Robotic-Assisted or Laparoscopic Radical Resection for Rectal Cancer With or Without Left Colic Artery Preservation

Brief Summary

Background The preservation of the left colic artery (LCA) during rectal cancer resection remains a topic of controversy, and there is a notable absence of robust evidence regarding the outcomes associated with LCA preservation. And the advantages of robotic-assisted laparoscopy (RAL) surgery in rectal resection remain uncertain. The objective of this study was to assess the influence of LCA preservation surgery and RAL surgery on intraoperative and postoperative complications of rectal cancer resection.

Methods Participants who underwent laparoscopic (LSC) or RAL with or without LCA preservation resection for rectal cancer between April 2020 and May 2023 were retrospectively assessed. The patients were categorized into two groups: low ligation (LL) which with preservation of LCA and high ligation (HL) which without preservation of LCA. A one-to-one propensity score-matched analysis was performed to decrease confounding. The primary outcome was operative findings, operative morbidity, and postoperative genitourinary function.

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Key information

Conditions

Rectal Cancer Colorectal Neoplasms Digestive System Diseases Digestive System Neoplasms Disease Gastrointestinal Diseases Gastrointestinal Neoplasms Intestinal Diseases Intestinal Neoplasms Left Colic Artery Stenosis (Diagnosis) Neoplasms Neoplasms by Site Pathologic Processes Pathological Conditions, Signs and Symptoms Rectal Diseases Rectal Neoplasms Robotic Assisted Laparoscopic Surgery

Age range

18 year–75 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Northern Jiangsu People's Hospital Affiliated to Yangzhou University, General Surgery Institute of Yangzhou, Yangzhou University , Yangzhou

Yangzhou, Jiangsu, 225001, China

About this study

The investigators retrospectively collected data from the medical records of participants who had rectal cancer at Northern Jiangsu People's Hospital, from April 2020 to May 2023. A total of 612 from 1164 cases were included in this study; in 462 cases, the LCA was preserved by LL intraoperatively (LL group), in which 202 cases underwent robotic-assisted laparoscopy (LL-RAL subgroup) and 260 cases underwent laparoscopy (LL-LSC subgroup). While in the remaining 150 cases, the LCA was not preserved by HL intraoperatively (HL group). in which 70 cases underwent robotic-assisted laparoscopy (HL-RAL subgroup) and 80 cases underwent laparoscopy (HL-LSC subgroup).

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Low anterior resection for rectal cancer
Postoperative pathological diagnosis of rectal adenocarcinoma
Informed consent signed prior to surgery.

Exclusion criteria

Recurrent rectal cancer
Emergency surgery
Preoperative and intraoperative detection of distant organ metastases or extensive
Implantation metastases in the abdominal cavity
Palliative surgery
A postoperative pathology report that showed residual cancer cells at the proximal or distal resection margin
No standard chemotherapy for tumor-node-metastasis (TNM) staging II or III after surgery
Synchronous colorectal carcinoma and other organ tumors
Incomplete case data.

Treatment and study plan

with or without Left Colic Artery Preservation

Procedure

low ligation (LL) which with preservation of LCA and high ligation (HL) which without preservation of LCA

Primary outcomes

The incidence of anastomotic leakage in postoperative patients with or without left colic artery preservation.

Time frame: 2 weeks within the surgery

Within two weeks after surgery, the patient experienced abdominal pain, fever, and imaging diagnosis showed anastomotic leakage.

Secondary outcomes

The genitourinary function of the patients after the radical resection with or without left colic artery preservation.

Time frame: 6 to 12 months after operation

The genitourinary function includes urinary dysfunction and sexual dysfunction. Residual urine volume and catheterization retention time for evaluating urinary function. Erectile and ejaculatory grading scores are used to evaluate sexual function.

Sponsors and collaborators

Lead sponsor

Northern Jiangsu People's Hospital

Other

Registry information

Official study title

With or Without Left Colic Artery Preservation

Important dates

Study start: 2020
Primary completion: 2023
Study completion: 2023
First posted: Apr 19, 2024
Registry last updated: Apr 22, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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