgeons. Therefore,the investigators aim to investigate the safety and feasibility of LTG with spleen-preserving splenic hilum lymph node dissection for proximal advanced gastric cancer and compare the early results of this procedure with open total gastrectomy (OTG).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
200
When the participants with advanced proximal gastric cancer are randomized in the laparoscopic totalgastrectomy (LATG) group, they will received LTG with spleen-preserving splenic hilum lymph nodes dissection.
When the participants with advanced proximal gastric cancer are randomized in the open total gastrectomy(OTG) group, they will received OTG with spleen-preserving splenic hilum lymph nodes dissection.
Chinese PLA General Hospital
Beijing, China
Number of group Splenic Hilum (No.10) lymph nodes harvested
Time frame: 7 days
Early complication rate
The early complication rate is defined as the event observed during operation
Time frame: 30 days
Operative time
Time frame: Intraoperative
Operative blood loss
Time frame: Intraoperative
Time of splenic hilum lymph nodes dissection
Time frame: Intraoperative
Number of total lymph nodes harvested
Time frame: 7 days
Post-operative recovery course
Time to first ambulation, flatus, liquid diet and duration of hospital stay are used to assess the postoperative recovery course
Time frame: 30 days
3-year disease free survival rate
Time frame: 3 years
3-year overall survival rate
Time frame: 3 years
Quality of life
It will be assessed by questionnaire (WHO quality of life-100)
Time frame: 1 year
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.