NCT03242187

Brief Summary

This study is designed to assess the surgical, oncological and functional outcome of either the laparoscopic or trans-anal TME in management of mid and low rectal cancer.

Trial Health

43
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
30

participants targeted

Target at P25-P50 for phase_2

Timeline
Completed

Started May 2017

Geographic Reach
1 country

1 active site

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

May 25, 2017

Completed
2 months until next milestone

First Submitted

Initial submission to the registry

August 1, 2017

Completed
7 days until next milestone

First Posted

Study publicly available on registry

August 8, 2017

Completed
1.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 25, 2019

Completed
11 months until next milestone

Study Completion

Last participant's last visit for all outcomes

December 30, 2019

Completed
Last Updated

August 8, 2017

Status Verified

August 1, 2017

Enrollment Period

1.7 years

First QC Date

August 1, 2017

Last Update Submit

August 3, 2017

Conditions

Keywords

Minimally invasive surgerytrans-anal total mesorectal excisionLaparoscopic total mesoretal excision

Outcome Measures

Primary Outcomes (3)

  • Circumferential radial margin (CRM)

    Percentage of participants with involved circumferential margin(pathological assessment)

    2 years

  • Distal safety margin

    Distance of free distal margin in mm (pathological assessment)

    2 years

  • Number of lymph nodes retrieved

    Number of infiltrated/ Number of harvested lymph nodes(pathological assessment)

    2 years

Secondary Outcomes (4)

  • Morbidity rate

    2 years

  • Rate of conversion

    2 years

  • Disease free survival

    30 months

  • Functional outcome

    18 months

Study Arms (2)

Trans-anal TME (TaTME)

EXPERIMENTAL

Trans-anal total mesorectal excision(TaTME) will be offered to patients in this group (assisted by minilaparoscopy to control the IMA and splenic flexure mobilisation)

Procedure: Trans-anal total mesorectal excision(TaTME)

Lap. TME

ACTIVE COMPARATOR

Laparoscopic total mesorectal excision(Lap.TME) starting by IMA ligation then splenic flexure mobilisation and pelvic dissection

Procedure: Lap. TME

Interventions

Trans-anal total mesorectal excision(TaTME) will be offered to patients in this group (assisted by minilaparoscopy to control the IMA and splenic flexure mobilisation)

Also known as: Bottom to up approach
Trans-anal TME (TaTME)
Lap. TMEPROCEDURE

Laparoscopic total mesorectal excision(Lap.TME) starting by IMA ligation then splenic flexure mobilisation and pelvic dissection

Lap. TME

Eligibility Criteria

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

You may qualify if:

  • Anesthetically fit patient.
  • Non metastatic pathologically proven rectal cancer (Mid-Low).
  • Patients who received neoadjuvant chemo-radiotherapy will be included

You may not qualify if:

  • Patients with American Society of Anesthesiologist (ASA) score 4 and 5.
  • Patients with cardiac or chest problems that cannot withstand CO2 insufflation.
  • Unresectable tumors (T4) (defined as those who cannot be resected without a high likelihood of leaving microscopic or gross residual disease at the local site because of tumor adherence or fixation).
  • Obstructed or perforated cancer.
  • Patients with unresectable metastatic rectal cancer.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Oncology Center, Mansoura University

Al Mansurah, Egypt

RECRUITING

Related Publications (6)

  • Brenner H, Kloor M, Pox CP. Colorectal cancer. Lancet. 2014 Apr 26;383(9927):1490-1502. doi: 10.1016/S0140-6736(13)61649-9. Epub 2013 Nov 11.

    PMID: 24225001BACKGROUND
  • Vennix S, Pelzers L, Bouvy N, Beets GL, Pierie JP, Wiggers T, Breukink S. Laparoscopic versus open total mesorectal excision for rectal cancer. Cochrane Database Syst Rev. 2014 Apr 15;2014(4):CD005200. doi: 10.1002/14651858.CD005200.pub3.

    PMID: 24737031BACKGROUND
  • Qu C, Yuan RF, Huang J, Liu L, Jiang CH, Yang ZQ, Shao JH. [Meta-analysis of laparoscopic versus open total mesorectal excision for middle and low rectal cancer]. Zhonghua Wei Chang Wai Ke Za Zhi. 2013 Aug;16(8):748-52. Chinese.

    PMID: 23980046BACKGROUND
  • Deijen CL, Velthuis S, Tsai A, Mavroveli S, de Lange-de Klerk ES, Sietses C, Tuynman JB, Lacy AM, Hanna GB, Bonjer HJ. COLOR III: a multicentre randomised clinical trial comparing transanal TME versus laparoscopic TME for mid and low rectal cancer. Surg Endosc. 2016 Aug;30(8):3210-5. doi: 10.1007/s00464-015-4615-x. Epub 2015 Nov 4.

    PMID: 26537907BACKGROUND
  • Atallah S, Martin-Perez B, Albert M, deBeche-Adams T, Nassif G, Hunter L, Larach S. Transanal minimally invasive surgery for total mesorectal excision (TAMIS-TME): results and experience with the first 20 patients undergoing curative-intent rectal cancer surgery at a single institution. Tech Coloproctol. 2014 May;18(5):473-80. doi: 10.1007/s10151-013-1095-7. Epub 2013 Nov 23.

    PMID: 24272607BACKGROUND
  • Simillis C, Hompes R, Penna M, Rasheed S, Tekkis PP. A systematic review of transanal total mesorectal excision: is this the future of rectal cancer surgery? Colorectal Dis. 2016 Jan;18(1):19-36. doi: 10.1111/codi.13151.

    PMID: 26466751BACKGROUND

MeSH Terms

Conditions

Rectal Neoplasms

Condition Hierarchy (Ancestors)

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

Central Study Contacts

Mohammad Z Metwally, Ass.Lecturer

CONTACT

Sameh R Abdelazeez, Professor

CONTACT

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Assistant Lecturer

Study Record Dates

First Submitted

August 1, 2017

First Posted

August 8, 2017

Study Start

May 25, 2017

Primary Completion

January 25, 2019

Study Completion

December 30, 2019

Last Updated

August 8, 2017

Record last verified: 2017-08

Data Sharing

IPD Sharing
Will not share

Locations