Safety and Efficacy Study of Cylindrical Abdominoperineal Resection to Treat Rectal Cancer

NCT ID: NCT00949273

Last Updated: 2013-11-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

300 participants

Study Classification

OBSERVATIONAL

Study Start Date

2009-07-31

Study Completion Date

2013-11-30

Brief Summary

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The purpose of this study is to determine whether cylindrical abdominoperineal resection is effective in the treatment of advanced very low rectal cancer

Detailed Description

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Abdominoperineal resection (APR) is still a common operation in patients with tumours less than 6 cm from the anal verge. The perineal phase of APR is a difficult part of the operation, often done with the patient in the supine position.The risk of inadvertent bowel perforation is high, the resulting specimen frequently has a waist at the lower border of the mesorectum, and the circumferential resection margin (CRM) is often close to the rectal muscle tube. The cylindrical APR may be performed via an extended posterior perineal approach, that aims to create a more cylindrical specimen without a waist. The potential benefit of this technique is a reduction in the risk of bowel perforation and tumour involvement of the CRM, and thus in the risk of local recurrence.

Perineal wounds in patients following APR are at considerable risk for infection, dehiscence and delayed healing when closed primarily. This can be further increased in patients who have received neoadjuvant chemoradiation therapy. The adoption of extended resection, such as the cylindrical APR, may cause additional risks. The use of acellular biomaterials, including human acellular dermal matrix (HADM) has drawn great interest for the complex abdominal wall reconstruction.

The purpose of this study is to determine whether cylindrical abdominoperineal resection is effective in the treatment of advanced very low rectal cancer, and to determine the initial results of pelvic reconstruction using human acellular dermal matrix after cylindrical abdominoperineal resection.

Conditions

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Rectal Cancer Treatment Postoperative Complications Neoplasm Recurrence, Local Survival Rate

Keywords

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cylindrical abdominoperineal resection rectal cancer acellular dermal matrix pelvic reconstruction circumferential resection margin overall survival

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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cylindrical abdominoperineal resection

patients underwent cylindrical abdominoperineal resection for advanced very low rectal cancer

cylindrical abdominoperineal resection

Intervention Type PROCEDURE

Extended abdominoperineal resection with human acellular dermal matrix reconstruction of the pelvic floor for rectal cancer

abdominoperineal resection

patients underwent conventional abdominoperineal resection for advanced very low rectal cancer

No interventions assigned to this group

Interventions

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cylindrical abdominoperineal resection

Extended abdominoperineal resection with human acellular dermal matrix reconstruction of the pelvic floor for rectal cancer

Intervention Type PROCEDURE

Other Intervention Names

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Ruinuo

Eligibility Criteria

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Inclusion Criteria

* Tumor within 6 cm of the anal verge, or with very narrow pelvis
* T3-T4 as determined by preoperative MRI or endorectal ultrasonography examination, or a low tumor is fixed or tethered at rectal examination
* Absence of distant metastases
* Absence of intestinal obstruction

Exclusion Criteria

* T1-T2 as determined by preoperative MRI or endorectal ultrasonography examination
* with distant metastases
* with intestinal obstruction
* pregnancy or lactation
* allergic constitution to heterogeneous protein
* with operation contraindication
* with mental disorder
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shandong Provincial Hospital

OTHER_GOV

Sponsor Role collaborator

Shandong Cancer Hospital and Institute

OTHER

Sponsor Role collaborator

The First Affiliated Hospital of Zhengzhou University

OTHER

Sponsor Role collaborator

Wuhan University

OTHER

Sponsor Role collaborator

Shenyang Anorectal Hospital

OTHER

Sponsor Role collaborator

Beijing Luhe Hospital

OTHER

Sponsor Role collaborator

Beijing Chao Yang Hospital

OTHER

Sponsor Role lead

Responsible Party

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Zhen Jun Wang

Professor and Head of General Surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Zhen Jun Wang, M.D.

Role: STUDY_CHAIR

Beijing Chao Yang Hospital

Yong Dai, M.D.

Role: PRINCIPAL_INVESTIGATOR

Shandong Provincial Hospital

Heng Ma, M.D.

Role: PRINCIPAL_INVESTIGATOR

Shandong Cancer Hospital and Institute

Qun Qian, M.D.

Role: PRINCIPAL_INVESTIGATOR

Zhong Nan Hospital, Wuhan University

Xian Dong Zeng, M.D.

Role: PRINCIPAL_INVESTIGATOR

Shenyang Anorectal Hospital

Jian Hua Cai, M.D.

Role: PRINCIPAL_INVESTIGATOR

Beijing Luhe Hospital

Wei Tang Yuan, M.D.

Role: PRINCIPAL_INVESTIGATOR

The First Affiliated Hospital of Zhengzhou University

Locations

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Beijing Luhe Hospital

Beijing, Beijing Municipality, China

Site Status RECRUITING

General Surgery, Beijing Chao Yang Hospital

Beijing, Beijing Municipality, China

Site Status RECRUITING

The first Affiliated Hospital of Zhengzhou University

Zhengzhou, Henan, China

Site Status RECRUITING

Zhongnan Hospital, Wuhan University

Wuhan, Hubei, China

Site Status RECRUITING

Shenyang Anorectal Hospital

Shenyang, Liaoning, China

Site Status RECRUITING

General Surgery, Shandong Provincial Hospital

Jinan, Shandong, China

Site Status RECRUITING

Shandong Cancer Hospital and Institute

Jinan, Shandong, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Zhen Jun Wang, M.D.

Role: CONTACT

Phone: 86-013601393711

Email: [email protected]

Jia Gang Han, M.D.

Role: CONTACT

Phone: 86-013522867841

Email: [email protected]

Facility Contacts

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Jian Hua Cai, M.D.

Role: primary

Jia Gang Han, M.D.

Role: primary

Wei Tang Yuan, M.D.

Role: primary

Qun Qian, M.D.

Role: primary

Xian Dong Zeng, M.D.

Role: primary

Yong Dai, M.D.

Role: primary

Heng Ma, M.D.

Role: primary

References

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Holm T, Ljung A, Haggmark T, Jurell G, Lagergren J. Extended abdominoperineal resection with gluteus maximus flap reconstruction of the pelvic floor for rectal cancer. Br J Surg. 2007 Feb;94(2):232-8. doi: 10.1002/bjs.5489.

Reference Type RESULT
PMID: 17143848 (View on PubMed)

Other Identifiers

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CAPR0668

Identifier Type: -

Identifier Source: org_study_id