Transanal Versus Laparoscopic Total Mesorectal Excision For Rectal Cancer
Rectal Neoplasms Malignant, Surgery
About this trial
This is an interventional treatment trial for Rectal Neoplasms Malignant focused on measuring Rectal cancer, Laparoscopic surgery, Total mesorectal excision, Transanal, Multicentre randomised clinical trial
Eligibility Criteria
Inclusion Criteria:
histologically proven rectal adenocarcinoma;
tumor located below the level of peritoneal reflection ;
diagnosis of rectal cancer amenable to curative surgery;
no evidence of distant metastases;
preoperative tumor stage within III;
no threaten mesorectal fascia (MRF)after neoadjuvant therapy;
no contraindication to laparoscopic surgery;
without history of other malignancies;
Written informed consent
Exclusion Criteria:
could not perform sphincter preservation surgery (requiring a Mile's procedure);
T4b tumor invading adjacent organs;
T1 tumors that can be locally resected
should take neoadjuvant therapy but refuse it;
recurrent cancer;
concurrent or previous diagnosis of invasive cancer within 5 years;
emergent surgery with intestinal obstruction or perforation;
history of colorectal surgery;
fecal incontinence;
history of inflammatory bowel disease;
with contraindications to general anaesthesia(ASA class 4 or 5);
pregnant or breast-feeding;
history of mental disorder
Sites / Locations
- Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical SciencesRecruiting
- Department of General Surgery, Daping Hospital, Army Medical universityRecruiting
- Department of colorectal surgery, the Sixth Affiliated Hospital, Sun Yat-Sen UniversityRecruiting
- Nanfang HospitalRecruiting
- The Affiliated Hospital of Guangdong Medical UniversityRecruiting
- Affiliated Hospital of Zunyi Medical UniversityRecruiting
- The Third Xiangya Hospital of Central South UniversityRecruiting
- The First Affiliated Hospital of University of South ChinaRecruiting
- Department of Gastrointestinal Surgery, The First Hospital of Jilin UniversityRecruiting
- Department of Colorectal Surgery, Shengjing Hospital of China Medical UniversityRecruiting
- The First Affiliated Hospital of Xi'an Jiaotong UniversityRecruiting
- Ruijin Hospital, Shanghai Jiao Tong University School of MedicineRecruiting
- Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University,Recruiting
- Department of Gastrointestinal Surgery,The Affiliated Nanchong Central Hospital of North Sichuan Medical CollegeRecruiting
- Department of gastrointestinal surgery, the Second People's Hospital of YibinRecruiting
- XinQiao Hospital of Army Medical UniversityRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Transanal Total Mesorectal Excision
Laparoscopic Total Mesorectal Excision
The rectum is mobilized and resected transanally (from bottom to up) according to TME principles, via transanal platform (either rigid or flexible platform).An ideal TaTME is defined as the extraperitoneal portion of the rectum being mobilized from below.
The traditional laparoscopic TME (LpTME) was performed via standard laparoscopic techniques, including multiple trocars and conventional laparoscopic instruments.