CRP-guided Transanal Drainage Removal After Rectal Surgery
Primary Purpose
Rectal Cancer, Anastomotic Leak
Status
Not yet recruiting
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
removal of transanal drainage tube
Sponsored by
About this trial
This is an interventional prevention trial for Rectal Cancer
Eligibility Criteria
Inclusion Criteria:
- age from 18 to 75 years old
- male and female
- primary rectal adenocarcinoma
- ASA I, II, or III
- laparoscopic LAR + DST
- with or without preoperative radio- or chemotherapy
- no distal metastasis
- no preoperative bowel obstruction
- no preventive ileostomy or colostomy
- patients and their families can understand and are willing to participate in this study and provide written informed consent
Exclusion Criteria:
- emergency operation
- preoperative abnormal liver function
- tatme or ISR procedure (healing process might differ from anterior resection)
- severe postoperative (Clavien-Dindo grade III IV V) complications other than anastomotic leak
- severe perioperative infection unrelated to anastomotic leak
- patients with serious mental illness
- pregnant or breastfeeding women
- patients with other clinical and laboratory conditions considered by the investigator should not participate in the trial
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
patients with TDT removal guided by postoperative CRP trajectory
Arm Description
Outcomes
Primary Outcome Measures
anastomotic rate
anastomotic rate
Secondary Outcome Measures
the grades of anastomotic leak
The severity grading of anastomotic leak according to the International Study Group of Rectal Cancer
rates of diarrhea after transanal drainage tube removal
rates of diarrhea after transanal drainage tube removal
visual analogue scale to assess anal postoperative pain
visual analogue scale of the included patients to assess the transanal drainage tube tolerability. Visual analogue scale ranges from 0-10. 0 indicates perfectly tolerated while 10 indicates complete intolerant and the tube has to be removed.
transanal drainage tube-related adverse events
transanal drainage tube-related adverse events such as bleeding and iatrogenic colonic perforations
Full Information
NCT ID
NCT05502354
First Posted
August 11, 2022
Last Updated
March 28, 2023
Sponsor
Qilu Hospital of Shandong University
1. Study Identification
Unique Protocol Identification Number
NCT05502354
Brief Title
CRP-guided Transanal Drainage Removal After Rectal Surgery
Official Title
A Single Arm Study to Investigate the Safety and Efficacy of C Reactive Protein (CRP) Guided Transanal Drainage Tube (TDT) Removal for Anastomotic Leak (AL) Prevention Following Laparoscopic Anterior Resection for Rectal Carcinoma
Study Type
Interventional
2. Study Status
Record Verification Date
March 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
May 1, 2023 (Anticipated)
Primary Completion Date
December 31, 2024 (Anticipated)
Study Completion Date
February 1, 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Qilu Hospital of Shandong University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
Transanal drainage tube (TDT) has the benefit of reducing intraluminal pressure after rectal surgery and may provide ideal regional environment for anastomotic healing. Postoperative C-reactive protein (CRP) trajectory has a high negative predictive value of 0.99 for ruling out anastomotic leak (AL). Previously, TDT was removed at the surgeon's own discretion. In the present study, we design a single arm study to investigate the safety and efficacy of CRP-guided TDT removal for AL prevention following laparoscopic anterior resection for rectal carcinoma
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Rectal Cancer, Anastomotic Leak
7. Study Design
Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
250 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
patients with TDT removal guided by postoperative CRP trajectory
Arm Type
Experimental
Intervention Type
Device
Intervention Name(s)
removal of transanal drainage tube
Intervention Description
removal of transanal drainage tube after laparoscopic anterior resection for rectal carcinoma according to postoperative CRP trajectory
Primary Outcome Measure Information:
Title
anastomotic rate
Description
anastomotic rate
Time Frame
30 days after surgery
Secondary Outcome Measure Information:
Title
the grades of anastomotic leak
Description
The severity grading of anastomotic leak according to the International Study Group of Rectal Cancer
Time Frame
30 days after surgery
Title
rates of diarrhea after transanal drainage tube removal
Description
rates of diarrhea after transanal drainage tube removal
Time Frame
from transanal drainage tube removal to 30 days after surgery
Title
visual analogue scale to assess anal postoperative pain
Description
visual analogue scale of the included patients to assess the transanal drainage tube tolerability. Visual analogue scale ranges from 0-10. 0 indicates perfectly tolerated while 10 indicates complete intolerant and the tube has to be removed.
Time Frame
from the date of transanal drainage tube positioning until the tube is removed, assessed up to 2 weeks
Title
transanal drainage tube-related adverse events
Description
transanal drainage tube-related adverse events such as bleeding and iatrogenic colonic perforations
Time Frame
from the date of transanal drainage tube positioning until the tube is removed, assessed up to 2 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
age from 18 to 75 years old
male and female
primary rectal adenocarcinoma
ASA I, II, or III
laparoscopic LAR + DST
with or without preoperative radio- or chemotherapy
no distal metastasis
no preoperative bowel obstruction
no preventive ileostomy or colostomy
patients and their families can understand and are willing to participate in this study and provide written informed consent
Exclusion Criteria:
emergency operation
preoperative abnormal liver function
tatme or ISR procedure (healing process might differ from anterior resection)
severe postoperative (Clavien-Dindo grade III IV V) complications other than anastomotic leak
severe perioperative infection unrelated to anastomotic leak
patients with serious mental illness
pregnant or breastfeeding women
patients with other clinical and laboratory conditions considered by the investigator should not participate in the trial
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xiang Zhang, M.D. Ph.D.
Phone
+8618560089182
Email
xiang.zhang02@hotmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Zhiqiang Cheng, M.D. Ph.D.
Phone
+8618560085238
Email
hill988276@sina.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kexin Wang, M.D. Ph.D.
Organizational Affiliation
Qilu Hospital of Shandong University
Official's Role
Study Director
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Learn more about this trial
CRP-guided Transanal Drainage Removal After Rectal Surgery
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