Surgical Adhesions Clinical Trial
Official title:
Does Icodextrin Reduce the Risk of Small Bowel Obstruction?
The study aims at investigating if icodextrin 4% instilled in abdominal cavity during surgery can reduce the risk of surgery and hospitalisation for small bowel obstruction in patients with colorectal cancer. Follow-up data is collected from the Swedish national colorectal cancer registry.Patients are followed for 5 years postoperatively.The study is a randomized Swedish multicenter study and planned to include 1,800 patients. A safety control is planned after 300 included patients.
Icodextrin 7.5% is used in peritoneal dialysis. In animal models and in gynecological surgery
a 4% solution of Icodextrin has been tested as a possible agent of reducing adhesions by
acting as a barrier between peritoneal surfaces. Some data support a reduction af adhesions
(van den Tool et al., Brown et al.). However, is not known whether icodextrin reduces the
need for surgery or hospitalisation for small bowel obstruction.This study aims to study
these parameters as well as complications and survival.
Patients with colorectal cancer and scheduled for surgery with curative intent will be (after
patients acceptance) randomized to have icodextrin 4% instilled in the abdominal cavity or
not. Patients allocated to icodextrin arm will have 100 ml of icodextrin 4% instilled every
30 minutes during surgery and at end of operation further 1000 ml instilled in the abdominal
cavity. Postoperative care is performed according to each hospital praxis.
Follow-up data will be collected from the Swedish National Colorectal cancer registry. Data
30 days postoperatively will be analysed for early small bowel obstruction and other early
complications. The study ends 5 years postoperatively with analysis of surgery and
hospitalization for small bowel obstruction as well as survival and longterm complications.
A safety analysis is planned after the first 300 randomized patients with respect to early
(30 days) complications. These data will analysed blindly by external reviewers.
Randomization (1:1) will be performed at the Regional Cancer Centrum in the Uppsala-Örebro
region. The study aims to randomise 1800 patients.
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