Robotic Assisted Transanal Total Mesorectal Excision Surgery for Rectal Cancer in Low Site

NCT ID: NCT03422835

Last Updated: 2018-02-06

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

Clinical Phase

PHASE2

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-02-15

Study Completion Date

2023-12-30

Brief Summary

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To investigates the feasibility, practicability, safety and subjective as well as functional outcome of Robotic transanal total mesentery excision for rectal cancer in low site.

Detailed Description

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Transanal total mesorectal excision (TaTME) may offer a better way to achieve radical resection and functional protection for lower rectal cancer, which have been regarded as challenging situations in rectal cancer surgery. However, the narrow angle and limited space of the operation restrict the wide spread of this technique. Da Vinci robotic system has achieved good results in rectal cancer surgery. Robotics may help to overcome technical difficulties in TaTME. The purpose of this study was to explore the availability of Da Vinci robotic-assisted transanal total mesorectal excision(R-TaTME) This study investigates the feasibility, practicability, safety and subjective as well as functional outcome of Robotic transanal total mesentery excision for rectal cancer in low site.

Conditions

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Rectal Neoplasms

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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R-TME

Robotic total mesentery excision surgery for rectal cancer.

Group Type ACTIVE_COMPARATOR

R-TME

Intervention Type PROCEDURE

Conventional Robotic Total Mesentery Excision

R-TaTME

Robotic transanal total mesentery excision surgery for rectal cancer.

Group Type EXPERIMENTAL

R-TaTME

Intervention Type PROCEDURE

Robotic Transanal Total Mesentery Excision

Interventions

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R-TME

Conventional Robotic Total Mesentery Excision

Intervention Type PROCEDURE

R-TaTME

Robotic Transanal Total Mesentery Excision

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* adenocarcinoma of the rectum by biopsy
* the lower edge of the tumor from the anal margin less than 8cm according to MRI or rigid endoscopy
* tumor diameter less than 4cm
* baseline clinical stage I-III: cT1-3 N0-2 M0 (AJCC v7)
* tolerable to surgery
* be able to understand and willing to participate in this trial with signature

Exclusion Criteria

* history of malignant colorectal neoplasia
* recent diagnosis with other malignancies
* patients requiring emergency surgery such as obstruction,perforation and bleeding
* tumor involving adjacent organs, anal sphincter, or levator ani muscle muti-focal colorectal cancer
* preoperative poor anal function, anal stenosis, anal injury, or fecal incontinence history of inflammatory bowel disease or familial adenomatous polyposis
* participating in other clinical trails
* History of pelvic radiation
* BMI \> 40
* Large uterine fibroids
* can not tolerate the surgery
* history of serious mental illness
* pregnancy or lactating women
* preoperative uncontrolled infection
* the researchers believe the patients should not enrolled in
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Daping Hospital and the Research Institute of Surgery of the Third Military Medical University

OTHER

Sponsor Role lead

Responsible Party

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fan li

Prof.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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fan li, MD.

Role: PRINCIPAL_INVESTIGATOR

Daping Hospital, Third Military Medical University

Central Contacts

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fan li, MD.

Role: CONTACT

+86 023 68757958

References

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Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery--the clue to pelvic recurrence? Br J Surg. 1982 Oct;69(10):613-6. doi: 10.1002/bjs.1800691019.

Reference Type BACKGROUND
PMID: 6751457 (View on PubMed)

Kim MJ, Park SC, Park JW, Chang HJ, Kim DY, Nam BH, Sohn DK, Oh JH. Robot-assisted Versus Laparoscopic Surgery for Rectal Cancer: A Phase II Open Label Prospective Randomized Controlled Trial. Ann Surg. 2018 Feb;267(2):243-251. doi: 10.1097/SLA.0000000000002321.

Reference Type BACKGROUND
PMID: 28549014 (View on PubMed)

Kuo LJ, Ngu JC, Tong YS, Chen CC. Combined robotic transanal total mesorectal excision (R-taTME) and single-site plus one-port (R-SSPO) technique for ultra-low rectal surgery-initial experience with a new operation approach. Int J Colorectal Dis. 2017 Feb;32(2):249-254. doi: 10.1007/s00384-016-2686-3. Epub 2016 Oct 15.

Reference Type BACKGROUND
PMID: 27744632 (View on PubMed)

Wang Y, Liu R, Zhang Z, Xue Q, Yan J, Yu J, Liu H, Zhao L, Mou T, Deng H, Li G. A safety study of transumbilical single incision versus conventional laparoscopic surgery for colorectal cancer: study protocol for a randomized controlled trial. Trials. 2015 Nov 30;16:539. doi: 10.1186/s13063-015-1067-5.

Reference Type BACKGROUND
PMID: 26620555 (View on PubMed)

Odermatt M, Flashman K, Khan J, Parvaiz A. Laparoscopic-assisted abdominoperineal resection for low rectal cancer provides a shorter length of hospital stay while not affecting the recurrence or survival: a propensity score-matched analysis. Surg Today. 2016 Jul;46(7):798-806. doi: 10.1007/s00595-015-1244-x. Epub 2015 Sep 5.

Reference Type BACKGROUND
PMID: 26342816 (View on PubMed)

Zhang H, Zhang YS, Jin XW, Li MZ, Fan JS, Yang ZH. Transanal single-port laparoscopic total mesorectal excision in the treatment of rectal cancer. Tech Coloproctol. 2013 Feb;17(1):117-23. doi: 10.1007/s10151-012-0882-x. Epub 2012 Aug 31.

Reference Type BACKGROUND
PMID: 22936590 (View on PubMed)

de Lacy AM, Rattner DW, Adelsdorfer C, Tasende MM, Fernandez M, Delgado S, Sylla P, Martinez-Palli G. Transanal natural orifice transluminal endoscopic surgery (NOTES) rectal resection: "down-to-up" total mesorectal excision (TME)--short-term outcomes in the first 20 cases. Surg Endosc. 2013 Sep;27(9):3165-72. doi: 10.1007/s00464-013-2872-0. Epub 2013 Mar 22.

Reference Type BACKGROUND
PMID: 23519489 (View on PubMed)

Fernandez-Hevia M, Delgado S, Castells A, Tasende M, Momblan D, Diaz del Gobbo G, DeLacy B, Balust J, Lacy AM. Transanal total mesorectal excision in rectal cancer: short-term outcomes in comparison with laparoscopic surgery. Ann Surg. 2015 Feb;261(2):221-7. doi: 10.1097/SLA.0000000000000865.

Reference Type BACKGROUND
PMID: 25185463 (View on PubMed)

Other Identifiers

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RATERAL-01

Identifier Type: -

Identifier Source: org_study_id

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