Human Intestinal Microbiome and Surgical Outcomes in Patients Undergoing Colorectal Cancer Surgery

NCT ID: NCT04005118

Last Updated: 2019-07-02

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

50 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-05-28

Study Completion Date

2020-04-01

Brief Summary

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Intro: Recent studies on colorectal cancer surgery have been focusing on the role of intestinal microbiome on surgical outcomes. Standard perioperative cares, like mechanic bowel preparation (MBP), administration of antibiotics (ABT) and surgery-related stress and injury influence the microbiome composition and possibly induce a shift toward a microbiome dysbiotic state, which predisposes to complicated postoperative course. Microbiome composition changes and enhanced virulence factors may increase the risk of postoperative complications, such as anastomotic leakage (AL), surgical site infection (SSI), and postoperative ileus (PI), which are known to impact on patient's overall survival and cancer recurrence.

Objective: The primary objective is to investigate if a significant association might exist between the microbiome composition and the occurrence of postoperative complications at 90 days.

Methods: 3 different microbiome samples will be taken from all patients. Two fresh fecal samples for detection of LM and fecal water preparation: a) a day before the surgery before MBP and/or ABT (LM1), b) postoperatively after first bowel movement (LM2). One sample will be taken intra-operatively from the stapled resection lines of circular stapler used for forming a colorectal anastomosis, to detect the MAM and to perform immunohistochemistry staining for detection of HACE1 expression.

DNA analysis will be performed for all samples. IHC will be performed for detecting HACE1 expression in the tumor and colorectal anastomosis tissues using anti-HACE1 antibodies. .

For proliferation assessment, human colon carcinoma cell lines HT29 will be plated in monolayers and scratched with a single scratch. Monolayers will be incubated for 24 hours with fecal water from patients with surgical complications and matched control patients without complications.

Descriptive statistics will be performed to describe the study population. This project aim to describe microbiome composition and its impact on postoperative complications.

Detailed Description

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Conditions

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Adenocarcinoma of the Colon Adenocarcinoma of the Rectum

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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preoperative preparation on microbiome composition

Mechanical Bowel Preparation + oral antibiotics group: receiving mechanical bowel preparation only MBP will be prepared with 4 liters of Polyethylene glycol (PEG) solution to be started 24 hours before the planned surgery. 500mg of Metronidazole will be administrated 3 times one day before the surgery at 2 pm, 3 pm and 10 pm.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Adult ≥ 18 years old
* With histologically confirmed rectal or left colon adenocarcinoma by biopsy material from colonoscopy
* Having elective colorectal surgery after standardized bowel preparation
* Affiliated to a social security system
* Signature of informed consent

Exclusion Criteria

* Major surgery 30 days before scheduled colorectal surgery
* Administration of systemic antibiotic therapy within 30 days prior to planned colorectal surgery
* Presenting a contraindication to elective colorectal surgery
* Patient protected by law
* Pregnant or breastfeeding woman
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assistance Publique - Hôpitaux de Paris

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Lelde Lauka, PHD

Role: PRINCIPAL_INVESTIGATOR

APHP

Locations

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Dr Lelde Lauka

Créteil, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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Lelde Lauka, PHD

Role: CONTACT

01 49 81 41 74 ext. +33

Facility Contacts

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Lauka Lelde, PhD

Role: primary

Other Identifiers

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APHP190088

Identifier Type: -

Identifier Source: org_study_id

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