Comparison of Partial Stomach-Partitioning and Conventional Gastrojejunostomy for the Treatment of Gastric Outlet Obstruction in Advanced Gastric Cancer

NCT07561073 | Recruiting DMC

• 1 other identifier: CS2026(16)
• Study Type: interventional
• Target: 80
• Locations: 1 country
• Sites: 1

Brief Summary

The primary goal of clinical treatment is to relieve obstruction, restore oral feeding, improve nutritional status and improve quality of life in patients with advanced gastric cancer outflow tract obstruction. At present, the common surgical treatment for relieving obstruction is traditional gastrojejunostomy. Although the operation can relieve the obstruction, there are problems such as tumor-induced bleeding, anastomotic invasion, and high incidence of delayed gastric emptying after operation. Partitioned gastrojejunostomy effectively relieves obstruction by anastomosis of a part of the stomach to the jejunum, and isolates the tumor from the anastomosis, which is beneficial to food emptying and can reduce the risk of bleeding and anastomotic invasion. The safety and efficacy of these two procedures are still controversial, mainly because previous studies were retrospective studies or included a small sample size or enrolled patients with different pathological characteristics. The purpose of this study was to compare the safety and efficacy of separated and traditional gastrojejunostomy in the treatment of advanced gastric cancer outflow tract obstruction, and to provide the best choice for the treatment of advanced gastric cancer outflow tract obstruction.

Conditions

Gastric Cancer

Keywords

Gastric cancer; conventional gastrojejunostomy; Partial Stomach-Partitioning Gastrojejunostomy

Outcome Measures

Primary Outcomes (1)

• To compare the incidence of delayed gastric emptying between SPGJ and CGJ in the treatment of advanced gastric cancer outflow tract obstruction.

  Effectiveness evaluationThe incidence of delayed gastric emptying and the classification of delayed gastric emptying were calculated.

  Evaluation time of delayed gastric emptying : 3d, 7d, 14d, 21d after operation. Early postoperative complications were measured within 21 days after surgery, and late postoperative complications were measured 21 days after surgery.

Secondary Outcomes (1)

• The anastomotic complications, total complications, nutritional status, OS and quality of life of SPGJ and CGJ in the treatment of advanced gastric cancer outflow tract obstruction were compared.

  Within 21 days after surgery, 21 days after surgery. The operation was completed before operation, 1 week, 2 weeks, 4 weeks after operation and before the first systematic treatment after operation.

Study Arms (2)

stomach-partitioning gastrojejunostomy

EXPERIMENTAL

At the junction of the gastric body and the antrum, or about 5cm from the upper edge of the tumor, a straight-line cutting closure device was used to cut off part of the gastric body from the greater curvature of the stomach to form a partition, and a 2-3cm wide gastric body near the lesser curvature was retained. A hole was made in the greater curvature of the posterior gastric wall at the proximal end of the septum, and a hole was made in the jejunum-to-mesenteric margin 5-10 cm from the Treitz ligament. A linear cutting closure device was placed through the transverse colon. The greater curvature-jejunum side-to-side anastomosis of the posterior gastric wall with pro-peristalsis or anti-peristalsis was performed, and the common opening was closed by using a linear cutting closure device or suture.

Procedure: stomach-partitioning gastrojejunostomy

conventional gastrojejunostomy

EXPERIMENTAL

The lowest point of the greater curvature of the stomach and the proximal jejunum 5-10 cm away from the Treitz ligament were subjected to side-to-side anastomosis of peristaltic or anti-peristaltic using a linear cutter before the transverse colon, and the common opening was closed using a linear cutter or suture.

Procedure: conventional gastrojejunostomy

Interventions

stomach-partitioning gastrojejunostomy PROCEDURE

At the junction of the gastric body and the antrum, or about 5cm from the upper edge of the tumor, a straight-line cutting closure device was used to cut off part of the gastric body from the greater curvature of the stomach to form a partition, and a 2-3cm wide gastric body near the lesser curvature was retained. A hole was made in the greater curvature of the posterior gastric wall at the proximal end of the septum, and a hole was made in the jejunum-to-mesenteric margin 5-10 cm from the Treitz ligament. A linear cutting closure device was placed through the transverse colon. The greater curvature-jejunum side-to-side anastomosis of the posterior gastric wall with pro-peristalsis or anti-peristalsis was performed, and the common opening was closed by using a linear cutting closure device or suture.

stomach-partitioning gastrojejunostomy

conventional gastrojejunostomy PROCEDURE

The lowest point of the greater curvature of the stomach and the proximal jejunum 5-10 cm away from the Treitz ligament were subjected to side-to-side anastomosis of peristaltic or anti-peristaltic using a linear cutter before the transverse colon, and the common opening was closed using a linear cutter or suture.

conventional gastrojejunostomy

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients and their families were fully aware of this study and voluntarily signed informed consent ;
• Age 18-75 years old ( including 18 and 75 years old ) ;
• Distal gastric cancer ( cT4bN + M0 / T3-4N + M1, stage IV ) with locally unresectable, distant metastasis or peritoneal metastasis confirmed by pathology and unable to undergo radical surgery ;
• Complicated with digestive tract obstruction ( gastric retention confirmed by upper gastrointestinal radiography or gastroscopy, and GOOSS score ≤ 1 ) ; the ECOG score was 0-2 points, and there was no deterioration within 7 days ;
• ASA score I-III ; 7.No previous anti-tumor therapy ( such as radiotherapy, chemotherapy, targeted therapy, immunotherapy, etc. ) :
• The functions of important organs meet the following requirements :
• ( a ) absolute neutrophil count ≥ 1.5 × 109 / L, white blood cell count ≥ 4.0 × 109/L; b ) Platelet ≥ 100 × 109 / L ; c ) Hemoglobin ≥ 60g / L ; d ) TBIL ≤ 1.5 times ULN ; e ) ALT and AST ≤ 2.5 times ULN ; f ) urea / urea nitrogen ( BUN ) and creatinine ( Cr ) ≤ 1.5 × ULN ( and creatinine clearance rate ( CCr ) ≥ 50mL / min ) ; g ) Left ventricular ejection fraction ( LVEF ) ≥ 50 % ; the corrected QT interval ( QTcF ) by Fridericia method was less than 470 ms. i ) INR ≤ 1.5 × ULN, APTT ≤ 1.5 × ULN. 9. women of childbearing age need to take effective contraceptive measures ; 10.No other surgical contraindications ; 11.good compliance, with follow-up.

You may not qualify if:

• Unable to comply with the research program or research procedures ;
• Patients with other malignant tumors within 5 years before enrollment, except for basal cell or squamous cell carcinoma of the skin after radical resection, or cervical carcinoma in situ ;
• Patients with active autoimmune diseases or a history of autoimmune diseases within 4 weeks before enrollment ;
• Previously received allogeneic bone marrow transplantation or organ transplantation ;
• Cardiovascular diseases with significant clinical significance, including but not limited to acute myocardial infarction, severe / unstable angina pectoris or coronary artery bypass grafting within 6 months before enrollment ; congestive heart failure New York Heart Association ( NYHA ) grade \> 2 ; ventricular arrhythmia requiring drug treatment ; lVEF ( left ventricular ejection fraction ) \< 50 % ;
• Active or uncontrolled severe infection ( ≥ CTCAE V5.0 grade 2 infection ) ;
• Known human immunodeficiency virus ( HIV ) infection. Patients with known clinical history of liver disease, including viral hepatitis \[ known as hepatitis B virus ( HBV ) carriers must be excluded from active HBV infection, that is, HBV DNA positive ( \> 1 × 104 copies / mL or \> 2000 IU / ml ) ; it is known that hepatitis C virus infection ( HCV ) and HCV RNA positive ( \> 1 × 103 copies / mL ) ;
• pregnant ( pregnancy test positive before medication ) or breastfeeding women ;

Sponsors & Collaborators

• Guangxi Medical University: lead

Study Sites (1)

Guangxi Medical University Cancer Hospital

Nanning, Guangxi, 530021, China

RECRUITING

MeSH Terms

Conditions

Stomach Neoplasms

Condition Hierarchy (Ancestors)

Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Stomach Diseases

Central Study Contacts

Yuzhou Qin

CONTACT

+867715310421; qyz402@126.com

Liucheng Wu

CONTACT

13737146973; wuliucheng@gxmu.edu.cn

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Guangxi Medical University Cancer Hospital

Study Record Dates

• First Submitted: April 26, 2026
• First Posted: May 1, 2026
• Study Start: January 1, 2026
• Primary Completion (Estimated): January 1, 2028
• Study Completion (Estimated): January 1, 2029
• Last Updated: May 1, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)