Rectal Surgery Evaluation Trial (RESET): Laparotomy vs Laparoscopy vs Robotic vs TaTME Rectal Surgery Matched Parallel Cohort Trial for High Surgical Risk Cancer Patients, With Mid- to Low Rectal Cancer
概览
- 阶段
- 不适用
- 干预措施
- 未指定
- 疾病 / 适应症
- Rectal Cancer
- 发起方
- Institut du Cancer de Montpellier - Val d'Aurelle
- 入组人数
- 1098
- 试验地点
- 1
- 主要终点
- Efficacy of surgical method (success determined by composite of Oncologic, morbidity and functional outcomes)
- 状态
- 已完成
- 最后更新
- 去年
概览
简要总结
Total mesorectal excision (TME) is the standard of care for rectal cancer, which can be combined with low anterior resection (LAR) in patients with mid-to-low rectal cancer. The narrow pelvic space and difficulties in obtaining adequate exposure make surgeries technically challenging. Four techniques are used to perform the surgery: open laparotomy, laparoscopy, robot-assisted surgery, and transanal surgery. Comparative data for these techniques is required to provide clinical data on the surgical management of rectal cancers by surgery.
详细描述
The Rectal Surgery Evaluation Trial will be a prospective, observational, case-matched, four-cohort, multicenter trial designed to study TME with LAR using open laparotomy, laparoscopy, robot-assisted surgery, or transanal surgery in high-surgical-risk patients with mid-to-low, non-metastatic rectal cancer. All surgeries will be performed by surgeons experienced in a technique. Oncologic, morbidity and functional outcomes will be assessed in a composite primary outcome, with success defined as circumferential resection margin ≥1 mm, TME grade III, and minimal postoperative morbidity (absence of Clavien-Dindo grade III-IV complications within 30 days after surgery). Secondary endpoints will include the co-primary endpoints over the long-term (2 years), quality of surgery, quality of life, length of hospital stay, operative time, and rate of unplanned conversions.
研究者
入排标准
入选标准
- •Age ≥ 18 years old
- •Rectal adenocarcinoma from middle and lower third (less than 10 cm from the anal verge) with a sphincter saving procedure
- •High risk operative patients (two of these factors as assessed on MRI):
- •Obese patient with a BMI \> 30 (male or female)
- •Narrow pelvis: inter-tuberous distance \< 10 cm
- •Large tumoral volume with suspicion of close predictive margin (CRM ≤ 1 mm) at diagnosis
- •Expected coloanal or ultra-low colorectal anastomosis
- •Patients with adequate performance status (Eastern Cooperative Oncology Group Scale score of ≤2)
- •Patient has signed and dated the informed consent before inclusion in the study.
排除标准
- •Patient with a comorbid illness or condition that would preclude the use of surgery.
- •Patients with T4b tumors which impose a pelvectomy
- •Patient requires an abdominal perineal resection (APR)
- •Patients with concurrent or previous invasive pelvic malignant tumors (cervical, uterine, or rectal; excluding the prostate) within 5 years before study enrollment
- •Patient undergoing emergency procedures
- •Planned rectal surgery along with major concomitant procedures (e.g. hepatectomies, other intestinal resections)
- •Metastatic disease
- •Pregnant or suspected pregnancy
- •Patients unwilling to comply with all follow-up study requirements
- •Patient included in another study which impact on the surgical technique or its choice.
结局指标
主要结局
Efficacy of surgical method (success determined by composite of Oncologic, morbidity and functional outcomes)
时间窗: up to 4 years
CRM, TME grade III, The absence of clavien dindo grade III-IV complications within 30 days post op