Laparoscopic IIeocecus-Sparing Right Hemicolectomy for Cancer of the Hepatic Flexure and Proximal Transverse Colon (LISH)
An Open, Single-arm, Single Center, Clinical Trial to Investigate the Feasibility and Safety of Laparoscopic Ileocecus-sparing Right Hemicolectomy for Cancer of the Hepatic Flexure and Proximal Transverse Colon
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Zhejiang
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Hangzhou, Zhejiang, China, 310000
- The Second Affiliated Hospital of Zhejiang University
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients suitable for curative surgery 18-75years old
- ASA grade I-III
- Qualitative diagnosis: a pathological diagnosis of adenocarcinoma;
- Localization diagnosis: the tumor located at hepatic flexure and proximal transverse colon(proximal to the right branch of middle colic artery);
- Enhanced CT scan of chest, abdominal and pelvic cavity: assessment of tumor stage is T1-T4N0 or TanyN+; there is no distant metastasis.
- Intraoperative measurement: the distance between colic branch of ileocolic artery and proximal edge of the tumor should be longer than 5cm.
- Informed consent
Exclusion Criteria:
- Simultaneous or metachronous multiple primary colorectal cancer;
- History of familial adenomatous polyposis, ulcerative colitis or Crohn's disease.
- Preoperative imaging examination results show: fused lymph node at the root of ileocolic artery.
- Distant metastasis.
- History of any other malignant tumor in recent 5 years.
- Patients need emergency operation.
- Not suitable for laparoscopic surgery (i.e., extensive adhesion caused by abdominal surgery, not suitable for artificial pneumoperitoneum, etc).
- Informed consent refusal
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
EXPERIMENTAL: LISRH group
Following the principle of complete mesocolic excision(CME), Ileocecus-Sparing Right colectomy refers to the resection of the most portion of the ascending colon, hepatic flexure and mid to distal transverse colon.
The extent of lymph node dissection and length of distal resection margin are similar to conventional right hemicolectomy.
The length of proximal resection margin varies.
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The ileocecal artery(ICA) is skeletonized.
The colic branch of ICA is divided and ligated.
Preserve anterior cecal artery, posterior cecal artery and ileocecal branch of ICA.
Divide and ligate the right colic artery(RCA) and middle colic artery(MCA) at their roots.
Dissect the lymph nodes surrounding the ICA, RCA and MCA accordingly.
Head-to-Head colocolic anastomois is done, with circular stapler via making an opening at the bottom of cecum.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Postoperative complications
Time Frame: up to 90 days after surgery
|
Postoperative complications used to calculate the Comprehensive Complication Index (CCI) will be recorded
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up to 90 days after surgery
|
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1-year local recurrence
Time Frame: 7 days after surgery
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rate of local recurrence one year after surgery, including anastomotic recurrence, recurrence around ileocolic vessels and surgical trunk of superior mesenteric vein,
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7 days after surgery
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Conversion to conventional right hemicolectomy
Time Frame: 1 day of surgery
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the rate of conversion to conventional right hemicolectomy
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1 day of surgery
|
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Time to first flatus after surgery
Time Frame: up to 7 days after surgery
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days from a colectomy procedure to first occurrence of flatus during subject's postoperative recovery
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up to 7 days after surgery
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Number of harvested lymph nodes
Time Frame: up to 1 week after surgery
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Number of harvested Lymph nodes according to the pathological report
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up to 1 week after surgery
|
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R0 resection
Time Frame: up to 1 week after surgery
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Rate of resection without any affected margins during the surgical procedure according to the pathological report
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up to 1 week after surgery
|
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Specimen morphometry
Time Frame: within 30 days
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The gross dimensions of resected specimen: length, the distal and proximal resection margins distance, vascular pedicle length
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within 30 days
|
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3-year disease free survival
Time Frame: 3 years
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the time from enrollment until disease relapse or death from any cause 3 years after surgery
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3 years
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: KeFeng Ding, PhD, Zhejiang University
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 (ACTUAL)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- CRCCZ-S02
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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