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Trial Title: Outcome of Laparoscopic Total Mesorectal Excision Versus Open Technique in Management of Rectal Carcimoma

NCT ID: NCT05685680

Condition: Rectal Carcinoma

Conditions: Official terms:
Carcinoma

Study type: Interventional

Study phase: N/A

Overall status: Recruiting

Study design:

Allocation: Randomized

Intervention model: Parallel Assignment

Primary purpose: Treatment

Masking: None (Open Label)

Intervention:

Intervention type: Procedure
Intervention name: total mesorectal excision in rectal carcinoma
Description: total mesorectal excision laparoscopic versus open technique in management of rectal carcinoma
Arm group label: Group A laparoscopic group
Arm group label: Group B

Summary: Colorectal cancer is the second leading cause of death in the West, and rectal cancer accounts for about 25% of colon cancers Low anterior resection has been the mainstay of rectal cancer surgery in low rectal cancer since the 1970s. Although the best efforts of experienced surgeons, The local recurrence rate is 3 to 33% in conventional surgery, while total mesorectal excision (TME) results indicate a recurrence rate of less than 10% The evolution of the concept of TME which was first revealed by Heald.in 1982 made a major shift in the treatment strategies (Rodriguez-Luna et al,2015). The concept of TME was the most important event in surgery for rectal cancer in the last two decades, because even without a curative approach, the local recurrence decreased to 6 to 12%, and 5-year survival improved by 53-87% TME described clear definitions of distal resection margin (DRM), circumferential resection margin (CRM), and least number of harvested lymph nodes, so oncological outcomes improved, locoregional recurrence and survival rates also influenced . Laparoscopic total mesorectal excision (LTME) may be associated with less blood loss, earlier recovery, and lower morbidity. Identification of the small nerves and vessels became easiear because of laparoscopic magnified view of pelvis and thus prevents these injuries (Sajid et al, 2019). Also, minimal surgical trauma will reduce the immunologic response and preserves postoperative immunologic defenses. This may lead to low rate of infections as well as low local recurrences and distant metastases in addition to, tissue handling with less manipulation, 'may reduces the spread of cancer cells TME in obese males with low and anterior rectal tumors is technically challenging especially post neoadjuvant chemoradiotherapy due to distortion of the anatomical planes (Ng et al, 2014). In these patients, it is difficult to obtain a proper view of the dissection plane, in open technique which threatens the integrity of TME and carries the risk of positive margins, which is related to higher rates of local recurrence LTME is a widely used approach for rectal cancers; although conversion rate varies from 1.2 to 17%, and it is higher if BMI is equal to or more than 30

Criteria for eligibility:
Criteria:
Inclusion Criteria: - All patients with pathologically confirmed rectal carcinoma involving middle or lower third rectum and operable by MRI and CT scan criteria. - Both sexes will be included. - Age: ranging from 20 to 70 years. Exclusion Criteria: - Patients with stage IV. - Recurrent rectal cancers. - Combined malignancy. - Patients admitted due to emergency situations (acute large bowel obstruction, abdominal abscess, or rectal perforation and hemorrhage). - Patients with contraindication for laparoscopic surgery. - Unfit patients (ASA score > II).

Gender: All

Minimum age: 20 Years

Maximum age: 70 Years

Healthy volunteers: Accepts Healthy Volunteers

Locations:

Facility:
Name: Sohag University Hospital

Address:
City: Sohag
Country: Egypt

Status: Recruiting

Contact:
Last name: Magdy M Amin, professor

Start date: December 20, 2022

Completion date: December 20, 2023

Lead sponsor:
Agency: Sohag University
Agency class: Other

Source: Sohag University

Record processing date: ClinicalTrials.gov processed this data on November 12, 2024

Source: ClinicalTrials.gov page: https://clinicaltrials.gov/ct2/show/NCT05685680

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