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To investigate whether laparoscopic ileocecus-sparing right hemicolectomy is feasible and oncologically safe
Our study is a single arm, single center clinical trial. The enrolled patients will accept laparoscopic ileocecus-sparing right hemicolectomy. The primary endpoint: postoperative complications, 1-year local recurrence. The second endpoint: conversion to conventional right hemicolectomy, time to first flatus after surgery, number of harvested lymph nodes, 3-year disease free survival, R0 resection, Specimen morphometry
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| LISRH group | Experimental | Following the principle of complete mesocolic excision(CME), Ileocecus-Sparing Right colectomy refers to the resection of the most portion of the ascending colon, hepatic flexure and mid to distal transverse colon. The extent of lymph node dissection and length of distal resection margin are similar to conventional right hemicolectomy. The length of proximal resection margin varies. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| laparoscopic ileocecus-sparing right hemicolectomy | Procedure | The ileocecal artery(ICA) is skeletonized. The colic branch of ICA is divided and ligated. Preserve anterior cecal artery, posterior cecal artery and ileocecal branch of ICA. Divide and ligate the right colic artery(RCA) and middle colic artery(MCA) at their roots. Dissect the lymph nodes surrounding the ICA, RCA and MCA accordingly. Head-to-Head colocolic anastomois is done, with circular stapler via making an opening at the bottom of cecum. |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative complications | Postoperative complications used to calculate the Comprehensive Complication Index (CCI) will be recorded | up to 90 days after surgery |
| 1-year local recurrence | rate of local recurrence one year after surgery, including anastomotic recurrence, recurrence around ileocolic vessels and surgical trunk of superior mesenteric vein, | 7 days after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Conversion to conventional right hemicolectomy | the rate of conversion to conventional right hemicolectomy | 1 day of surgery |
| Time to first flatus after surgery | days from a colectomy procedure to first occurrence of flatus during subject's postoperative recovery |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| KeFeng Ding, PhD | Zhejiang University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Second Affiliated Hospital of Zhejiang University | Hangzhou | Zhejiang | 310000 | China |
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| up to 7 days after surgery |
| Number of harvested lymph nodes | Number of harvested Lymph nodes according to the pathological report | up to 1 week after surgery |
| R0 resection | Rate of resection without any affected margins during the surgical procedure according to the pathological report | up to 1 week after surgery |
| Specimen morphometry | The gross dimensions of resected specimen: length, the distal and proximal resection margins distance, vascular pedicle length | within 30 days |
| 3-year disease free survival | the time from enrollment until disease relapse or death from any cause 3 years after surgery | 3 years |