LISH Trial for the Hepatic Flexure and Proximal Transverse Colon Cancer
Laparoscopic Ileocecal-Sparing Right Hemicolectomy for Cancer of the Hepatic Flexure and Proximal Transverse Colon -- A Prospective, Multicenter Randomized Control Clinical Trial
Zhejiang University
568 participants
May 14, 2023
INTERVENTIONAL
Conditions
Summary
The goal of this clinical trial is to compare the long-term outcomes of Laparoscopic Ileocecal-Sparing Right Hemicolectomy(LISH) compared to traditional laparoscopic right hemicolectomy(TRH) in the treatment of hepatic flexure colon cancer and proximal transverse colon cancer.
Eligibility
Inclusion Criteria6
- Age between 18-75 years old
- ASA classification ≤III
- Colon adenocarcinoma confirmed by endoscopy and pathological biopsy
- Enhanced abdominal CT indicating the primary lesion is located in the hepatic flexure of the colon or proximal transverse colon (proximal 1/3 of the transverse colon)
- Preoperative clinical staging: TanyNanyM0
- Patients able to understand the study protocol, willing to participate in the research, and providing written informed consent
Exclusion Criteria11
- Preoperative examination indicates synchronous multiple primary colorectal cancers or other diseases requiring bowel segment resection
- Preoperative imaging or intraoperative exploration reveals: 1) tumor involving surrounding organs requiring combined organ resection; 2) presence of distant metastasis; 3) inability to perform R0 resection; 4) fused and fixed lymph nodes at the root of the ileocolic vessels
- Additional radical surgery following Endoscopic Mucosal Resection (EMR) and Endoscopic Submucosal Dissection (ESD) procedures
- History of any other malignant tumor within the last 5 years or familial adenomatous polyposis, except for cured in situ cervical cancer, basal cell carcinoma, papillary thyroid carcinoma, or skin squamous cell carcinoma
- Presence of bowel obstruction, bowel perforation, or intestinal bleeding requiring emergency surgery
- Patients unsuitable for or unable to tolerate laparoscopic surgery
- Pregnant or lactating women
- Patients with a history of psychiatric disorders
- Patients who have received neoadjuvant therapy prior to surgery
- Patients deemed unsuitable for the study by MDT discussion
- Patients unable to understand the study's conditions and objectives, and refusing to sign informed consent.
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Interventions
Preserve the ileocolic blood vessels, and perform dissection of lymph node groups 203, 202, and 201d along the root of ICV(Ileocolic artery)/ICA(Ileocolic vein). Group 201d lymph nodes are defined as the distal lymph nodes of the ileocolic vessels (colonic branch). Use an intracavitary cutting and sealing device to transect the proximal colon along the predetermined margin, and transect the transverse colon at 10cm distal to the tumor. Perform ileocecal-transverse colonic anastomosis.
Transect the root of the ileocolic vessels and perform dissection of lymph node groups 203, 202, and 201; sever the roots of the right colic and middle colic vessels, and clear the surrounding lymphoadipose tissue (lymph node groups 211/212/213 and 221/222/223). Transect the transverse colon 10cm distal to the tumor and cut the terminal ileum 10cm from the ileocecal junction. Perform ileum-to-transverse colon anastomosis.
Locations(29)
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NCT05923255