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Gastric/gastroesophageal junction (G/GEJ) cancer patients who underwent laparoscopic total gastrectomy (LTG) were eligible for this study
All patients enrolled in our study underwent standard laparoscopic total gastrectomy (LTG) with D2 lymphadenectomy and OGT-overlap oesophagojejunostomy according to the Japanese Gastric Cancer Association treatment guidelines and our previous reports. When the surgeons decided to perform OGT-overlap oesophagojejunostomy after gastrectomy, we randomised the patients into the Traditional Decompression Nasogastric Tube (TNT) group or Joint Nasogastric Tube (JNT) group by simple randomization operatively.
In the TNT group, the TNT was put into the oesophageallumen from the nose, to guide the cutting of a small enterotomy on the posterior oesophagealstump . While in the JNT group, the JNT was used to substitute the TNT. After the anastomosis was completed, the team of surgeons performed an intraoperative gastroscopy to check for defects, bleeding, and stenosis in the anastomosis, and esophageal pseudocanals, and also to confirm whether the esophageal mucosa was damaged by TNT or JNT.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| JNT group | Experimental | In the JNT group, the Joint Nasogastric Tube (JNT) was put into the oesophageallumen from the nose, to guide the cutting of a small enterotomy on the posterior oesophageal stump. |
|
| TNT group | Active Comparator | In the TNT group, the traditional decompression nasogastric tube (TNT) was put into the oesophageallumen from the nose, to guide the cutting of a small enterotomy on the posterior oesophageal stump. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| JNT Guided OGT-overlap Oesophagojejunostomy | Procedure | In the JNT group, the Joint Nasogastric Tube (JNT) was put into the oesophageallumen from the nose, to guide the cutting of a small enterotomy on the posterior oesophageal stump. |
| Measure | Description | Time Frame |
|---|---|---|
| Time of OGT and nasogastric tube (NT) connection | Time starts from insertion of the NT through the nose, to the end of the NT docking with the OGT and successfully implanted into the esophageal cavity. | Surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Time of nasogastric tube (NT) insertion | Time starts from insertion of the NT through the nose, to the front end of the NT reaching the esophageal stump. | Surgery |
| Time of oesophagojejunostomy |
| Measure | Description | Time Frame |
|---|---|---|
| Oesophageal mucosal injury | the oesophagealmucosa is observed endoscopically after the common hole is closed. Patients with esophageal mucosal injury can be shown as esophageal mucosal surface with mucosal injury caused by nasogastric tube (NT) . | Surgery |
| )Inserting anvil fork into oesophageallumen at first attempt |
Inclusion Criteria:
(1) Age 18-75 years; (2) Physical status score (ECOG) 0-2 points; (3) Preoperative pathological examination to diagnose gastric/gastroesophageal junction (G/GEJ) cancer; (4)No obvious contraindications for surgery; (5)Did not found metastasis preoperatively and intraoperatively; (6)Confirmed tumours invade oesophagus no more than 3cm intraoperatively; (7) Expected to perform OGT-overlap oesophagojejunostomy after lymphadenectomy and gastrectomy in the operation of laparoscopic total gastrectomy.
Exclusion Criteria:
(1)Underwent radiotherapy for G/GEJ cancer preoperatively; (2) continuous HIPEC after operation.
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| Name | Affiliation | Role |
|---|---|---|
| Xinhua Chen, Ph.D | Nanfang Hospital, Southern Medical University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Nanfang Hospital, Southern Medical University | Guangzhou | Guangdong | 510515 | China |
If other researchers are interest in the IPD, please contact Xinhua Chen(xinhuachen03@163.com）.
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| ID | Term |
|---|---|
| D009369 | Neoplasms |
| D013274 | Stomach Neoplasms |
| ID | Term |
|---|---|
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D004066 | Digestive System Diseases |
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This study was a parallel, open-label randomized trial that aimed to assess safety and efficiency of JNT and TNT to guided OGT-overlap oesophagojejunostomy. Gastric/gastroesophageal junction (G/GEJ) cancer patients who underwent LTG with OGT-overlap oesophagojejunostomy
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| TNT Guided OGT-overlap Oesophagojejunostomy | Procedure | In the TNT group, the Traditional Decompression Nasogastric Tube (TNT) was put into the oesophageallumen from the nose, to guide the cutting of a small enterotomy on the posterior oesophageal stump. |
|
Time starts from making the entry hole for the anastomosis on the oesophagealstump, to the end of the common entry hole was closed using barbed threads.
| Surgery |
when inserting the anvil fork into the oesophagealhole, the anvil fork can be correctly placed in a satisfactory position and at a satisfactory angle into the oesophagealmucosa canal to be fired for oesophagojejunostomy by inserting it only once. |
| Surgery |
| Inserting NT to oesophagealstump at first attempt | when inserting the NT from nose to the oesophagealstump only once without pulling out and reinserting. | Surgery |
| Early postoperative complications | postoperative complications were assessed within 30 days after the surgery and rated following Clavien-Dindo classification (CDC) system | Within 30 days after the surgery |
| D005767 | Gastrointestinal Diseases |
| D013272 | Stomach Diseases |