A Trial of Robotic-assisted Versus Laparoscopic Abdominoperineal Resection for Treating Low Rectal Cancer (RLAPR)
A Single-centre, Prospective, Randomised, Controlled, Unblinded, Parallel-group Trial of Robotic-assisted Versus Laparoscopic Abdominoperineal Resection for the Curative Treatment of Low Rectal Cancer
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Patients will be eligible for inclusion if their primary tumors is low rectal cancer.
Eligible patients will be randomly assigned to robotic-assisted (arm A) versus laparoscopic (arm B) abdominoperineal resection.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Shanghai
-
Shanghai, Shanghai, China, 200032
- Zhongshan Hospital, Fudan University
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Histologically proven rectal adenocarcinoma
- Inferior edge of the tumor located within 5 cm from the anal verge as determined by colonoscopy withdrawing and digital rectal examination
- No evidence of distant metastases (including pelvis, peritoneum, liver, lung, brain, bone, distant lymph node, etc) according to ultrasound, CT, PET-CT, etc
- Tumor assessed as cT1-T3 or ycT1-T3 after preoperative neoadjuvant chemoradiotherapy by pelvic MRI
- No other malignancies in medical history except adequately treated basocellular carcinoma of the skin or in situ carcinoma of the cervix uteri
- Suitable for both robot-assisted and laparoscopic surgery
- American Society of Anesthesiologists (ASA) class I - III
- No other preoperative treatment except neoadjuvant chemoradiotherapy
- Informed consent
Exclusion Criteria:
- Tumors assessed as cT1N0 and suitable for local excision
- Signs of acute intestinal obstruction, bleeding or perforation needing emergency surgery
- More than one colorectal tumor
- Familial Adenomatosis Polyposis, Lynch Syndrome, acute inflammatory bowel disease
- Schedules need for other synchronous colon surgery
- Absolute contraindications to general anesthesia or prolonged pneumoperitoneum (ASA class > III)
- Pregnancy or lactation
- Patients and/or family members can not understand and accept this study
- Patients received chemoradiotherapy or other anti-tumor therapy before surgery
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Robotic-assisted resection
patients with low rectal cancer receiving robotic-assisted abdominoperineal resection.
|
Robotic-assisted abdominoperineal resection.
|
|
Active Comparator: Laparoscopic resection
patients with low rectal cancer receiving laparoscopic abdominoperineal resection.
|
Laparoscopic abdominoperineal resection
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
postoperative complications
Time Frame: 30 days post operatively
|
postoperative complications related to operation
|
30 days post operatively
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
locoregional recurrence rate
Time Frame: 3 and 5 years
|
local recurrence rate at 3 and 5 years after operation
|
3 and 5 years
|
|
operative mortality
Time Frame: 30 days post operatively
|
death occurred 30 days after operation
|
30 days post operatively
|
|
disease-free survival
Time Frame: 3 years
|
disease-free survival rate at 3 years after operation
|
3 years
|
|
overall survival
Time Frame: 3 and 5 years
|
overall survival rate at 3 and 5 years after operation
|
3 and 5 years
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
estimated blood loss
Time Frame: Day 1
|
Blood loss will be measured according to the suction and the weight of wet gauze, and then minus the irrigation.
|
Day 1
|
|
postoperative hospital stay
Time Frame: 30 days post operatively
|
The postoperative hospital stay is defined as the number of date from the first day after operation to discharge.
|
30 days post operatively
|
|
self reported bladder function
Time Frame: at postoperative 3, 6 and 1 2 months
|
This section is assessed using a self-rating scale "International prostate symptom score" (IPSS)
|
at postoperative 3, 6 and 1 2 months
|
|
self reported sexual function for female patients
Time Frame: at postoperative 3, 6 and 1 2 months
|
This section is assessed using a self-rating scale "Female Sexual Function Index" (FSFI).
|
at postoperative 3, 6 and 1 2 months
|
|
operative time
Time Frame: Day 1
|
Time from cutting the skin to suturing the incision during the surgery, recorded in minute
|
Day 1
|
|
rate of conversion to open surgery
Time Frame: Day 1
|
The rate of patients actually receiving open surgery in robotic or laparoscopic surgery groups.
|
Day 1
|
|
circumferential resection margin
Time Frame: 10 days post operatively
|
The circumferential margin will be reported as "positive" or "negative" to define whether tumor is radically resected.
It will be reported according to the post-operative pathology.
Details are based on NCCN and Chinese guidelines for colorectal cancer.
|
10 days post operatively
|
|
proximal/distal resection margin
Time Frame: 10 days post operatively
|
The proximal/distal resection margin will be reported as "positive" or "negative" to define whether tumor is radically resected.
It will be reported according to the post-operative pathology.
Details are based on NCCN and Chinese guidelines for colorectal cancer.
|
10 days post operatively
|
|
number of retrieved lymph nodes
Time Frame: 10 days post operatively
|
It will be reported according to the post-operative pathology.
|
10 days post operatively
|
|
self reported sexual function for male patients
Time Frame: at postoperative 3, 6 and 1 2 months
|
This section is assessed using a self-rating scale "International Index of Erectile Function" (IIEF-5).
|
at postoperative 3, 6 and 1 2 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Chair: Jianmin Xu, MD, Fudan University
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- RLAPR
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