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The incidence of prerectal resection syndrome (LARS) after middle and low rectal cancer surgery is as high as 70%, which seriously affects the quality of life of patients. Studies have shown that colon pouch can reduce and alleviate LARS symptoms. However, most previous studies focused on open surgery, and the evaluation index lacked objectivity. Therefore, in the context of minimally invasive rectal cancer surgery, it is necessary to re-evaluate the value of improved surgical methods for the prevention of LARS, so as to improve the quality of life of patients.
The incidence of prerectal resection syndrome (LARS) after middle and low rectal cancer surgery is as high as 70%, which seriously affects the quality of life of patients. LARS may be related to the injury of anal internal sphincter, anal sensory nerve injury, defecation reflex pathway injury, changes in anorectal Angle and rectum sigmoid Angle, changes in new rectal sensory function and compliance, and changes in dynamics,etc. After AR surgery, the rectum loses its good compliance and the storage capacity is reduced, which is one of the important reasons for the increased frequency and urgency of defecation.Therefore, on the basis of traditional colon-rectum (or anal canal) end-to-end anastomosis, "J" shaped pouch anastomosis, end-to-end anastomosis, coloplasty and other special anastomosis methods were performed. Meanwhile, for the lack of objective evaluation index, the results were not credible. The LARS score was first published in 2012,and has been validated, evaluated, or used as an outcome measure in more than 30 published scientific papers. Further more,laparoscopic surgery is widely used in gastrointestinal surgery. Herein, current randomized controlled trial comparing coloplasty with straight colorectal anastomosis in LARS in order to guide clinical practise was conducted.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| coloplasty(CP) | Experimental | After purse-string suture and ligation of the head of the stapler at the colonic end, 5cm away from the colonic end, 5cm longitudinal incision was made to the proximal end of the teniae coli in the anterior wall of the colon, transverse suture was performed, and the plasmomuscular layer was embedded, then end to end colon-rectum (or anal canal) anastomosis was performed |
|
| straight colorectal anastomosis (SCA) | No Intervention | End to end colon-rectum (or anal canal) anastomosis was performed routinely |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| transverse coloplasty pouch | Procedure | a transverse coloplasty pouch was performed before end to end colon-rectum (or anal canal) anastomosis |
|
| Measure | Description | Time Frame |
|---|---|---|
| anterior resection syndrome incidence | LARS score≥21 | 1 year after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Early postoperative complication incidence | Anastomotic fistula, Hemorrhage, Pulmonary infection,Death | 30 days after surgery |
| Length of hospital stay after surgery | Length of hospital stay |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Bo Wei, M.D | Contact | (86)20-85252228 | sanpi2013@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Hongbo Wei, Ph.D | Third Affiliated Hospital, Sun Yat-Sen University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Third Affiliated Hospital of Sun Yat-Sen university | Recruiting | Guanzhou | Guangdong | 510000 | China |
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| ID | Term |
|---|---|
| D012004 | Rectal Neoplasms |
| D000094123 | Low Anterior Resection Syndrome |
| ID | Term |
|---|---|
| D015179 | Colorectal Neoplasms |
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
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| 30 days after surgery |
| Bowel recovery time | Time interval from surgery to flatus and defecation | 7 days after surgery |
| Long-term postoperative complication incidence | Anastomotic fistula, Hemorrhage,Intestinal obstruction | 1 year after surgery |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |
| D003108 | Colonic Diseases |
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |