End to End Anastomosis With Omega Suture Versus End to Anterior Rectal Wall In Colorectal Anastomosis in Sigmoid and Upper Rectal Cancer
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: End to end with Omega suture, End to anterior rectal wall.
- Who it may be relevant to
- Registry conditions: End to End Anastomosis, Colorectal Anastomosis, End to Anterior Rectal Wall, Sigmoid Cancer. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Egypt
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
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
Overview
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.
Detailed description
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.
Interventions
- Other 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. - Other 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.
Primary outcome measures
- Anastomotic leakage [Time frame: 5 days after surgery]
Secondary outcome measures (4)
- Operative time [Time frame: Until the procedure is completed]
- Hospital stay [Time frame: 28 days postoperative]
- Time of bowel function [Time frame: 7 days postoperative]
- Wound complications [Time frame: 7 days postoperative]
Eligibility criteria
Inclusion criteria
- Patients aged >18 years.
- Both sexes.
- Recto sigmoidal carcinoma.
- Upper rectal cancer.
Exclusion criteria
- 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
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Treatment
Study locations
Egypt · 1 center
- Ain Shams University — Cairo
Identifiers
NCT: NCT06546176 · 13/8/2023