Local Methylene Blue Injection for Prevention of Anastomotic Leakage and Permanent Stoma After Low Anterior Resection for Rectal Cancer (PKUCH-R10)

September 19, 2026 updated by: Peking University Cancer Hospital & Institute

A Prospective Single-arm Phase II Clinical Study Evaluating Local Methylene Blue Injection for Prevention of Anastomotic Leakage and Permanent Stoma in High-risk Patients With Rectal Cancer Undergoing Low Anterior Resection

Rectal cancer surgery has become increasingly effective, allowing many patients to avoid permanent colostomy. However, anastomotic leakage remains one of the most serious complications after rectal cancer surgery, especially in patients undergoing low anterior resection. Anastomotic leakage may lead to pelvic infection, prolonged hospitalization, additional treatments, and may affect the recovery of temporary diverting stomas.

This investigator-initiated clinical study aims to evaluate the safety and potential effectiveness of local methylene blue injection around the pelvic floor after completion of colorectal anastomosis in patients with high-risk rectal cancer undergoing low anterior resection with a temporary diverting ileostomy.

In this study, eligible patients will receive local injection of diluted methylene blue solution into the pelvic floor muscles surrounding the anastomosis after surgery. Participants will be followed for 12 months after surgery. The study will evaluate postoperative outcomes, including the occurrence of anastomotic leakage, complications related to the injection procedure, and whether the temporary stoma can be successfully reversed.

The information collected in this study may help determine whether local methylene blue injection is a safe and feasible approach for reducing postoperative complications and improving recovery after rectal cancer surgery.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

26

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Aiwen Wu, M.D.
  • Phone Number: +8613911577190
  • Email: wuaw@sina.com

Study Locations

    • Beijing Municipality
      • Beijing, Beijing Municipality, China, 100142
        • Recruiting
        • Beijing Cancer Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. Adults aged 18 years or older with histologically confirmed rectal adenocarcinoma.
  2. Patients with mid or low rectal cancer (tumor located within 10 cm from the anal verge) who are scheduled to undergo curative low anterior resection with a temporary diverting ileostomy.
  3. Patients with one or more risk factors associated with postoperative stoma non-closure or anastomotic complications, including male sex, narrow pelvis, neoadjuvant chemoradiotherapy, prolonged operative time, or increased intraoperative bleeding risk.
  4. Patients who are considered suitable candidates for surgery and postoperative follow-up according to the investigator's assessment.
  5. Patients who are willing to provide written informed consent.

Exclusion Criteria:

  1. Patients with emergency surgical conditions, including intestinal obstruction, bowel perforation, or acute abdominal infection before surgery.
  2. Patients undergoing abdominoperineal resection, local excision, or other surgical procedures without colorectal anastomosis and diverting ileostomy.
  3. Patients with other active malignancies or recurrent rectal cancer. Patients who are unable to tolerate the planned surgery or follow-up procedures.
  4. Patients with contraindications or known hypersensitivity to methylene blue injection.
  5. Patients with severe medical conditions or laboratory abnormalities that may increase study-related risks or interfere with study outcome evaluation.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Experimental

methylene blue injection

Eligible patients have mid-low locally advanced rectal adenocarcinoma (≤10 cm from anal verge) with at least one risk factor for stoma non-closure, scheduled for low anterior resection with defunctioning ileostomy. After anastomosis, 20 mL of 0.1% methylene blue is injected into the pelvic floor muscles.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Proportion of participants with successful stoma closure within 12 months after surgery
Time Frame: 12 months after surgery

Successful stoma closure is defined as reversal of the temporary diverting ileostomy within 12 months after low anterior resection. The outcome will be reported as the proportion of participants who undergo stoma closure among all enrolled participants.

12 months after surgery

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of participants with postoperative surgical complications within 30 days after surgery
Time Frame: 30 days after surgery

Postoperative surgical complications will be assessed within 30 days after surgery and reported as the number and proportion of participants experiencing at least one complication. Complications will be graded according to the Clavien-Dindo classification system. Assessed complications include, but are not limited to, anastomotic leakage, surgical site infection, bleeding, ileus, and other surgery-related complications.

30 days after surgery
Number of participants with methylene blue-related adverse events within 30 days after surgery
Time Frame: 30 days after surgery

Methylene blue-related adverse events will be within 30 days after surgery and reported as the number and proportion of participants experiencing adverse events considered related to local methylene blue injection. Assessed events include local tissue irritation, injection-site pain, tissue necrosis, allergic reactions, and other unexpected adverse events related to methylene blue administration.

30 days after surgery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 25, 2025

Primary Completion (Estimated)

July 1, 2027

Study Completion (Estimated)

July 1, 2028

Study Registration Dates

First Submitted

July 28, 2026

First Submitted That Met QC Criteria

September 19, 2026

First Posted (Actual)

September 22, 2026

Study Record Updates

Last Update Posted (Actual)

September 22, 2026

Last Update Submitted That Met QC Criteria

September 19, 2026

Last Verified

November 1, 2025

More Information

Terms related to this study

Other Study ID Numbers

  • PKUCH-R10

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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