Quality of Life Clinical Trial
Official title:
Ultrasonic Scalpel vs. Monopolar Electrocautery for D2 Distal Gastric Carcinoma Surgery: a Multicenter Randomized Controlled Trial
Gastric cancer as one of the most common gastrointestinal cancers, radical resection of
primary lesions combined with dissection of regional lymph-nodes is acknowledged by surgeons
all over the world. By the invented and adopted energy surgical instruments, surgical
procedure is safer and easier than before. The newly surgical instruments reduce the
post-operative mortality and morbidity combined easy procedures of surgery. As the most
popular instruments used in the gastric surgery, ultrasonic scalpel and monopolar
electrocautery were received lots of attention and concern. Some studies have shown some
advantage of the two instruments, which were they can facilitate the surgical treatment and
make the surgery safer and more effective. Although, some small retrospective sample reports
claimed that ultrasonic scalpel brought benefit in blood loss, dissection lymph-node
intraoperative complications and even postoperative complications. And Korea small sample
randomized controlled trail presentation that ultrasonic scalpel can reduced blood loss and
surgical duration. However, postoperative complications were with no statistical significance
between the two instruments. Cost- effective analysis of the energy instruments is still
controversial. Large sample randomized control trail with high quality is needed.
By the reasons above, a multicenter randomized controlled trial conducted by 9 hospitals from
North to South in China aims to compare the clinical characteristics and outcomes, when using
of the ultrasonic scalpel or monopolar electrocautery in traditional open gastrectomy. The
aim of this study is to evaluate the outcomes of ultrasonic scalpel compared with monopolar
electrocautery in D2 distal gastrectomy, include, intraoperative parameters, postoperative
complications, cost data, and post-operative quality of life.
Standard Operating Procedure (SOP)
1. Preoperative evaluation Patients satisfied with inclusion/exclusion criteria will be
informed to join in the clinical study and signature the inform consent.
2. Randomization preoperative evaluation found that R0, D2 Gastrectomy can be performed,
the case will entrance into the Randomization period. Random numbers are
computer-generated, with the third party applications.
3. Surgical procedures The surgical treatments is adopted the traditional open gastrectomy
approach and adjuvant D2 lymphadenectomy. The SOP of the surgical treatments are
according to the Japanese Gastric Cancer treatments guidelines, 2010, Version 3.
4. Postoperative recovery Postoperative recovery period need to collect those relevant
parameters of all the patients. All the relevant parameters had definitely definition in
the Case Report Form of this study.
5. Follow-up The follow-up of this study divide into two parts, the postoperative quality
of life and tumor characteristics outcomes. The information of the postoperative quality
of life is collected by the EuroQol-5 Dimensions (EQ-5D) questionnaire in four
postoperative time intervals. The tumor related outcomes included long-term
postoperative complications, recurrence type, relapse free survival (months) and the
overall survival (months).
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