Comparative Study Between End to End Anastomosis With Omega Suture Versus End to Anterior Rectal Wall In Colorectal Anastomosis in Sigmoid and Upper Rectal Cancer
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 40
- 试验地点
- 1
- 主要终点
- Anastomotic leakage
研究概览
简要总结
The aim of this study is to compare end to end anastomosis with omega suture versus end to anterior rectal wall in colorectal anastomosis as regard post operative anastomotic leakage, bowel function, operative time and intra operative blood loss.
详细描述
Colorectal cancer has been reported to be the 3rd most common and the second most deadly cancer world wide.
Anterior resection is the gold standard operation for both rectal and recto-sigmoid cancer with considering oncological safety maintenance to be the most important goal which can be achieved by keeping abundant resection margin and ensuring anastomotic safety, despite the technical difficulties of working in a narrow deep pelvis.
Understanding the characteristics of each anastomotic technique and establishing a stable anastomotic procedure both are pillars in anastomotic leakage prevention.
The intersection of the linear staple line and circular staple line in conventional anastomotic way is considered a risk factor for anastomotic leakage by creating stapled corners (called "dog-ears") which considered potentially ischemic and represent the area with high incidence of anastomotic leakage. Single stapled technique using ether end to end with omega suture or end to side stapled anastomosis allows avoidance of the formation of this intersection.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients aged >18 years.
- •Both sexes.
- •Recto sigmoidal carcinoma.
- •Upper rectal cancer.
排除标准
- •Patients younger than 18 years
- •Recurrent or non-resectable cancer
- •Complicated cancer (e.g., obstructed or perforated)
- •Previous left-sided colorectal surgery or anorectal surgeries
- •Lower rectal cancer
研究组 & 干预措施
Group A(end to end with Omega suture)
After the rectum was divided with a linear stapler, the circular stapler was placed allowing the anvil rod to penetrate the rectal stump near the linear stapler line. An omega suture including both ends of the linear stapler line was placed. The linear stapler line was approximated around the anvil rod of the circular stapler in an omega shape fashion as the omega suture was tied. This technique resulted in a complete resection of linear stapler line by the circular stapler.
干预措施: End to end with Omega suture (Other)
Group B (end to anterior rectal wall)
A burse string suture was applied over the anvil of the circular stapler at the transection point of the descending colon using prolene 2/0.
The circular stapler introduced though the anus and its rod directed toward the anterior rectal wall and colorectal anastomosis was performed.
干预措施: End to anterior rectal wall (Other)
结局指标
主要结局
Anastomotic leakage
时间窗: 5 days after surgery
Anastomotic leakage will be measured for 5 days after surgery
次要结局
- Time of bowel function(7 days postoperative)
- Operative time(Until the procedure is completed)
- Hospital stay(28 days postoperative)
- Wound complications(7 days postoperative)
研究者
Asmaa fathi
Assistant Lecturer of General Surgery, Ain Shams University
Ain Shams University