Mesenteric Vascular Preconditioning Combined With Laparoscopic and Endoscopic Cooperative Surgery for Submucosal Tumor at the Gastroesophageal Junction
Submucosal Tumor of Gastrointestinal TractGastrointestinal Stromal Tumor (GIST)
Investigational drug(s) / intervention(s)
laparoscopic and endoscopic cooperative surgery
laparoscopic and endoscopic cooperative surgery: The mesenteric preconditioning technique is employed in combination with Submucosal Tunneling Endoscopic Resection (STER), endoscopic submucosal dissection (ESD), or traditional laparoscopic and endoscopic cooperative surgery(LECS), supplemented by laparoscopic reinforcement suturing
Study summary
This study is a single-center, prospective, single-arm, exploratory clinical study (phase II exploratory trial). No parallel control group was established in the study, and all subjects who met the inclusion criteria underwent a uniform surgical treatment approach, namely, double-scope combined resection with mesenteric vascular preconditioning. The study aims to preliminarily evaluate the safety and effectiveness of this novel surgical strategy for the treatment of submucosal tumor at the gastroesophageal junction, and to provide data support for subsequent larger-scale controlled studies.
Eligibility
Sex
ALL
Min age
18 Years
Max age
80 Years
Healthy volunteers
No
Inclusion Criteria:
* Aged 18 to 80 (inclusive), of either gender.
* Preoperative gastroscopy, enhanced CT, and/or endoscopic ultrasonography (EUS) examinations led to a clinical diagnosis of submucosal tumor (SMT) at the gastroesophageal junction.
* The maximum diameter of SMT is 1\~5 cm (based on radiological measurements).
* The distance from the upper margin of the SMT to the dentate line of the esophagogastric junction is ≤2 cm.
* Eastern Cooperative Oncology Group (ECOG) physical status score of 0 or 1.
* Plan to undergo laparoscopic surgery, and the researcher judges that the patient is suitable for the combined surgical procedure involved in this study.
* Volunteer to participate in this study and sign a written informed consent form.
Exclusion Criteria:
* SMT that meets the absolute indications for endoscopic treatment alone (such as lesions with a diameter of \<1cm that can be completely resected endoscopically).
* Patients with severe systemic diseases such as heart, lung, liver, and kidney dysfunction, who are unable to tolerate surgery or anesthesia after evaluation.
* Women who are pregnant or breastfeeding.
* Previous history of upper abdominal surgery.
* Previously received upper abdominal radiotherapy.
* Have suffered from or currently suffer from other malignant tumors within the past 5 years.
* Lesions accompanied by clear ulcers, metastasis, or lesions after neoadjuvant and conversion therapy.
* The researcher determines that there are any other situations that make the participant unsuitable for participating in this study (such as mental disorders, poor adherence, etc.)
Primary outcome measure(s)
Conversion to open surgery rate — During surgery It is defined as the proportion of cases that are converted to open surgery due to operational difficulties during the procedure, preventing the continuation of laparoscopic and endoscopic cooperative surgery.
Total operation time — During surgery The total duration (in minutes) from the commencement of laparoscopic incision to the completion of suturing all incisions
Number of endoscopic hemostasis procedures — The day of surgery The number of times endoscopic hemostasis (including having to interrupt the surgery to use electrocoagulation and hemostatic clips alone for hemostasis) was required due to submucosal or wound bleeding during the operation
Endoscopic hemostasis time — The day of surgery (in minutes),up to 1440minutes (24hours) Total duration (in minutes) for endoscopic hemostasis during the procedure
Perioperative complication rate — Within 30 days after surgery Based on the Clavien-Dindo classification system, complications occurring within 30 days after surgery, including anastomotic leakage, postoperative bleeding, delayed gastric emptying, abdominal infection, and esophagogastric anastomotic stenosis, are recorded, and their severity is assessed
Postoperative peripheral white blood cell count — On the first and third days after surgery. Blood tests for inflammation indicator, including peripheral white blood cell count, conducted on the first and third days after surgery.
Adverse Events (AE) — within 30 days after surgery Record all adverse events that occur from the time of signing the informed consent form to within 30 days after surgery, grade them according to the Common Terminology Criteria for Adverse Events (CTCAE 5.0) of the National Cancer Institute, and assess their correlation with the patient's surgery.
Serious Adverse Event (SAE) — within 30 days after surgery Any event that leads to death, endangers life, requires hospitalization or prolongs hospitalization, or results in permanent or severe disability or loss of function must be reported to the ethics committee and relevant hospital authorities within 24 hours of being notified.
Trial sites (1)
Facility
City
Region
Status
Peking University People' Hosptial
Beijing
Beijing Municipality
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This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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