Early Implementation of Sacral Neuromodulation in Patients With Low Anterior Resection Syndrome.
Early Implementation of Sacral Neuromodulation in Patients With Low Anterior Resection Syndrome: a Randomized, Multicenter, Prospective, Open-label, Pragmatic Study.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
Catalonia
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Barcelona, Catalonia, Spain, 08035
- Vall d'Hebron Barcelona Hospital Campus
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Contact:
- Franco Marinello, Dr.
- Phone Number: +34 934896587
- Email: franco.marinello@vallhebron.cat
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adult patients (18 years of age or older) who are capable of signing the appropriate informed consent form.
- Patients who have undergone an anterior rectal resection for rectal cancer, with an anastomosis, whether or not they have received neoadjuvant therapy, and who have bowel function, either via a direct anastomosis or following reconstruction of a lateral ileostomy.
- Patients who experience more than 6 episodes of urgency and/or incontinence in the following two weeks after the screening visit, as recorded in a daily bowel diary.
- Patients with a LARS score >21 points (major or minor LARS).
- Patients who report at least one symptom and one consequence as defined by the international definition.
Exclusion Criteria:
- Metastatic disease at the time of surgery.
- Need for adjuvant chemotherapy at the time of assessment.
- Active chemotherapy.
- Patients with an ileostomy.
- Intellectual or language-related difficulty in answering the questionnaires.
- Refusal to participate in the study or failure to commit to follow-up visits.
- Patients with contraindications for sacral neuromodulation implantation (those with pacemakers, active infections, or allergies to prosthetic materials).
- Patients with active inflammatory bowel disease at the time of surgery.
- Patients who have undergone other intestinal resections in addition to rectal resection.
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: Sacral neuromodulation
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Sacral neuromodulation implantation within 120 days from discharge following rectal surgery or bowel reconstruction (ileostomy closure)
|
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No Intervention: Personalized conservative treatment
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
To evaluate bowel function in terms of at least a 50% improvement in episodes of urgency and/or incontinence due to LARS, as measured by a two-week bowel diary, following early NMS implantation compared with personalized conservative treatment.
Time Frame: 6 months
|
6 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Assess changes in the fragmentation component of the syndrome as recorded in the patient's daily bowel movement diary.
Time Frame: 6 months
|
6 months
|
|
Assess changes in stool consistency as recorded in the patient's daily bowel movement diary.
Time Frame: 6 months
|
6 months
|
|
Assess changes in soiling episodes as recorded in the patient's daily bowel movement diary.
Time Frame: 6 months
|
6 months
|
|
Assess changes in symptoms and outcomes as defined by the International Consensus Definition of LARS.
Time Frame: 6 months
|
6 months
|
|
Assess changes in bowel function in both groups using patient's daily bowel function and quality-of-life scales: the LARS score (Low Anterior Resection Syndrome Score), which divides patients in three groups: 0-20 No LARS; 21-29: Mild LARS; 30-42: Severe
Time Frame: 6 months
|
6 months
|
|
Assess changes in bowel function in both groups using patient's daily bowel function and quality-of-life scales: the Vaizey score, which measures the presence and severity of incontinence assigning a score from 0 (meaning complete continence) to 24 (mean
Time Frame: 5 years
|
5 years
|
|
Assess changes in bowel function in both groups using patient's daily bowel function and quality-of-life scales: ad hoc scale. The minimum value for the scale is 0 (meaning the worst health the patient can imagine) and the maximum value is 100 (meaning t
Time Frame: 6 months
|
6 months
|
|
Analyze subjective clinical improvement as assessed by patients using PGI-I scale (Patient Global Impression of Improvement). It consists of the answer to a question choosing one of 7 options from "1=Much better" to "7=Much worst".
Time Frame: 6 months
|
6 months
|
|
Examine changes in urinary and sexual function, analyzed by gender and specific scale. For male, the IIEF-5 (Índice Internacional De Función Erectil) will be used, which assesses erectile dysfunction from 5 (severe) to 25 (healthy). For female, The Rec
Time Frame: 6 months
|
6 months
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- E-SANLARS
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
product manufactured in and exported from the U.S.
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