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Stomach NeoplasmsNCT05892289

Feasibility and Safety of Robotic Assisted Proximal Gastrectomy With Double-flap Technique for Proximal Early Gastric Cancer

A study testing Robotic assisted proximal gastrectomy with double-flap technique in people with Stomach Neoplasms, run by Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University at 1 site in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Proximal early gastric cancer can choose radical total gastrectomy or proximal gastrectomy. The patients have poor nutritional status and quality of life after total gastrectomy. Compare to total gastrectomy, the nutritional status can improve after proximal gastrectomy . Read more about this study

Who is it for?
Ages 20 to 80 years
Conditions the study is for
Stomach Neoplasms
What is being tested?
Robotic assisted proximal gastrectomy with double-flap technique
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
42 participants
Where
1 siteChina
Study dates
10 Jun 2024to 10 Dec 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

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 20 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 20 years ≤ age ≤ 80 years
  • The primary gastric lesions were located in the proximal third of the stomach
  • histologically proven gastric adenocarcinoma (by preoperative gastrofiberscopy)
  • clinical stage IA (T1N0M0) or IB (T1N1M0 / T2N0M0) according to the 8th edition of the American Joint Committee on Cancer System(Clinical stage was determined based on the finding of endoscopic ultrasonography and/or thoraco-abdominal contrast-enhanced computed tomography)
  • scheduled for robotic assisted proximal gastrectomy with D1+/D2 lymphadenectomy, and possible for R0 surgery by this procedures (Lymphadenectomy is performed on the basis of the criteria of the Japanese Gastric Cancer Treatment Guidelines 2021 (6th edition).).
  • The preoperative American Society of Anesthesiologists (ASA) physical status was I-III;
  • The patient's cardiopulmonary function can tolerate robotic assisted surgery;
  • The subjects have signed the informed consent form.

Who cannot join

  • history of upper abdominal surgery and not suitable for robotic assisted surgery
  • the tumor invades the esophagus 3cm above gastro-esophageal junction (Z-line)
  • with other malignant diseases or have suffered from other malignant diseases within 5 years
  • Excessive tension for esophagogastric anastomosis and require changing the reconstruction procedure
  • women are pregnant or in lactation period
  • Suffering from serious mental illness
  • history of continuous systemic corticosteroid or immunosuppressive drug treatment within 1 month

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Yang bin, associate professor contact

13798163278

yyzsu@163.com

China1 site, 1 recruiting
  • Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University

    Guangzhou, Guangdong

    Yang bin, 13798163278, yyzsu@163.com

    Recruiting

Other trials in China

About this study

Official title: Feasibility and Safety of Robotic Assisted Proximal Gastrectomy With Double-flap Technique for Proximal Early Gastric Cancer: a Phase II, Multi-center, Single-arm Clinical Study

Proximal early gastric cancer can choose radical total gastrectomy or proximal gastrectomy. The patients have poor nutritional status and quality of life after total gastrectomy. Compare to total gastrectomy, the nutritional status can improve after proximal gastrectomy . But if use simple esophagogastric anastomosis for proximal gastrectomy, the incidence of postoperative reflux esophagitis is high, which seriously affects the quality of life, and the short-term outcome is poorer than the total gastrectomy. If the incidence of postoperative reflux esophagitis can be reduced, proximal gastrectomy would be the treatment choice for proximal early gastric cancer, which may more improve both quality of life and nutritional condition than total gastrectomy.

Double-flap technique is a new surgical reconstruction procedure between esophagus and remnant stomach. It can reduce the occurrence of reflux oesophagitis through reconstruction a simulative cardia. At present, the technique has been carried out in some hospitals in China but still lack large-scale prospective studies and evidence of evidence-based medicine. At present, some retrospective studies have shown that robotic assisted proximal gastrectomy with double-flap technique is safe and effective, and the learning curve is shorter than laparoscopic surgery. The applicant have finished two robotic assisted proximal gastrectomy with double-flap technique cases. Two patients recovered well after surgery, with no occurrence of anastomotic leakage or stenosis and the postoperative quality of life was good. Now we plan to conduct a multi-center, single arm study on proximal early gastric cancer patients(T1N0-1M0 and T2N0M0) to evaluate the feasibility of robotic assisted proximal gastrectomy with double-flap technique , and to evaluate the surgical and oncological safety of this surgical method. Aim to provide initial evidence of evidence-based medicine for its clinical application..

Being tested
Robotic assisted proximal gastrectomy with double-flap technique
Keywords
Robotic Surgical Procedures, minimally invasive surgical procedures, stomach neoplasm, Gastrectomy, Reflux Esophagitis
Medical subject headings
Stomach Neoplasms, Esophagitis, Peptic

What participants receive

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

  • Robotic assisted proximal gastrectomy with double-flap techniqueProcedure or surgery

    Patients in this group receive robotic assisted proximal gastrectomy with D1+/D2 lymph node dissection(D1+ for stage IA:Nos.1, 2, 3a, 4 sa, 4 sb, 7, 8a, 9,11p;D2 for stage IB: Nos.1, 2, 3a, 4 sa, 4 sb, 7, 8a, 9,11p and 11d).The double-flap technique is used for the digestive tract reconstruction.

Study groups in NCT05892289
Study groupRoleWhat they receive
Robotic assisted proximal gastrectomy with double-flap techniqueExperimentalNot described
Receives: Procedure: Robotic assisted proximal gastrectomy with double-flap technique

What is being measured

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

  1. The Proportion of Patients With Reflux Esophagitis Within 12 Months Postoperatively

    During follow-up endoscopy 1 year after surgery, reflux esophagitis were graded according to the Los Angeles (LA) classification.

    Measured: 12 months postoperatively

Secondary outcomes (24)
  1. Quality of Life after Surgery

    Quality of life(QoL) is evaluated using the European Organization for Research and Treatment of Cancer (EORTC) 30-item core QoL (QLQ-C30 ver.3.0). Higher scores mean a worse outcome.

    Measured: Follow-up evaluations are performed 3, 6 and 12 months postoperatively

  2. Gastrointestinal Symptoms after Surgery

    gastrointestinal symptoms are assessed by Gastrointestinal Quality of Life Index (GIQLI) questionnaires. Higher scores mean a better outcome.

    Measured: Follow-up evaluations are performed 3, 6 and 12 months postoperatively

  3. Changes in total protein at Follow-up

    blood total protein(g/L) levels

    Measured: Follow-up evaluations are performed 3, 6 and 12 months postoperatively.

  4. Changes in serum albumin at Follow-up

    blood serum albumin(g/L) levels

    Measured: Follow-up evaluations are performed 3, 6 and 12 months postoperatively.

  5. Changes in prealbumin at Follow-up

    blood prealbumin(g/L) levels

    Measured: Follow-up evaluations are performed 3, 6 and 12 months postoperatively.

  6. Changes in hemoglobin at Follow-up

    blood hemoglobin(g/L) levels

    Measured: Follow-up evaluations are performed 3, 6 and 12 months postoperatively.

  7. Changes in Vitamin B12 at Follow-up

    blood Vitamin B12(μg/ml) levels

    Measured: Follow-up evaluations are performed 3, 6 and 12 months postoperatively.

  8. Late Postoperative Morbidity

    adhesive ileus, anastomosis stenosis, malnutrition, dumping syndrome. All postoperative complications are classified according to the Clavien-Dindo(CD) classification standard.

    Measured: Follow-up evaluations are performed 3, 6 and 12 months postoperatively.

  9. Early Postoperative Morbidity

    operation wound with seroma, hematoma, infection, dehiscence, or evisceration, anastomotic leakage, anastomotic bleeding, abdominal bleeding, abdominal abscess, intestinal obstruction morbidity, gastrointestinal bleeding, gastroparesis, postoperative pancreatitis, pancreatic fistula, chylous leakage, lung morbidity, cerebrovascular morbidity, cardiovascular morbidity, deep vein thrombosis, cholecystitis, liver dysfunction, kidney dysfunction. All postoperative complications are classified according to the Clavien-Dindo(CD) classification standard.

    Measured: From surgery to discharge, up to 30 days

  10. Short-term Clinical Outcome After Surgery

    time to pass gas(hours)

    Measured: From surgery to discharge, up to 30 days

  11. Short-term Clinical Outcome After Surgery

    time to oral intake(hours)

    Measured: From surgery to discharge, up to 30 days

  12. Short-term Clinical Outcome After Surgery

    time to indwell gastric tube(hours)

    Measured: From surgery to discharge, up to 30 days

  13. Short-term Clinical Outcome After Surgery

    length of postoperative hospitalisation(days)

    Measured: From surgery to discharge, up to 30 days

  14. Surgical Characteristics

    operative time(minutes)

    Measured: 24 hours postoperatively

  15. Surgical Characteristics

    time for reconstruction the digestive tract(minutes) during surgery

    Measured: 24 hours postoperatively

  16. Surgical Characteristics

    blood loss during surgery(ml)

    Measured: 24 hours postoperatively

  17. Quality of Life postoperatively

    Quality of life(QoL) is evaluated using the European Organization for Research and Treatment of Cancer (EORTC) gastric cancer module (QLQ-STO22) questionnaire. Higher scores mean a worse outcome.

    Measured: Follow-up evaluations are performed 3, 6 and 12 months postoperatively

  18. Pathological Characteristics

    R0 resection rate. R0 resection represents complete resection of the tumor, meaning there is no residual tumor.

    Measured: 1 week postoperatively

  19. Pathological Characteristics

    lymph nodes dissection extent for each patient in the surgery

    Measured: 1 week postoperatively

  20. Pathological Characteristics

    number of dissected lymph nodes for each patient in the surgery

    Measured: 1 week postoperatively

  21. body mass index postoperatively

    body mass index(kg/m^2)

    Measured: Follow-up evaluations are performed 3, 6 and 12 months postoperatively.

  22. pain assessment postoperatively

    We measured the pain score using visual analog scale(VAS) at 24 h after the surgery is completed. Higher scores mean a worse outcome.

    Measured: Day 1 postoperatively

  23. Proportion of participants die after surgery

    mortality rate

    Measured: From surgery to discharge, up to 30 days

  24. Proportion of participants need to rehospitalized after surgery

    rehospitalization rate

    Measured: From surgery to discharge, up to 30 days

Timeline

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

  1. First posted7 Jun 2023
  2. Study start10 Jun 2024
  3. Primary completion10 Dec 2026 (estimated)
  4. Study completion10 Dec 2026 (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
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
42 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05892289
Sponsor's protocol ID
SYSKY-2022-275-02
Status last verified
May 2025
First submitted
4 May 2023
Last updated
25 May 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: The data sets generated and/or analysed during the current study are not publicly available due to governmental policy regarding individual information. However, they are available from the Sun Yat-Sen Memorial Hospital data center upon reasonable request, subject to approval by the Sun Yat-Sen Memorial Hospital Ethics Committee and the Data and Safety Monitoring Committee. This will be after the publication of the main findings, in line with standard data-sharing practices for clinical trial data sets. The Sun Yat-Sen Memorial Hospital data center will ensure the confidentiality of all participants' data and will not disclose information by which participants may be identified to any third party other than those directly involved in the treatment of the participant and organisations for which the participant has provided explicit consent for data transfer.

Publications

  • Zhong G, Xie Y, Chen G, Zhu Y, Yang B, Tan J, Han F, Zhou S. Assessing the feasibility and safety of robotic-assisted proximal gastrectomy with double-flap technique for proximal early gastric cancer: study protocol for a phase II, multicentre, single-arm clinical trial. BMJ Open. 2025 Aug 10;15(8):e094661. doi: 10.1136/bmjopen-2024-094661.

    PubMed 40789587

Questions about this trial

What is this clinical trial studying?

A study testing Robotic assisted proximal gastrectomy with double-flap technique in people with Stomach Neoplasms, run by Sun Yat-Sen Memorial Hospital of Sun Yat-Sen 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 8 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: looking for participants now, as of the sponsor's last update on 25 May 2025. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Yang bin, associate professor (13798163278, yyzsu@163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The Proportion of Patients With Reflux Esophagitis Within 12 Months Postoperatively (time frame: 12 months postoperatively). 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 NCT05892289, which also lists 1 linked publication.

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 25 May 2025.

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