Study Results
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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RECRUITING
NA
120 participants
INTERVENTIONAL
2025-05-01
2028-04-28
Brief Summary
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Detailed Description
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Primary endpoint: 3-year disease-free survival (DFS).
Secondary endpoints:
1. Complications within 90 days postoperatively;
2. Pathology-related indicators, including positive margin rate, number of harvested lymph nodes, and lymph-node metastasis rate;
3. Assessment of postoperative intestinal microbiota changes;
4. 5-year overall survival (OS).
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
SINGLE
Study Groups
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LIRRH group
Participants will undergo laparoscopic ileocecal-reconstruction right hemicolectomy (LIRRH), in which the ileocecal junction is reconstructed; procedure follows the same oncologic resection margins as standard laparoscopic surgery.
Laparoscopic ileocecal-reconstruction right hemicolectomy (LIRRH)
The ileocolic vessels are divided at their roots, and lymph nodes of stations 203, 202, and 201 are dissected. The right colic and middle colic vessels are also divided at their roots, and the surrounding lymphatic and adipose tissue (stations 211/212/213 and 221/222/223) is cleared. The transverse colon is transected 10 cm distal to the tumor, and the ileum is divided 10 cm proximal to the ileocecal region. After tailoring the ileal mesentery, an end-to-end ileo-transverse colonic anastomosis is performed. Using a seromuscular suture, the ileum and its tailored mesentery are invaginated into the wall of the transverse colon 2 cm proximal to the anastomosis, thereby reconstructing the ileocecal valve complex.
TRH group
Participants will undergo traditional laparoscopic right hemicolectomy (TRH) with standard en-bloc mesenteric resection and ileocolic anastomosis
traditional laparoscopic right hemicolectomy (TRH)
The ileocolic vessels are divided at their roots, and lymph nodes of stations 203, 202, and 201 are dissected. The right colic and middle colic vessels are likewise divided at their roots, and the surrounding lymphatic and adipose tissue (stations 211/212/213 and 221/222/223) is cleared. The transverse colon is transected 10 cm distal to the tumor, and the ileum is divided 10 cm proximal to the ileocecal junction. An end-to-side or side-to-side ileo-transverse colonic anastomosis is then performed.
Interventions
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Laparoscopic ileocecal-reconstruction right hemicolectomy (LIRRH)
The ileocolic vessels are divided at their roots, and lymph nodes of stations 203, 202, and 201 are dissected. The right colic and middle colic vessels are also divided at their roots, and the surrounding lymphatic and adipose tissue (stations 211/212/213 and 221/222/223) is cleared. The transverse colon is transected 10 cm distal to the tumor, and the ileum is divided 10 cm proximal to the ileocecal region. After tailoring the ileal mesentery, an end-to-end ileo-transverse colonic anastomosis is performed. Using a seromuscular suture, the ileum and its tailored mesentery are invaginated into the wall of the transverse colon 2 cm proximal to the anastomosis, thereby reconstructing the ileocecal valve complex.
traditional laparoscopic right hemicolectomy (TRH)
The ileocolic vessels are divided at their roots, and lymph nodes of stations 203, 202, and 201 are dissected. The right colic and middle colic vessels are likewise divided at their roots, and the surrounding lymphatic and adipose tissue (stations 211/212/213 and 221/222/223) is cleared. The transverse colon is transected 10 cm distal to the tumor, and the ileum is divided 10 cm proximal to the ileocecal junction. An end-to-side or side-to-side ileo-transverse colonic anastomosis is then performed.
Eligibility Criteria
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Inclusion Criteria
* ASA physical status ≤ III
* Endoscopy and biopsy-proven colon adenocarcinoma
* Contrast-enhanced abdominal CT showing primary tumor located in the ascending colon or proximal transverse colon (proximal one-third)
* Pre-operative clinical stage: TanyNanyM0
* Able to understand the study protocol, willing to participate, and provide written informed consent
Exclusion Criteria
* Severe cardiopulmonary insufficiency or any other contraindication to surgery.
* Uncorrectable electrolyte disturbances (e.g., potassium, calcium, magnesium).
* Evidence of significant bleeding diathesis or high hemorrhagic risk:
* Prior intracranial or intraspinal hemorrhage.
* Tumor invading major vessels with obvious bleeding risk.
* Thrombotic or embolic event within 6 months before study treatment, or significant vascular disease (e.g., surgical-repair aortic aneurysm).
* Clinically relevant hemoptysis or tumor bleeding of any cause within 1 month before screening.
* Therapeutic-dose anticoagulation within 2 weeks before study treatment (except low-molecular-weight heparin).
* Antiplatelet therapy within 10 days before study treatment (e.g., aspirin \> 325 mg/day, clopidogrel \> 75 mg/day, dipyridamole, ticlopidine, cilostazol).
* Active tuberculosis.
* Any active autoimmune disease or history of autoimmune disease with expected recurrence (including but not limited to SLE, RA, autoimmune hepatitis, uveitis, enteritis, hepatitis, hypophysitis, vasculitis, nephritis, hyper- or hypothyroidism, asthma requiring bronchodilators).
* Pre-operative evidence of synchronous multiple primary colorectal cancers or other conditions requiring additional bowel resection.
* Pre-operative imaging or intra-operative findings showing:
* Tumor infiltration into adjacent organs requiring multi-visceral resection;
* Distant metastasis;
* Unresectable (unable to achieve R0) disease.
* Other malignancies within the past 5 years, or familial adenomatous polyposis; except cured carcinoma in situ of the cervix, basal-cell carcinoma, papillary thyroid carcinoma, or cutaneous squamous-cell carcinoma.
* Intestinal obstruction, perforation, or bleeding requiring emergency surgery.
* Patient unsuitable or unable to tolerate laparoscopic surgery.
* Pregnant or lactating women.
* History of psychiatric disorders precluding compliance.
* Prior neoadjuvant therapy.
* Multidisciplinary team (MDT) decision that the patient is not appropriate for the study.
* Patient unable to understand the study conditions/objectives and refuses to give informed consent.
18 Years
75 Years
ALL
No
Sponsors
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Chaoxi Zhou
OTHER
Responsible Party
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Chaoxi Zhou
Associate Chief Physician, Department of General Surgery
Locations
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The Fourth Hospital of Hebei Medical University
Shijiazhuang, Hebei, China
Countries
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Central Contacts
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Facility Contacts
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Other Identifiers
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2025KS060
Identifier Type: OTHER
Identifier Source: secondary_id
2025KS060
Identifier Type: -
Identifier Source: org_study_id
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