Comparison Between Results of 2 Laparoscopic Surgical Procedures in Operable Colon Cancer Cases in Upper Egypt

NCT ID: NCT05421702

Last Updated: 2022-12-14

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

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-07-01

Study Completion Date

2023-04-30

Brief Summary

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The investigators will assess and compare Surgical, pathological and oncological outcomes between two laparoscopic procedures conventional colectomy versus complete mesocolic excision for operable colon cancer cases in Upper Egypt

Detailed Description

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Colon cancer is considered a huge clinical surgical burden accounting for 10% of cancer cases and deaths all over the world with consideration that surgery and adjuvant chemotherapy(if indicated) are the main lines of treatment .

When Werner Hohenberger and colleagues described complete mesocolic excision (CME) in 2009; resection along the embryological and lymphovascular planes with appropriate resection margins, they did it for years before describing it with suggestion of improved disease outcomes and overall survival compared to the conventional colectomy (CC).

The principles of CME were described after the significant improvement of rectal adenocarcinoma surgical outcomes with establishment of total mesorectal excision (TME) in which tumor resection is associated with dissection of mesorectal fascial embryologic and lymphovascular planes.

CME includes the same principles of the CC with maximizing lymph node dissection level into (D3 extended lymphadenectomy instead of D1 and D2 in conventional colectomy) and central vascular ligation (CVL) of the main feeding vessel(s) at their origin, with suggested improved disease-free and overall survival with suggested superior pathological and oncological results in the specimen.

Some surgeons consider that CME; with D3 extended lymphadenectomy and CVL is the optimal or standard surgical method in primary cancer colon based on suggested reduced local recurrence and improved disease-free and overall survival.

Although CME has a theoretical advantages and promising early results, it is not widely adopted as the standard in some areas. CME is technically more demanding than CC and suggested to be associated with more intraoperative visceral injuries and non-surgical complications and many doubts persist about safety and efficacy of the procedure.

The questions of interest and research, should CME be regarded as the optimal procedure for colon cancer cases? And also another question; is conventional colectomy suboptimal?

Conditions

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Colon Cancer Stage I Colon Cancer Stage II

Keywords

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Colon cancer Colectomy Mesocolic Conventional Laparoscopic Surgical Pathological

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Operable colon cancer cases
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Group A Operable colon cancer cases

All patients with operable colon cancer who will undergo laparoscopic conventional colectomy

Group Type ACTIVE_COMPARATOR

laparoscopic conventional colectomy

Intervention Type PROCEDURE

Laparoscopic colectomy with only lymph node dissection up to level 2 lymph nodes D2.

Group B Operable colon cancer cases

All patients with operable colon cancer who will undergo laparoscopic complete mesocolic excision

Group Type ACTIVE_COMPARATOR

laparoscopic complete mesocolic excision

Intervention Type PROCEDURE

Laparoscopic colectomy with lymphovascular dissection from level 3 lymph nodes or more D3.

Interventions

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laparoscopic conventional colectomy

Laparoscopic colectomy with only lymph node dissection up to level 2 lymph nodes D2.

Intervention Type PROCEDURE

laparoscopic complete mesocolic excision

Laparoscopic colectomy with lymphovascular dissection from level 3 lymph nodes or more D3.

Intervention Type PROCEDURE

Other Intervention Names

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D2 colectomy

Eligibility Criteria

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Inclusion Criteria

1. Both sexes will be included.
2. Age: all adult patients.
3. All diagnosed patients with operable cancer colon.
4. Cancer at cecum, appendix, ascending colon, hepatic flexure or at splenic flexure, transverse and descending colon and sigmoid colon.
5. Fit patients.

Exclusion Criteria

1. Irresectable colon cancer.
2. Inoperable colon cancer.
3. Rectal cancer.
4. Unfit patients.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sohag University

OTHER

Sponsor Role lead

Responsible Party

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Mostafa Farrag Mohammed

assistant lecturer of general surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ahmed E Ahmed, Professor

Role: STUDY_CHAIR

Sohag University

Mena Z Helmy, Ass prof.

Role: STUDY_DIRECTOR

Sohag University

Mostafa F Mohammed, Ass lecturer

Role: PRINCIPAL_INVESTIGATOR

Sohag University

Locations

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Sohag faculty of medicine

Sohag, , Egypt

Site Status

Countries

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Egypt

Other Identifiers

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Soh-Med-22-06-17

Identifier Type: -

Identifier Source: org_study_id