NCT01766661

Brief Summary

The aim of this study is to decrease the morbidity by 30% using the Turnbull-Cutait procedure in comparison to the standard surgery for low rectal cancer. The investigators compare quality of life, faecal incontinence and recurrence of neoplasm in patients who received standard colo-anal anastomosis with protective ileostomy or two-staged Turnbull-Cutait colo-anal anastomosis after Low Anterior Resection for rectal cancer.

Trial Health

47
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
92

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Jan 2013

Longer than P75 for not_applicable

Geographic Reach
2 countries

4 active sites

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

January 1, 2013

Completed
9 days until next milestone

First Submitted

Initial submission to the registry

January 10, 2013

Completed
1 day until next milestone

First Posted

Study publicly available on registry

January 11, 2013

Completed
6.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 1, 2019

Completed
2.9 years until next milestone

Study Completion

Last participant's last visit for all outcomes

February 1, 2022

Completed
Last Updated

February 27, 2019

Status Verified

February 1, 2019

Enrollment Period

6.2 years

First QC Date

January 10, 2013

Last Update Submit

February 25, 2019

Conditions

Outcome Measures

Primary Outcomes (1)

  • post-operative morbidity

    within the first 30 days after surgery

Secondary Outcomes (3)

  • Quality of life

    3 years

  • Fecal incontinence

    3 years

  • local and/or distant recurrence of neoplasm

    3 years

Study Arms (2)

Coloanal anastomosis with ileostomy

ACTIVE COMPARATOR

Hand-sewn coloanal anastomosis protected by a loop ileostomy

Procedure: Hand-sewn coloanal anastomosisProcedure: Ultralow anterior rectal resection with total mesorectal excision

Two stage Turnbull-Cutait anastomosis

EXPERIMENTAL

Two staged coloanal anastomosis without protective ileostomy (Turnbull-Cutait procedure).

Procedure: Two staged Turnbull-Cutait procedureProcedure: Ultralow anterior rectal resection with total mesorectal excision

Interventions

After low anterior rectal resection due to low rectal neoplasm patients undergo intestinal reconstructions as hand-sewn coloanal anastomosis with protective loop ileostomy.

Coloanal anastomosis with ileostomy

After low anterior rectal resection due to low rectal neoplasm patients undergo intestinal reconstructions as two staged Turnbull-Cutait procedure anastomosis without protective ileostomy.

Two stage Turnbull-Cutait anastomosis

Standard ultralow anterior rectal resection with total mesorectal excision

Coloanal anastomosis with ileostomyTwo stage Turnbull-Cutait anastomosis

Eligibility Criteria

Age18 Years - 74 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients with adenocarcinoma of the lower-middle third of the rectum proctoscopy established by rigid proctoscopy, with histological confirmation and candidates of colo-anal anastomosis;
  • Patients over 18 years and under 75 years, who can tolerate neoadjuvant and surgical treatment;
  • Patients who undergo an ultra-low anterior rectal resection with total mesorectal excision and nerve and sphincter-sparing with curative intention
  • Any extension of the primary tumor (T 1-2-3-4) according to the TNM classification;
  • Patients with or without lymph node metastasis (N - / +) and with or without resectable distant metastases;
  • Patients clinically without fecal incontinence prior to the current illness and with a Wexner incontinence Score less than or equal to 5;
  • Patients ASA I, II or III and adequate hematological, renal and hepatic function;
  • Patients who signed informed consent.

You may not qualify if:

  • Altered cognitive state(eg mental retardation or dementia) that prevents collaboration in the study or patients who can neither read nor write
  • Fecal incontinence (Wexner equal to or greater than 6);
  • Previous surgery or proctological, colonic and anorectal functional disease
  • Diagnosis of synchronous colorectal or any other active neoplasm;
  • Patients ASA IV, V;
  • Pregnancy and lactation;
  • Rejection of the patient to sign the consent form.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (4)

Istituto Nazionale Tumori "Fondazione G, Pascale" - IRCCS

Naples, 80131, Italy

Location

Corporació Sanitària Parc Taulí Hospital Universitari

Sabadell, Barcelona, Spain

Location

Vall d'Hebron Universitary Hospital

Barcelona, 08035, Spain

Location

Bellvitge University Hospital

Barcelona, 08907, Spain

Location

Related Publications (3)

  • Biondo S, Barrios O, Trenti L, Espin E, Bianco F, Falato A, De Franciscis S, Solis A, Kreisler E; TURNBULL-BCN Study Group. Long-Term Results of 2-Stage Turnbull-Cutait Pull-Through Coloanal Anastomosis for Low Rectal Cancer: A Randomized Clinical Trial. JAMA Surg. 2024 Sep 1;159(9):990-996. doi: 10.1001/jamasurg.2024.2262.

  • Biondo S, Trenti L, Espin E, Bianco F, Barrios O, Falato A, De Franciscis S, Solis A, Kreisler E; TURNBULL-BCN Study Group. Two-Stage Turnbull-Cutait Pull-Through Coloanal Anastomosis for Low Rectal Cancer: A Randomized Clinical Trial. JAMA Surg. 2020 Aug 1;155(8):e201625. doi: 10.1001/jamasurg.2020.1625. Epub 2020 Aug 19.

  • Biondo S, Trenti L, Galvez A, Espin-Basany E, Bianco F, Romano G, Kreisler E; Turnbull-BCN study group. Two-stage Turnbull-Cutait pull-through coloanal anastomosis versus coloanal anastomosis with protective loop ileostomy for low rectal cancer. Protocol for a randomized controlled trial (Turnbull-BCN). Int J Colorectal Dis. 2017 Sep;32(9):1357-1362. doi: 10.1007/s00384-017-2842-4. Epub 2017 Jun 30.

MeSH Terms

Conditions

Rectal Neoplasms

Condition Hierarchy (Ancestors)

Colorectal NeoplasmsIntestinal NeoplasmsGastrointestinal NeoplasmsDigestive System NeoplasmsNeoplasms by SiteNeoplasmsDigestive System DiseasesGastrointestinal DiseasesIntestinal DiseasesRectal Diseases

Study Officials

  • Sebastiano Biondo, MD, Phd

    Bellvitge University Hospital

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
SUPPORTIVE CARE
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
PhD, MD

Study Record Dates

First Submitted

January 10, 2013

First Posted

January 11, 2013

Study Start

January 1, 2013

Primary Completion

March 1, 2019

Study Completion

February 1, 2022

Last Updated

February 27, 2019

Record last verified: 2019-02

Locations