Laparoscopy-Assisted Transanal Endoscopy Rectosigmoid Resection for Rectal Cancer
Primary Purpose
Adenocarcinoma of the Rectum
Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Transanal endoscopic surgery
Sponsored by
About this trial
This is an interventional treatment trial for Adenocarcinoma of the Rectum focused on measuring Rectal cancer
Eligibility Criteria
Inclusion Criteria:
- Biopsy-proven adenocarcinoma of the rectum
- Eligible to undergo standard open or laparoscopic low anterior resection with a temporary diverting stoma
- Node negative (N0), T1 (high risk features), T2 and T3 rectal cancer on pelvic MRI
- Closest distance between tumor edge and mesorectal fascia 5mm or more based on pelvic MRI
- Rectal cancer located 4-12 cm from the anal verge
- ECOG performance status 2 or less
Exclusion Criteria:
- Metastasis
- Obstructing rectal cancer
- Synchronous colon cancer
- T3 rectal cancer not treated preoperatively with full-course chemoradiation
- Pregnant or breast-feeding
- Receiving any other study agents
- Fecal incontinence
- History of prior colorectal cancer
- History of inflammatory bowel disease
- History of pelvic radiation
- Prior pelvic surgery or multiple abdominal procedures
- BMI > 30
- Large uterine fibroids
- Uncontrolled intercurrent illness
- Other malignancies diagnosed within the previous year, except basal cell cancer
Sites / Locations
- Massachusetts General Hospital
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Transanal endoscopic surgery
Arm Description
Laparoscopy-assisted transanal endoscopic rectosigmoid resection
Outcomes
Primary Outcome Measures
Adequacy of the total mesorectal excision based on standard guidelines on pathologic evaluation of TME specimens.
Secondary Outcome Measures
Incidence of 30-day perioperative complications including intraoperative, surgical postoperative, and medical postoperative complications.
Incidence of long-term complications
Oncologic outcomes in subjects receiving transanal endoscopic rectosigmoid resection
Full Information
NCT ID
NCT01340755
First Posted
April 21, 2011
Last Updated
September 1, 2017
Sponsor
Massachusetts General Hospital
1. Study Identification
Unique Protocol Identification Number
NCT01340755
Brief Title
Laparoscopy-Assisted Transanal Endoscopy Rectosigmoid Resection for Rectal Cancer
Official Title
A Pilot Study of Laparoscopy-Assisted Transanal Endoscopy Rectosigmoid Resection for Rectal Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
September 2017
Overall Recruitment Status
Completed
Study Start Date
March 2011 (undefined)
Primary Completion Date
May 2012 (Actual)
Study Completion Date
May 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Massachusetts General Hospital
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Transanal Endoscopic Rectosigmoid Resection with Laparoscopic Assistance was developed at Massachusetts General Hospital and performed successfully to remove cancer of the lower rectum. Based on the outcomes, the research doctors believe that this investigational surgery may be as safe and effective as standard laparoscopic or open surgery performed to remove rectal cancer, may facilitate the operation and reduce the size of the abdominal incisions. In this research study, the investigators are looking to see if this investigational procedure is a safe and effective approach to remove rectal cancer of the mid and lower rectum.
Detailed Description
Subjects will have their rectal cancer removed using a technique combining surgery through the anus and standard laparoscopy. At the end of the procedure, the rectum will be removed though the anus, the bowel will be re-connected to the anus, and a temporary diverting stoma will be created, which is standard of care following surgery for this type of cancer.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Adenocarcinoma of the Rectum
Keywords
Rectal cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
5 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Transanal endoscopic surgery
Arm Type
Experimental
Arm Description
Laparoscopy-assisted transanal endoscopic rectosigmoid resection
Intervention Type
Procedure
Intervention Name(s)
Transanal endoscopic surgery
Intervention Description
Laparoscopy-assisted transanal endoscopic rectosigmoid resection
Primary Outcome Measure Information:
Title
Adequacy of the total mesorectal excision based on standard guidelines on pathologic evaluation of TME specimens.
Time Frame
1-5 years
Secondary Outcome Measure Information:
Title
Incidence of 30-day perioperative complications including intraoperative, surgical postoperative, and medical postoperative complications.
Time Frame
1-5 years
Title
Incidence of long-term complications
Time Frame
1-5 years
Title
Oncologic outcomes in subjects receiving transanal endoscopic rectosigmoid resection
Time Frame
1-5 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Biopsy-proven adenocarcinoma of the rectum
Eligible to undergo standard open or laparoscopic low anterior resection with a temporary diverting stoma
Node negative (N0), T1 (high risk features), T2 and T3 rectal cancer on pelvic MRI
Closest distance between tumor edge and mesorectal fascia 5mm or more based on pelvic MRI
Rectal cancer located 4-12 cm from the anal verge
ECOG performance status 2 or less
Exclusion Criteria:
Metastasis
Obstructing rectal cancer
Synchronous colon cancer
T3 rectal cancer not treated preoperatively with full-course chemoradiation
Pregnant or breast-feeding
Receiving any other study agents
Fecal incontinence
History of prior colorectal cancer
History of inflammatory bowel disease
History of pelvic radiation
Prior pelvic surgery or multiple abdominal procedures
BMI > 30
Large uterine fibroids
Uncontrolled intercurrent illness
Other malignancies diagnosed within the previous year, except basal cell cancer
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Patricia Sylla, MD
Organizational Affiliation
Massachusetts General Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
23572214
Citation
Sylla P, Bordeianou LG, Berger D, Han KS, Lauwers GY, Sahani DV, Sbeih MA, Lacy AM, Rattner DW. A pilot study of natural orifice transanal endoscopic total mesorectal excision with laparoscopic assistance for rectal cancer. Surg Endosc. 2013 Sep;27(9):3396-405. doi: 10.1007/s00464-013-2922-7. Epub 2013 Apr 10.
Results Reference
result
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Laparoscopy-Assisted Transanal Endoscopy Rectosigmoid Resection for Rectal Cancer
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