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Effects of Inferior Mesenteric Artery Preservation in Laparoscopic Colorectal Resection for Diverticular Disease.

Not Applicable
Completed
Conditions
Colonic Diverticuar Disease
Defecatory Functions
Fecal Incontinence
Constipation
Interventions
Procedure: IMA preserving
Procedure: IMA sectioning
Registration Number
NCT06506552
Lead Sponsor
University of Roma La Sapienza
Brief Summary

This is a prospective randomized study aimed to verifying the short and long-term results of inferior mesenteric artery preservation following colorectal resection for diverticular disease

Detailed Description

This study wants to demonstrate that the preservation of the inferior mesenteric artery allow to improve postoperative defecatory function and improve patient\'s quality of life.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
300
Inclusion Criteria
  • BMI < 35
  • ASA I-III
  • Hinchey I-III
Exclusion Criteria
  • BMI > 35
  • ASA IV
  • Hinchey IV
  • Previous procedures that could have been modified the nervous mesenteric pattern (surgery, radiotherapy or chemotherapy)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Inferior mesenteric artery preservationIMA preservingPerforming colorectal resection for diverticular disease the IMA was preserved ligating the sigmoids arteries close to colonic wall.
Inferior mesenteric ligationIMA sectioningPerforming colorectal resection the IMA was sectioned just below the origin of left colic artery.
Primary Outcome Measures
NameTimeMethod
Defecatory disorders6 years from surgery

the presence of defecatory disorders was evaluated (Costipation, Evacuation frequency,evacuation urgency, fragmented evacuation,flatus incontinence, liquid incontinence)

Secondary Outcome Measures
NameTimeMethod
Postoperative surgical complication1 month from surgery

The incidence of postoperative surgical complications was evaluated

Constipation6 years from surgery

The incidence and severity of postoperative constipation was evaluated with Cleveland Clinic Constipation Score ( score range from 0 to 30, the higher score defines worse constipation status)

Incontinence6 years from surgery

The presence of fecal incontinence was evaluated with Cleveland Clinic Incontinence Score( score ranges from 0 to 20, the higher score defines worse symptoms)

Anorectal Muscles function6 years from surgery

the anorectal muscles function was evaluated with anorectal manometry ( sphincter lenght, maximum squeeze pression, resting anal pressure, squeeze duration, maximum pressure sustained)

Postoperative quality of life6 years from surgery

The postoperative QOL was evaluated with SF-36 score (Short form-36 score, each item scored from 0 to 100, the higher scores defines a favorable health state)

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