NCT04248634

Evaluation of Delayed Coloanal Anastomosis

Short and Midterm Results of Delayed Colo-anal Anastomosis After Rectal Resection

• Status: Completed
• Phase: —
• Study type: Observational
• Enrollment: 20 (actual)
• Sponsor: Institut National d'Oncologie, Morocco · Other Government
• Sex: All
• Age: 18 Years
• Healthy volunteers: —

Summary

After rectal resection for cancer of the lower rectum, the restoration of continuity is done by a colo-anal anastomosis with a protective ileostomy. However, the ileostomy is very little accepted by patients. It is associated with significant morbidity and a deterioration in the quality of life. Delayed colo-anal anastomosis has been proposed as an alternative to direct colo-anal anastomosis with a protective ileostomy. The theoretical advantage of this technique is to reduce the risk of anastomotic leaks and to avoid ileostomy. In this study, the investigators will retrospectively evaluate the short and midterm results of this technique.

Detailed description

After rectal resection for cancer of the lower rectum, the restoration of continuity is done by a colo-anal anastomosis with a protective ileostomy. The latter reduces the risk and severity of clinical anastomotic fistulas. However, the ileostomy is very little accepted by patients. It is associated with significant morbidity reaching up to 30% of patients, a deterioration in the quality of life and the need for a second surgery to restore digestive continuity. And specifically in low-income countries, ostomy bags are expensive and are not reimbursed, and therefore constitute a heavy burden for Moroccan patients. In order to overcome these drawbacks, delayed colo-anal anastomosis has been proposed as an alternative to direct colo-anal anastomosis with a protective ileostomy. This technique consists of externalizing the colon in the first stage by the transanal route, without creating an ileostomy, and waiting a week for the creation of the anastomosis. The theoretical advantage of this technique is to reduce the risk of anastomotic leaks and to avoid ileostomy. Several studies have shown encouraging results in the short and midterm, and it is listed among the technical options in the French recommendations for the management of rectal cancer. In this study, the investigators will retrospectively evaluate the short and midterm results of this technique.

Conditions

• Rectal Neoplasms

Interventions

Type	Name	Description
PROCEDURE	Delayed colo-anal anastomosis	Colo-anal anastomosis performed in two surgical steps: \- Step one: the colon is exteriorized transanally and 5 cm of the colon is left outside without anastomosis creation. Step two: after 7 days, the excess colon is resected and the colo-anal anastomosis is created.

Timeline

• Start date: 2018-01-01
• Primary completion: 2019-12-31
• Completion: 2019-12-31
• First posted: 2020-01-30
• Last updated: 2020-02-20

Locations

1 site across 1 country: Morocco