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Suprapubic Versus Transurethral Catheterization After Rectal Resection With Low Anastomosis for Cancer in Males

Not Applicable
Completed
Conditions
Cancer
Infection
Interventions
Device: suprapubic catheterization
Device: transurethral catheterization
Registration Number
NCT02922647
Lead Sponsor
University Hospital, Grenoble
Brief Summary

The purpose of this study is to compare the urinary tract infection rate on the four postoperative day between the 2 groups of patients who have undergone total mesorectal excision for cancer and low anastomosis, with either suprapubic or transurethral catheterization.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
240
Inclusion Criteria
  • Male patients of at least 18 years of age
  • Histologically proven rectal adenocarcinoma
  • Stage T1-4 Nx Mx
  • With or without neoadjuvant treatment
  • TME and low anastomosis (colorectal or coloanal, stapled or handsewn)
  • With or without loop ileostomy
  • Open or laparoscopic approach
  • Patient and doctor have signed a study specific informed consent form
Exclusion Criteria
  • Colonic and upper third rectal cancer (No or Partial Mesorectal Excision)
  • Abdominoperineal resection
  • Associated prostate, and/or seminal glands and/or bladder resection
  • Infected tumour, Emergency surgery
  • Epidural analgesia
  • Patient with antibiotic therapy (other than prophylaxis)
  • Previous treated/untreated known prostate or bladder carcinoma
  • Patient with symptomatic preoperative voiding dysfunction (IPSS score >19)
  • Medical history of bladder catheterization for obstruction, or urethral surgery
  • Patient necessitating urinary output monitoring (impaired renal function etc)
  • Patient deprived of liberty or under guardianship or incapable of giving consent
  • Against the usual indications of suprapubic drainage and / or urethral sounding any known allergies to medical device materials. (p. ex. latex) and in general the known allergies to sterilizing agents (particularly oxide ethylene and its derivatives.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
suprapubic catheterizationsuprapubic catheterizationIntervention:suprapubic catheterization after rectal resection with low anastomosis. Evaluate the urinary tract infection rate on the four days postoperative.
transurethral catheterizationtransurethral catheterizationIntervention:transurethral catheterization after rectal resection with low anastomosis. Evaluate the urinary tract infection rate on the four days postoperative.
Primary Outcome Measures
NameTimeMethod
Number of participants with urinary tract infection when using suprapubic versus transurethral catheterization as assessed by significant bacteriuria and pyuriafour days postoperative

The urinary tract infection, defined as significant bacteriuria ( \> 104 CFU / mL) and pyuria (\> 6 white blood cells per high power field) in urine samples obtained immediately after removal of the urethral catheter or clamping suprapubic catheter and removing the fourth postoperative day.

Secondary Outcome Measures
NameTimeMethod
Duration of catherism as assessed by the number of days for participants with the catheter and number of participants leaving the hospital with the catheter1 month
Participants morbidity and mortality as assessed by Dindo and Clavien classificationat 1 month and 6 months
Cost as assessed by the addition of the costs of the full process depending on the catheterism duration and additional consultations and readmissions for complicationsat 6 months

Estimated cost of complications, urologic surgery, medication , hospitalization, additional consultations and readmissions.

Specific complicationsin the first 6 months
Pain as assessed by visual analogue scale (0 to 10 score) for abdomen and urethraat 1, 2, 3 and 4 days

visual analogue scale (0-10) for both the abdomen and the urethra (a measure daily until hospital discharge )

Duration of postoperative return to normal bladder function as assessed by IPSS scoreat 1 and 6 months
Number of additionnal consultationsin the first 6 months
Rate of satisfaction for participants as assessed by questionnaries (Fact-C and EQ-5D-3Lat 30 days and 6 months

Patient satisfaction : very, or moderately dissatisfied , unchanged , slightly , moderately , or very disappointed at the exit of the Fact- C hospital and EQ-5D - 3L at 30 days and 6 months.

Duration of hospital stay in dayswithin 6 months

the hospital stay by day

Rate of recatheterizationin the first 6 months
Lack of comfort as assessed by visual analogue scale (0 to 10 score) for abdomen and urethraat 1, 2, 3 and 4 days

visual analogue scale (0-10) for both the abdomen and the urethra (a measure daily until hospital discharge )

Trial Locations

Locations (1)

University Hospital Grenoble

🇫🇷

Grenoble,, Rhone Alpes, France

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