Ignite Creation Date:
2024-05-05 @ 5:35 PM
Last Modification Date:
2024-10-26 @ 9:33 AM
Study NCT ID:
NCT00485251
Status:
COMPLETED
Last Update Posted:
2009-11-25
First Post:
2007-06-11
Brief Title:
Prospective Randomized Trial of Hand-assisted Laparoscopic Right Hemicolectomy vs Total Laparoscopic Right Hemicolectomy
Sponsor:
Pamela Youde Nethersole Eastern Hospital
Organization:
Pamela Youde Nethersole Eastern Hospital
Study Overview
Official Title:
None
Status:
COMPLETED
Status Verified Date:
2009-11
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The operation used for treating cancer in this location of the colon is called right hemicolectomy Currently the investigators have two methods of minimal access approach to the abdominal cavity in order to complete this operation
1 Total Laparoscopic right hemicolectomy The operation is completed by laparoscopic instruments using video laparoscopy At the end of the procedure a small wound was created for the delivery of bowel and extracorporeal anastomosis
2 Hand-assisted laparoscopic right Hemicolectomy A 65cm incision is used to allow insertion of one of the surgeons hands into the abdomen The operation is completed by the surgeons hand and laparoscopic instruments using video laparoscopy
These two operations are essentially identical except for the surgical access Both total laparoscopic and Hand-assisted laparoscopic surgery has been practiced in the United States and Europe for over 10 years Studies from the United State and Europe have demonstrated the safety and the benefits of both techniques in terms of pain and recovery In order to find out which one is a better procedure the investigators are carrying out a clinical trial to compare the two surgical options in their short-term and long term outcomes
The results of this study may have an impact on the care of similar patients in the future
1 Total Laparoscopic right hemicolectomy The operation is completed by laparoscopic instruments using video laparoscopy At the end of the procedure a small wound was created for the delivery of bowel and extracorporeal anastomosis
2 Hand-assisted laparoscopic right Hemicolectomy A 65cm incision is used to allow insertion of one of the surgeons hands into the abdomen The operation is completed by the surgeons hand and laparoscopic instruments using video laparoscopy
These two operations are essentially identical except for the surgical access Both total laparoscopic and Hand-assisted laparoscopic surgery has been practiced in the United States and Europe for over 10 years Studies from the United State and Europe have demonstrated the safety and the benefits of both techniques in terms of pain and recovery In order to find out which one is a better procedure the investigators are carrying out a clinical trial to compare the two surgical options in their short-term and long term outcomes
The results of this study may have an impact on the care of similar patients in the future
Detailed Description:
Under ALL circumstances the principles in the Declaration of Helsinki MUST be complied
One of the colorectal specialists Dr CC Chung Dr KK Yau Dr JCH Wong and Dr HY S Cheung in the colorectal team will be informed Clear explanation of the diagnosis natural history of the disease different treatment options their likely outcomes and potential complications will be given If the patient opts for surgical treatment he she will be invited to enter the study Further explanation about the study will then be given The patient information sheet will be given The patient will then be allowed with all the time heshe needed for decision
Randomization
By drawing from concealed envelopes into either the total lap Total laparoscopic right hemicolectomy or the hand-assisted Hand-assisted laparoscopic right hemicolectomy groups
The Operation
1 Patients were put on a liquid diet the day before operation All received mechanical bowel preparation the night before surgery
2 Prophylactic antibiotics with be given
Cefuroxime 15gm IVI Metronidazole 500mg IVI on induction
3 Operation should be performed by two of the following surgeons under general anaesthesia
Dr HYS Cheung Dr JCH Wong Dr CC Chung Dr KK Yau
4 either Total laparoscopic right hemicolectomy or Hand-assisted right hemicolectomy will be performed according to the randomization
Standardized post-operative care
1 All patients would receive patient control analgesia PCA in the form of intravenous bolus morphine in the immediate postoperative period The dosage and regimen were reviewed by the anaesthetists in-charge who would stop the PCA according to their usual practice Thereafter Pethidine 1mgkg was given intramuscularly every 4 hours on demand In addition two tablets of dologesic were prescribed orally every 4 hours on demand
2 Resume diet and off intravenous fluid as tolerated
3 The pain score was recorded from postoperative day 1 to day 7
4 Date of ambulation postoperative mortality and pathology were recorded
Discharge Criteria
1 Ambulatory or resume the pre-operative motility status
2 Free from any complications that required inpatient management
3 Had at least one bowel motion
4 Did not require parental analgesia
Follow Up Arrangement
1 They were reviewed by clinical oncologists as outpatients and adjuvant chemotherapy were selectively offered based on the final histological staging of the disease
2 All patients were followed up in the surgical clinic according to the structured proforma They were followed up 4-monthly in the first 3 years and 6-monthly thereafter CEA would be taken at each visit CXR and ultrasound abdomen would be analyzed annually Surveillance colonoscopy would be analyzed every 3 years
One of the colorectal specialists Dr CC Chung Dr KK Yau Dr JCH Wong and Dr HY S Cheung in the colorectal team will be informed Clear explanation of the diagnosis natural history of the disease different treatment options their likely outcomes and potential complications will be given If the patient opts for surgical treatment he she will be invited to enter the study Further explanation about the study will then be given The patient information sheet will be given The patient will then be allowed with all the time heshe needed for decision
Randomization
By drawing from concealed envelopes into either the total lap Total laparoscopic right hemicolectomy or the hand-assisted Hand-assisted laparoscopic right hemicolectomy groups
The Operation
1 Patients were put on a liquid diet the day before operation All received mechanical bowel preparation the night before surgery
2 Prophylactic antibiotics with be given
Cefuroxime 15gm IVI Metronidazole 500mg IVI on induction
3 Operation should be performed by two of the following surgeons under general anaesthesia
Dr HYS Cheung Dr JCH Wong Dr CC Chung Dr KK Yau
4 either Total laparoscopic right hemicolectomy or Hand-assisted right hemicolectomy will be performed according to the randomization
Standardized post-operative care
1 All patients would receive patient control analgesia PCA in the form of intravenous bolus morphine in the immediate postoperative period The dosage and regimen were reviewed by the anaesthetists in-charge who would stop the PCA according to their usual practice Thereafter Pethidine 1mgkg was given intramuscularly every 4 hours on demand In addition two tablets of dologesic were prescribed orally every 4 hours on demand
2 Resume diet and off intravenous fluid as tolerated
3 The pain score was recorded from postoperative day 1 to day 7
4 Date of ambulation postoperative mortality and pathology were recorded
Discharge Criteria
1 Ambulatory or resume the pre-operative motility status
2 Free from any complications that required inpatient management
3 Had at least one bowel motion
4 Did not require parental analgesia
Follow Up Arrangement
1 They were reviewed by clinical oncologists as outpatients and adjuvant chemotherapy were selectively offered based on the final histological staging of the disease
2 All patients were followed up in the surgical clinic according to the structured proforma They were followed up 4-monthly in the first 3 years and 6-monthly thereafter CEA would be taken at each visit CXR and ultrasound abdomen would be analyzed annually Surveillance colonoscopy would be analyzed every 3 years
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None