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Colonic J-Pouch Reconstruction Versus Straight Colorectal Anastomosis After Low Anterior Resection for Rectal Cancer: Impact on Anastomotic Leak, Bowel Function and Quality of Life


N/A
18 Years
N/A
Open (Enrolling)
Both
Colorectal Cancer, Gastrointestinal Complication, Perioperative/Postoperative Complications

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Trial Information

Colonic J-Pouch Reconstruction Versus Straight Colorectal Anastomosis After Low Anterior Resection for Rectal Cancer: Impact on Anastomotic Leak, Bowel Function and Quality of Life


OBJECTIVES:

Primary

- To assess whether the incidence of major anastomotic leak after low anterior resection,
in patients with rectal cancer, is reduced by using the J-pouch reconstruction vs
straight colorectal anastomosis.

Secondary

- To compare the global anastomotic leak (major and minor) rate, the incidence of other
complications in addition to anastomotic leak, and the functional outcome and the
quality of life in these patients.

- To describe, in the J-pouch reconstruction group, the feasibility of the colonic
J-pouch.

OUTLINE: Ths is a multicenter study. Patients are stratified according to clinical center,
gender (male vs female), and neoadjuvant treatment types. Patients are randomized to 1 of 2
treatment arms.

- Arm I: Patients undergo a total mesorectal excision with a low anterior rectal
resection followed by a mechanical straight stapled colorectal anastomosis.

- Arm II: Patients undergo a total mesorectal excision with a low anterior rectal
resection followed by a mechanical J-pouch stapled anastomosis reconstruction.

Quality of life is assessed periodically using EORTC Quality of Life Questionnaires (EORTC
QLQ-C30 and -CR38), and the MSKCC Bowel Function Questionnaire.

After completion of study treatment, patients are followed at 1, 6, 12, and 24 months.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically confirmed rectal adenocarcinoma meeting the following criteria:

- Mid and/or low rectal cancer

- Tumor site ≤ 11 cm from anal verge

- Must have a temporary stoma (ileostomy or colostomy)

- Must be scheduled for a total mesorectal excision with a low anterior rectal
resection and mechanic colorectal anastomosis that is potentially curative or with a
microscopic residual resection (R0-R1)

- No locally recurrent disease

- No distant metastasis

PATIENT CHARACTERISTICS:

- Must be able to understand the study

PRIOR CONCURRENT THERAPY:

- No prior handsewn coloanal anastomosis

- No prior colonic resection

- No prior surgery for local recurrence

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Major anastomotic leak rate

Safety Issue:

No

Principal Investigator

Donato Nitti, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

Azienda Ospedaliera di Padova

Authority:

Unspecified

Study ID:

CDR0000671070

NCT ID:

NCT01110798

Start Date:

October 2009

Completion Date:

Related Keywords:

  • Colorectal Cancer
  • Gastrointestinal Complication
  • Perioperative/Postoperative Complications
  • perioperative/postoperative complications
  • gastrointestinal complications
  • adenocarcinoma of the rectum
  • stage I rectal cancer
  • stage II rectal cancer
  • stage III rectal cancer
  • Rectal Neoplasms
  • Colorectal Neoplasms
  • Postoperative Complications

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