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The traditional positioning and surgical methods for temporary ileostomy no longer meet the requirements of minimally invasive surgery: (1) Conventional stoma positioning often leads to the trocar incision being too close to the stoma site, increasing the risk of baseplate leakage and skin infection. (2) Since stoma positioning is required to be within the rectus abdominis, the proximity between the stoma and auxiliary incision can heighten difficulties in stoma bag attachment and raises the risk of fecal leakage. (3) Stoma retraction surgery within the rectus abdominis is more traumatic and complex. We introduce for the first time a modified stoma positioning and surgical method, termed Reduced-Port Fusion Surgery. This technique includes preoperative trocar/stoma fusion positioning and intraoperative trocar/stoma fusion surgery. The procedure is based on the 3R principles: Reposition - the stoma is repositioned within the Joint Trocar/Stoma Zone, allowing for more lateral placement to meet surgical needs without being confined to the rectus abdominis. Reduce Port - the same fusion point is used for both trocar insertion and stoma creation, enabling dual use of one site. Recognize - surgeons participate in stoma positioning, recognize the positioning, and follow the procedure. This prospective, randomized, parallel-controlled clinical study aims to evaluate whether Reduced-Port Fusion Surgery can reduce stoma-related complications, postoperative pain, improve quality of life, and facilitate stoma retraction surgery compared to traditional methods. A total of 80 participants will be randomly assigned in a 1:1 ratio. The experimental group will undergo Reduced-Port Fusion Surgery while the control group will receive traditional surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Reduced-Port Fusion Surgery Group | Experimental | Recive preoperative trocar/stoma fusion positioning and intraoperative trocar/stoma fusion surgery |
|
| Traditional surgery group | Active Comparator | Recive traditional preoperative stoma positioning and traditional stoma surgery |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Reduced-Port Fusion Surgery | Procedure | (1) The Joint Trocar/Stoma Zone will be delineated by the stoma therapist. (2) The placement of the fusion point will involve collaboration between the surgeon and stoma therapist. This will be based on the surgeon's trocar placement plan and the stoma therapist's positioning principles. (3) Follow the principles of modified stomal positioning. (4) The surgeon will insert the main trocar based on the preoperative positioning point. During stoma creation, the 12 mm main trocar incision will be extended to 25-30 mm to create an ileostomy. |
| Measure | Description | Time Frame |
|---|---|---|
| Overall complication rate of stoma | Observe and assess for stoma complications | 7, 30, and 90 days after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| DETļ¼Discolorationļ¼Erosion and Tissue overgrowthļ¼ score | Measure the state of the skin around the stoma and the corresponding lesion area, ranging from 0-15, higher scores mean a worse outcome of stoma | 7, 30, and 90 days after surgery |
| Stomal skin infection rate |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Tingyu Wu, PhD | Contact | China: +86-021-25077855 | wutingyu@xinhuamed.com.cn |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Xinhua Hospital, Shanghai Jiao Tong University School of Medicine | Recruiting | Shanghai | China | 200092 | China |
In this study personal information and data such as patient history, physical examination results, surgical records, and study questionnaire data will be collected. These data will be used to evaluate the efficacy and safety of the new procedure and for academic publication. The researcher will treat the patients' personal data confidentially and anonymize the data and information in any public release of the results of the study.
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| Traditional surgery | Procedure | (1) The stoma therapists perform stoma positioning using traditional stoma positioning method. The surgeon will determine the primary trocar location, ensuring it does not overlap with the stoma site. (2) The surgeon will insert the primary trocar based on the preoperative positioning point and conduct the surgery. During stoma creation, the surgeons create ileal stoma according to the preoperative stoma positioning point. |
|
Observe and assess for stomal skin infection rate |
| 7, 30, and 90 days after surgery |
| Parastostomy trocar incision infection rate | To observe whether trocar incision infection occurred | 7, 30, and 90 days after surgery |
| Parastomal hernia rate | To observe whether parastomal hernia occurred | 7, 30, and 90 days after surgery |
| Stoma Pain Score | Measurement of stoma pain level using numerical rating scaleļ¼ranging from 0-10, higher scores mean a worse outcome of pain | 7, 30, and 90 days after surgery |
| Quality of life scale score | Measurement of quality of life for patients using the European Organization for Reasearch and Treatment of Cancer QLQ-C30 Questionnaire (EORTC QLQ-C30), ranging from 0-100, higher scores mean a better outcome of quality of life | 30 and 90 days after surgery |