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Short-term Outcomes of Full Bowel Preparation (MBP+OA) for Colon Cancer Resections Versus no Bowel Preparation

Not Applicable
Recruiting
Conditions
Colon Cancer
Interventions
Procedure: No bowel preparation
Procedure: Full bowel preparation prior to colon resection for cancer
Registration Number
NCT05546892
Lead Sponsor
N.N. Petrov National Medical Research Center of Oncology
Brief Summary

The purpose of the study is to determine if short-term outcomes of colon resections after full bowel preparation (mechanical bowel preparation plus oral antibiotics) are superior to colon resections with no bowel preparation.

Detailed Description

The design involves random allocation of eligible patients to full bowel preparation or no bowel preparation in 1:1 ratio. After that colon resection is performed in both groups.

Short-term outcomes are assessed in 30 day period after surgery. This is a superiority trial evaluating statistical superiority. Rate of anastomotic leak is anticipated to decrease from 8% (data from local registry) to 3%. For power of 80% enrolment of 586 patients is required.

The intent-to-treat principle is used for the data analysis.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
586
Inclusion Criteria
  • histologically confirmed adenocarcinoma of the colon (caecum, ascending, transverse, descending, sigmoid)
  • clinical stage T1-4aN0-2M0-1 (distant metastases must be resectable)
  • indications for surgical colonic resection
  • ECOG status 0-2
  • At least 18 years of age
  • Written informed consent
Exclusion Criteria
  • Medical or psychiatric conditions that compromise the patient's ability to give informed consent or comply with the study protocol
  • Pregnancy or breast feeding
  • Medical contraindications for surgical treatment
  • Any use of antibiotics 30 days prior to inclusion
  • Functioning stoma
  • Contraindications for use of MBP or OA drugs or their components
  • Indications for mandatory MBP (planned intraoperative colonoscopy etc)
  • Indications for obstructive resection
  • Acute bowel obstruction, bleeding or perforation
  • Other malignancies not in remission

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
No bowel preparationNo bowel preparationNo bowel preparation (enema of not more then 500 ml is allowed prior or during surgery)
Full bowel preparation (MBP+OA)Full bowel preparation prior to colon resection for cancerRifaximin 400 mg twice daily for three days prior to surgery Day prior to surgery: 17.00 - 18.00 Macrogol-3350 - 100 g Natrium sulfate - 7,5 g Natrium chloride - 2,691 g Potassium chloride - 1,015 g Ascorbic acid - 4,7 g Natrii ascorbate - 5,9 g Clear fluids - 1000 ml 18.00 - 19.00 Clear fluids 500 ml 19.00 - 20.00 Macrogol-3350 - 100 g Natrium sulfate - 7,5 g Natrium chloride - 2,691 g Potassium chloride - 1,015 g Ascorbic acid - 4,7 g Natrii ascorbate - 5,9 g Clear fluids - 1000 ml 20.00 - 21.00 Clear fluids 500 ml
Primary Outcome Measures
NameTimeMethod
Anastomotic leak rate30 days

Rate of anastomotic leak in patients after colon resections

Secondary Outcome Measures
NameTimeMethod
Intraabdominal and or pelvic abscess rate30 days

Rate of intraabdominal and or pelvic abscess

Rate of intraoperative complicationsDuration of surgical procedure

Rate of patients with intraoperative complications

Quality of bowel preparation assessed by surgeonDay of surgical procedure

Assessment of bowel preparation quality by surgeon (qualitative scale)

Surgical site infection (SSI) rate30 days

Rate of Surgical site infection

Overall morbidity30 days

Rate of patients with any complications after surgery

Surgery duration in minutesDuration of surgical procedure

Time of surgical procedure

Bowel preparation complianceDay of surgical procedure

Rate of patients in experimental arm undergoing complete bowel preparation according to protocol

Trial Locations

Locations (1)

N.N. Petrov National Medical Research Center of Oncology

🇷🇺

Saint Petersburg, Russian Federation

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