Comparison of Laparoscopic Colectomy Versus Open Colectomy for Colorectal Cancer: … A Prospective Randomized Trial
Comparison of Treatment Outcome for Laparoscopic Colectomy Versus Traditional Open Colectomy for the Treatment of Colorectal Cancer: … A Prospective Randomized Clinical Trial
The laparoscopic colectomy has been enthusiastically used by many colorectal surgeons in Taiwan, Japan, Europe, and USA, for around 10 years. Further clarification of the controversies cited above will be based on the evidence-based medicine, i.e., the randomized, well-controlled, prospective clinical trials. Actually, a handful of randomized prospective data regarding the laparoscopic colectomy has been appeared in USA and Europe. However, we still do not have this kind of data in Taiwan, and therefore this study is important and mandatory.
In this project, we assumed that a difference in cancer-related survival of less then 15% between treatments indicates an equivalent efficacy. Assuming a 70% 5-year, cancer-related survival of stage II and III colorectal cancer patients in the open colectomy group, a minimum of 100 patients per group was required to showed that both surgical techniques were equivalent with an α-level of 0.20 and a β error of 0.05. Only patients with stage II and III disease undergoing curative resection will be enrolled onto this study. The patients will be randomly allocated to either treatment group by block randomization method. Postoperatively, the patients will be prospectively evaluated regarding the following parameters including operative stress, such as erythrocyte sedimentation rate, serum interleukin-6, WBC counts and classification, CD-4 to CD-8 ratio, postoperative life quality, such as wound size, degree of pain, time to have flatus passage and feeding, time to resume daily activity and work, and the oncological outcomes, such as recurrence patterns of tumor, and 5-year patient survival. The evaluation of above-mentioned parameters will be single-blindly done by our research assistant, who has no idea of both surgical techniques. We hope this study will promote the level of surgical research in Taiwan.
研究概览
地位
条件
详细说明
The appropriateness of laparoscopic surgery for the resection of colorectal cancer has been the focus of controversy. The pros insist that besides the smaller wound size, laparoscopic colectomy should induce lesser perioperative stress, which was evidenced by the less pain, quicker flatus passage, early feeding, and more rapid to resume daily activity and work. Moreover, since the laparoscopic colectomy induces lesser immunosuppression, this may be potentially positive for the treatment of colorectal cancer patients. However, the cons insist that first of all, when the summation of 4 or 5 ports, and incisional wound to retrieve specimen in laparoscopic colectomy were considered, the total wound size in laparoscopic colectomy is basically similar to that of the open colectomy. Secondly, since the laparoscopic surgeons advocated that the extent of intra-abdominal dissection was the same between laparoscopic and open colectomy, it seems illogical to speculate that laparoscopic procedure is less invasive for the colorectal cancer patients than the open procedure. Moreover, in regard of the short-term improvement of life quality (based on the evaluation of parameters including less painful, quicker to have flatus passage, feeding, to resume daily activity, to return to work, etc.), there is no denying that these potential benefits are at the sacrifice of spending more money, and therefore, it is still unknown if laparoscopic colectomy is cost-effective. Thirdly and most important of all, laparoscopic colectomy is a more difficult for most surgeons, and therefore the learning curve is more difficult to overcome. Moreover, many surgeons concerned if pneumoperitoneum during the laparoscopic procedure will reinforce the intraperitoneal spread of colorectal cancer. Based on above-mentioned reasons, many colorectal surgeons hesisted between the lines of safety and efficacy of laparoscopic colectomy.
However, apparently, the laparoscopic colectomy has been enthusiastically used by many colorectal surgeons in Taiwan, Japan, Europe, and USA, for around 10 years. Further clarification of the controversies cited above will be based on the evidence-based medicine, i.e., the randomized, well-controlled, prospective clinical trials. Actually, a handful of randomized prospective data regarding the laparoscopic colectomy has been appeared in USA and Europe. However, we still do not have this kind of data in Taiwan, and therefore this study is important and mandatory.
In this project, we assumed that a difference in cancer-related survival of less then 15% between treatments indicates an equivalent efficacy. Assuming a 70% 5-year, cancer-related survival of stage II and III colorectal cancer patients in the open colectomy group, a minimum of 100 patients per group was required to showed that both surgical techniques were equivalent with an α-level of 0.20 and a β error of 0.05. Only patients with stage II and III disease undergoing curative resection will be enrolled onto this study. The patients will be randomly allocated to either treatment group by block randomization method. Postoperatively, the patients will be prospectively evaluated regarding the following parameters including operative stress, such as erythrocyte sedimentation rate, serum interleukin-6, WBC counts and classification, CD-4 to CD-8 ratio, postoperative life quality, such as wound size, degree of pain, time to have flatus passage and feeding, time to resume daily activity and work, and the oncological outcomes, such as recurrence patterns of tumor, and 5-year patient survival. The evaluation of above-mentioned parameters will be single-blindly done by our research assistant, who has no idea of both surgical techniques. We hope this study will promote the level of surgical research in Taiwan.
研究类型
注册
联系人和位置
学习地点
-
-
-
Taipei、台湾、100
- 招聘中
- Department of Surgery, National Taiwan University Hospital, No.7, Chung-Shan South Road, Taipei, TAIWAN, R.O.C.
-
接触:
- Jin-Tung Liang, M.D., Ph.D.
- 电话号码:886-2-23562068
- 邮箱:jintung@ha.mc.ntu.edu.tw
-
首席研究员:
- Jin-Tung Liang, M.D., Ph.D.
-
-
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- All consecutive patients admitted to our unit since January 2000 with adenocarcinoma of the colon and rectum will be assessed.
Exclusion Criteria:
- Cancer with distant metastasis, adjacent organ invasion, intestinal obstruction, past colonic surgery, and no consent to participate in the study.
学习计划
研究是如何设计的?
设计细节
- 时间观点:预期
合作者和调查者
研究记录日期
研究主要日期
学习开始
研究完成
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.