Clinical trial NCT03776370: Preserving Left Colonic Artery During Radical Resection of Rectal Cancer
Official title: A Clinical Cohort Study on the Effect of Preserving Left Colonic Artery During Radical Resection of Rectal Cancer on Anastomotic Leakage and Oncology Efficacy
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Postoperative Complications
Proteinosis
Keywords: rectal cancer
Postoperative Complications
Preserve the left colonic artery
Lead sponsor: Third Military Medical University
Sponsor class: OTHER
First posted: 2018-12-14
Enrollment: 200
Sex: ALL
Minimum age (years): 18
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients who underwent laparoscopic or robotic anterior rectal resections carried out by two surgeons at Daping Hospital.

Brief summary: To evaluate the feasibility and clinical significance of preserving left colonic artery in rectal cancer surgery.The investigators will focus on the effect of preserving left colonic artery during radical resection of rectal cancer on anastomotic leakage and oncology efficacy.

Detailed description: The investigators performed three-dimensional (3D) reconstruction to investigate the vascular anatomy, including the inferior mesenteric artery (IMA) and left colic artery (LCA),to help make pre-operative strategies of rectal cancer surgery.The investigators will preserving the left colonic artery during rectal cancer surgery and evaluate its feasibility and clinical significance.The investigators will focus on the effect of preserving left colonic artery during radical resection of rectal cancer on anastomotic leakage and oncology efficacy.

Eligibility criteria: Inclusion Criteria:

1. Pathological biopsy confirmed adenocarcinoma of the rectum；
2. Preoperative assessment of tolerance to surgery without major organ dysfunction；
3. Patients must be able to understand and voluntarily sign written informed consent；
4. The surgical method is laparoscopic or robotic anterior rectal cancer resection.

Exclusion Criteria:

1. The patient cannot tolerate the operation；
2. Refusal to sign informed consent；
3. Patients with distant metastasis of rectal cancer；
4. The surgical method was changed to miles or Hartman;
5. Unable to complete the follow - up

Primary outcomes:
measure: The incidence of postoperative anastomotic leakage was compared between the two groups.
timeFrame: Within 30 days after surgery
measure: The distant metastasis rates of rectal cancer between the two groups were compared.
timeFrame: Two years after surgery
measure: The local recurrence rates of rectal cancer between the two groups were compared.
timeFrame: Two years after surgery
measure: The five-year survival rates of rectal cancer between the two groups were compared.
timeFrame: Five years after surgery
Secondary outcomes:
Other outcomes:
Locations:
city: Chongqing
country: China
facility: zongming,Kang
state: Chongqing
city: Yuzhong
country: China
facility: zongming,Kang
state: Chongqing
Study officials:
affiliation: Army Military Medical University
name: Wei d tong, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Fan YC, Ning FL, Zhang CD, Dai DQ. Preservation versus non-preservation of left colic artery in sigmoid and rectal cancer surgery: A meta-analysis. Int J Surg. 2018 Apr;52:269-277. doi: 10.1016/j.ijsu.2018.02.054. Epub 2018 Mar 1.
citation: Sekimoto M, Takemasa I, Mizushima T, Ikeda M, Yamamoto H, Doki Y, Mori M. Laparoscopic lymph node dissection around the inferior mesenteric artery with preservation of the left colic artery. Surg Endosc. 2011 Mar;25(3):861-6. doi: 10.1007/s00464-010-1284-7. Epub 2010 Aug 20.
citation: Zheng H, Li F, Xie X, Zhao S, Huang B, Tong W. Preservation versus nonpreservation of the left colic artery in anterior resection for rectal cancer: a propensity score-matched analysis. BMC Surg. 2022 May 10;22(1):164. doi: 10.1186/s12893-022-01614-y.