- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT07711509
Autologous Fecal Microbiota Transplantation for Anal Function Recovery After Ileostomy Reversal in Rectal Cancer
Autologous Fecal Microbiota Transplantation for Anal Function Recovery After Ileostomy Reversal in Patients With Rectal Cancer: A Prospective, Single-center, Single-arm, Open-label Clinical Study
Studieoversikt
Status
Forhold
Intervensjon / Behandling
Detaljert beskrivelse
Patients with rectal cancer who undergo radical resection with protective loop ileostomy may experience diversion-related changes in the distal bowel, gut microbiota dysbiosis, diversion colitis, and impaired bowel function after ileostomy reversal. Autologous fecal microbiota transplantation may help restore the intestinal microbial environment in the defunctioned bowel and improve postoperative bowel function.
In this study, eligible patients will undergo standard radical rectal cancer surgery with protective loop ileostomy. At approximately 8 weeks after surgery, patients without severe postoperative complications such as anastomotic leakage will undergo anal swab sampling for 16S rRNA gene sequencing. Autologous fecal microbiota transplantation will be performed once weekly at postoperative weeks 8, 9, 10, and 11. At approximately 12 weeks after surgery, colonoscopy will be performed to evaluate the distal bowel mucosa, and intestinal secretion samples will be collected for 16S rRNA gene sequencing. Ileostomy reversal will then be performed according to routine clinical practice. Bowel function will be followed for 3 months after ileostomy reversal, with the primary endpoint being the LARS score at 3 months after reversal.
Studietype
Registrering (Faktiske)
Fase
- Ikke aktuelt
Kontakter og plasseringer
Studiesteder
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Beijing Municipality
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Beijing, Beijing Municipality, Kina, 100044
- Peking University People's Hospital
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Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Voksen
- Eldre voksen
Tar imot friske frivillige
Beskrivelse
Inclusion Criteria:
- Age 18 to 75 years.
- Histologically or clinically confirmed rectal cancer with the lower tumor margin less than 12 cm from the anal verge.
- Undergoing radical rectal cancer surgery with protective loop ileostomy.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
- Able to understand the study procedures and willing to provide written informed consent.
Exclusion Criteria:
- History of inflammatory bowel disease, bacterial colitis, or other preoperative colonic inflammatory disease.
- Requirement for emergency surgery due to intestinal obstruction, perforation, bleeding, or other emergency conditions.
- Pregnant or lactating women.
- Presence of clinically significant gut microbiota dysbiosis before enrollment, as judged by the investigator.
- Planned postoperative radiotherapy, chemotherapy, or chemoradiotherapy.
- Poor compliance, inability to tolerate the intervention, or judged by the investigator to be unsuitable for participation in this clinical study.
- Severe postoperative complications such as anastomotic leakage.
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: N/A
- Intervensjonsmodell: Enkeltgruppeoppdrag
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
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Eksperimentell: Autologous Fecal Microbiota Transplantation Group
Participants with rectal cancer who underwent radical rectal cancer surgery with protective loop ileostomy will receive autologous fecal microbiota transplantation before ileostomy reversal.
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Autologous fecal microbiota transplantation will be prepared from the participant's own fecal material collected from the ileostomy output.
Approximately 50 g of fecal material will be mixed with 100 mL sterile normal saline, homogenized, filtered through sterile sieves, and administered slowly into the distal bowel via transanal catheter/enema.
The procedure will be performed once weekly at postoperative weeks 8, 9, 10, and 11, for a total of four administrations.
Participants will be observed after the procedure according to the study protocol.
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Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Low Anterior Resection Syndrome Score at 3 Months After Ileostomy Reversal
Tidsramme: 3 months after ileostomy reversal
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Low Anterior Resection Syndrome (LARS) score will be assessed using the LARS questionnaire at 3 months after ileostomy reversal.
The total score ranges from 0 to 42 points, with higher scores indicating more severe bowel dysfunction.
Scores of 0-20 indicate no LARS, 21-29 indicate minor LARS, and 30-42 indicate major LARS.
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3 months after ileostomy reversal
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Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Colonoscopic Mucosal Findings Before Ileostomy Reversal
Tidsramme: Approximately 12 weeks after initial surgery and before ileostomy reversal
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The distal bowel mucosa will be evaluated by colonoscopy before ileostomy reversal.
Findings related to diversion colitis, including mucosal erythema, edema, friability, erosion, ulceration, bleeding, and mucus retention, will be recorded.
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Approximately 12 weeks after initial surgery and before ileostomy reversal
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Samarbeidspartnere og etterforskere
Studierekorddatoer
Studer hoveddatoer
Studiestart (Faktiske)
Primær fullføring (Faktiske)
Studiet fullført (Antatt)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
- Postoperative komplikasjoner
- Patologiske prosesser
- Neoplasmer etter nettsted
- Neoplasmer
- Tarmsykdommer
- Gastrointestinale neoplasmer
- Neoplasmer i fordøyelsessystemet
- Sykdommer i fordøyelsessystemet
- Gastrointestinale sykdommer
- Kolorektale neoplasmer
- Intestinale neoplasmer
- Rektale sykdommer
- Kolonsykdommer
- Patologiske tilstander, tegn og symptomer
- Lavt fremre reseksjonssyndrom
- Rektale neoplasmer
- Fekal inkontinens
Andre studie-ID-numre
- PKUPH-FMT-01
Plan for individuelle deltakerdata (IPD)
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IPD-planbeskrivelse
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