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Exploring the Effect of Colonic J-pouch in Anorectal Preservation Surgery for Ultra-low Rectal Cancer.

Active, not recruiting
Conditions
Rectum Cancer
Faecal Incontinence
Faecal Incontinence with Faecal Urgency
Low Anterior Resection Syndrome
Leakage, Anastomotic
Interventions
Procedure: J-pouch anastomosis
Procedure: direct anastomosis
Registration Number
NCT06601985
Lead Sponsor
Shanghai 10th People's Hospital
Brief Summary

The occurrence of colorectal cancer has increased from the third most common cancer in 2018 to the second most common cancer in 2023. The practice of anal preservation surgery for ultra-low rectal cancer is being adopted gradually. Ultra-low rectal cancer patients who have undergone anal preservation are at an increased risk of developing significant bowel complications. The objective of this study was to examine the relationship between the type of bowel reconstruction following anal preservation surgery, and the subsequent outcomes of bowel function, quality of life and complication rates in patients with ultra-low rectal cancer.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
154
Inclusion Criteria
  1. A confirmed diagnosis of intestinal cancer, with the lower edge of the tumour <5 cm from the anus or <3 cm from the dentate line, and treated with anus-preserving surgery;
  2. No distant metastasis;
  3. Age >18 years old;
  4. Voluntary enrollment in the study and signing of an informed consent.
Exclusion Criteria
  1. A combination of severe cardiopulmonary, hepatic, renal, and other underlying diseases with a greater anaesthetic risk (ASA ≥ grade 4);
  2. preoperative anal stenosis and anal nonfunction;
  3. temporary stoma diversion.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
J-pouch anastomosis groupJ-pouch anastomosisPatient with ultra-low rectal cancer undergoing Sphincter- preserving surgery with one-stage anastomosis using a colon J-pouch.
direct anastomosis groupdirect anastomosisPatient with ultra-low rectal cancer undergoing Sphincter- preserving surgery with one-stage direct anastomosis.
Primary Outcome Measures
NameTimeMethod
LARS scoreFrom 1 month postoperatively to 12 months postoperatively

The LARS scale has five questions with a total score of 42. A score of 0-20 lacks diagnostic value for LARS, while a score of 21-29 indicates mild LARS and a score above 29 indicates major LARS.

FIQLFrom 1 month postoperatively to 12 months postoperatively

The FIQL is a specific quality-of-life assessment scale applicable to the symptoms of colorectal cancer patients. It comprises 29 items, which are divided into four dimensions: lifestyle (10 items), coping/behavior restriction(9 items), depression/self-perception (7 items), and embarrassment (3 items).

Vaizey scoreFrom 1 month postoperatively to 12 months postoperatively

The Wexner scale has five parts with a total score of 20, while the Vaizey scale is further refined on the basis of Wexner and has seven parts with a total score of 24. Higher scores on these scales indicate poorer anal functioning.

Wexner scoreFrom 1 month postoperatively to 12 months postoperatively

The Wexner scale has five parts with a total score of 20, while the Vaizey scale is further refined on the basis of Wexner and has seven parts with a total score of 24. Higher scores on these scales indicate poorer anal functioning.

Secondary Outcome Measures
NameTimeMethod
Surgical complicationsFrom 1 month postoperatively to 12 months postoperatively

Records post-operative anastomotic fistula, infection, bleeding, etc.

Trial Locations

Locations (1)

Shanghai Tenth People's Hospital, Yanchang Road, Jing'an District, Shanghai, China

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Shanghai, jingan, China

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