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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04890015
Other study ID # 62019
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date July 10, 2017
Est. completion date July 10, 2023

Study information

Verified date September 2021
Source Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta
Contact Ander Timoteo, MD
Phone +34972940256
Email andertimoteo@gmail.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

There is currently no standardization in the use of the transanal decompressive tube during the postoperative after a colorectal surgery. The available evidence is based on studies with methodological differences. Most of the studies exclude patients with a diverting ileostomy, which are those patients who have a higher risk of anastomotic leak, so the real effect of transanal decompressive tube could have been masked. For this reason we believe that to assess the true effect of rectal decompression, patients with diverting stoma should be included.


Description:

One of the complications of performing the colorectal anastomosis is the anastomotic leak, which sometimes entails the need for reinterventions and stoma formation (provisional or definitive). In recent decades, the improvement in surgical techniques together with the knowledge of the causes that predispose to the anastomotic failure have allowed to reduced the rates. The placement of a tube probe through the anus in the postoperative period that decompresses the contents of the interior of the intestine (liquid or air) has been proposed as a factor that could influence the healing between intestines. In studies carried out in other centers, with the same characteristics as the present one, differences have been shown in the probability of anastomotic leakage, but these results are not conclusive and do not allow us to know the effectiveness of this procedure.


Recruitment information / eligibility

Status Recruiting
Enrollment 202
Est. completion date July 10, 2023
Est. primary completion date June 10, 2023
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Patients undergoing scheduled laparoscopic, robotic or laparotomic colorectal cancer surgery who undergo colorectal anastomosis. - Both mechanical and manual colorectal anastomosis with or without diverting ileostomy. - Negative intraoperative air-leak test. - Height of the anastomosis: promontory or distal to it. - Age=18 years. - Histology of Adenocarcinoma with or without prior neoadjuvant treatment. - Any T, any N, any M. - Informed consent signed by the patient and by the researcher. Exclusion Criteria: - No performance of colorectal anastomosis. - Colorectal tumor with histology other than adenocarcinoma or adenoma. - Patients with psychiatric illnesses, addictions or any disorder that prevents understanding of surgery. - Inability to read or understand any of the informed consent languages (Catalan, Spanish). - Emergency surgery. - Any patient who, due to his medical characteristics, presents a high individual risk when being included and completing the study.

Study Design


Intervention

Procedure:
Intraoperative transanal decompression tube placement
Intraoperatively under direct vision in the lower rectum, the balloon of the catheter will be inflated with 5-10cc of distilled water and it will be secured with a dressing / tape to the buttock connected to a collection bag.

Locations

Country Name City State
Spain Hospital Universitari Dr. Josep Trueta de Girona Girona

Sponsors (1)

Lead Sponsor Collaborator
Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta

Country where clinical trial is conducted

Spain, 

Outcome

Type Measure Description Time frame Safety issue
Primary Anastomotic leakage rate between treatment arms Anastomotic leakage (No/Yes), degree of anastomotic leakage (A, B or C), days of anastomotic leak diagnosis after colorectal surgery Within 30 days after surgery
Secondary Reintervention rate Reintervention due to any cause within 30 days after surgery Within 30 days after surgery
Secondary Postoperative complication rate Rate of medical and surgical complications within 30 days after surgery using the Dindo-Clavien classification, described as:
Grade I = Any deviation from the normal postoperative course. Grade 2 = Requiring pharmacological treatment with drugs other than such allowed for grade I complications.
Grade III = Requiring surgical, endoscopic or radiological intervention, not under (Grade IIIa) or under general anesthesia (Grade IIIb) Grade IV = Life-threatening complication with single organ (Grade IVa) or Multiorgan dysfunction (Grade IVb) Grade V = Death of a patient.
Within 30 days after surgery
Secondary Definitive and / or temporary stoma rate after anastomotic leakage Stoma formation due to anastomotic leak (No/Yes) Within 30 days after surgery
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