Endoscopically Assisted Colostomy With Colopexy for Critically Ill Patients Without General Anesthesia or Laparotomy

NCT ID: NCT02308631

Last Updated: 2014-12-04

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

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

5 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-02-28

Study Completion Date

2014-09-30

Brief Summary

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Indications for colostomy are rectal or anal cancer, diverticular disease, radiation enteritis, complex perirectal fistulas, anorectal trauma, severe incontinence, motility and functional disorders. It is frequently required in critically ill patients who may not be able to tolerate a laparotomy. Laparoscopic-assisted colostomy is an alternative method for colostomy without laparotomy, but require general anesthesia.

Additionally, percutaneous anterior colopexy under colonocopic control offers the possibility for improved and faster fixation of the anterior colonic wall to the anterior abdominal wall.

The objective of this study is to evaluate the feasibility of performing fecal diversion with the help of a colonoscope and colopexy, without the additional morbidity of abdominal exploration.

Detailed Description

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The colonoscope will be passed transanally into the left colon. It will be identified the endoscopic transilluminating point to the abdominal wall. Percutaneous anterior colopexy will be performed, using a gastropexy device that is included in the percutaneous endoscopic gastrostomy (PEG) kit . This technique involves the placement of a threaded nylon fastener into the colon through a needle.

The endoscope will be manipulated until the light approaches the premarked site. A small skin disc will then be removed at this location and a loop colostomy will be made. The colonoscope will also be used as a guide to identify the proximal and distal limbs of the loop colostomy.

Conditions

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Colonic Neoplasms Rectal Neoplasms Fecal Incontinence

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Colostomy with colopexy by endoscopy

Colostomy with colopexy by endoscopy. 5 porks underwent endoscopic assisted colostomy with percutaneous colopexy. Animals were evaluated in post-operative days 1, 2, 5 and 7 Procedure/Surgery: ENDOSCOPICALLY ASSISTED COLOSTOMY WITH COLOPEXY

Group Type EXPERIMENTAL

ENDOSCOPICALLY ASSISTED COLOSTOMY WITH COLOPEXY

Intervention Type PROCEDURE

The endoscope was manipulated until the light approached the pre-set for the use of transillumination site and puncture with the Loop Fixture II gastropexy kit

Interventions

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ENDOSCOPICALLY ASSISTED COLOSTOMY WITH COLOPEXY

The endoscope was manipulated until the light approached the pre-set for the use of transillumination site and puncture with the Loop Fixture II gastropexy kit

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* good health and without surgery

Exclusion Criteria

\-
Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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LEONARDO ALFONSO BUSTAMANTE L

UNKNOWN

Sponsor Role collaborator

MARIANNY NAZARETH SULBARAN N

UNKNOWN

Sponsor Role collaborator

PAULO SAKAI

UNKNOWN

Sponsor Role collaborator

EDUARDO MOURA

UNKNOWN

Sponsor Role collaborator

CRISTIANO SAKAI

UNKNOWN

Sponsor Role collaborator

CAIO SERGIO NAHAS

UNKNOWN

Sponsor Role collaborator

CARLOS FREDERICO MARQUES

UNKNOWN

Sponsor Role collaborator

IVAN CECONELLO

UNKNOWN

Sponsor Role collaborator

SERGIO CARLOS NAHAS

UNKNOWN

Sponsor Role collaborator

University of Sao Paulo

OTHER

Sponsor Role lead

Responsible Party

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Leonardo Alfonso Bustamante

M.D. Colon and Rectal surgeon

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Leonardo A Bustamante, MD

Role: PRINCIPAL_INVESTIGATOR

University of Sao Paulo

Locations

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Medicine School, Sao Paulo University

São Paulo, São Paulo, Brazil

Site Status

Countries

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Brazil

References

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Mattingly M, Wasvary H, Sacksner J, Deshmukh G, Kadro O. Minimally invasive, endoscopically assisted colostomy can be performed without general anesthesia or laparotomy. Dis Colon Rectum. 2003 Feb;46(2):271-3. doi: 10.1007/s10350-004-6534-0.

Reference Type RESULT
PMID: 12576903 (View on PubMed)

Senapati A, Phillips RK. The trephine colostomy: a permanent left iliac fossa end colostomy without recourse to laparotomy. Ann R Coll Surg Engl. 1991 Sep;73(5):305-6.

Reference Type RESULT
PMID: 1929133 (View on PubMed)

Hellinger MD, Martinez SA, Parra-Davila E, Yeguez J, Sands LR. Gasless laparoscopic-assisted intestinal stoma creation through a single incision. Dis Colon Rectum. 1999 Sep;42(9):1228-31. doi: 10.1007/BF02238581.

Reference Type RESULT
PMID: 10496568 (View on PubMed)

Other Identifiers

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12267

Identifier Type: -

Identifier Source: org_study_id