Safe D3 Right Hemicolectomy for Cancer Through Multidetector Computed Tomography (MDCT) Angio

This study is currently recruiting participants.
Verified January 2013 by Sykehuset i Vestfold HF
Sponsor:
Collaborators:
University Hospital, Akershus
Haukeland University Hospital
Information provided by (Responsible Party):
Dejan Ignjatovic, University Hospital, Akershus
ClinicalTrials.gov Identifier:
NCT01351714
First received: May 9, 2011
Last updated: January 25, 2013
Last verified: January 2013

May 9, 2011
January 25, 2013
May 2011
May 2015   (final data collection date for primary outcome measure)
Number of additional lymph nodes removed through radical D3 resection [ Time Frame: 1 year ] [ Designated as safety issue: No ]
The short term outcome of this study will compare number of lymph nodes removed, operating time and complications between the two groups.
Same as current
Complete list of historical versions of study NCT01351714 on ClinicalTrials.gov Archive Site
Disease free survival 2 and 5 years after initial surgery [ Time Frame: 5 years ] [ Designated as safety issue: No ]
One will compare disease free survival at 2 and 5 years between the two groups to see if those more radically operated through D3 resection will have better outcomes.
Same as current
Not Provided
Not Provided
 
Safe D3 Right Hemicolectomy for Cancer Through Multidetector Computed Tomography (MDCT) Angio
Safe D3 Right Hemicolectomy for Cancer Through 3D MDCT Angiography Reconstruction

When performing a resection of the right colon due to cancer one aims not only to remove the tumor bearing bowel segment, but also lymph nodes draining the affected area. These lymph nodes are located along the arteries supplying the right colon. Through using a preoperative CT scan which can map these arteries very precisely one can ligate these vessels closer to their origin and thus remove more lymph nodes which may potentially harbor cancer cells. This study aims to compare patients operated more radically through use of preoperative CT which maps the mentioned arteries with patients operated in the standard way.

The Norwegian gastrointestinal cancer group has recommended D3 resection as the standard operative technique for colon cancer. D3 resection implies ligation of the blood vessels at their origin. There is evidence that the recurrence free period and survival improves with the number of lymph nodes harvested at surgery. However, the current practice in Norway, while performing right hemicolectomy for cancer is to ligate the feeding vessels for the right colon on the right hand side of the superior mesenteric vein (SMV). Significant arterial stumps have been demonstrated in patients operated for right colon cancer with this technique (right colic artery and ileocolic artery vascular stumps with an average length of 3.5 cm and 2.5 cm, respectively). This leaves reason to believe that a certain number of central lymph nodes remain after the procedure.

The complex anatomical relationship between the right colic artery and ileocolic artery with the superior mesenteric vein make D3 resection demanding, especially if the right colic artery lies posterior to the SMV. These relationships are investigated in detail in postmortem anatomical studies. These studies show that the right colic artery lies most often anterior to the SMV, while the ileocolic artery lies most often posterior to the SMV. Data has also been provided that a CT angiography can verify these relations as well as postmortem anatomical studies in living patients, thus allowing the surgeon to be aware of them prior to surgery. This could prove to be crucial in planning the procedure.

Interventional
Not Provided
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Colon Cancer
Procedure: D3 resection
Radical D3 resection of the right colon through the use of preoperative MDCT angiography
D3 resection
Radical D3 resection of the right colon through the use of preoperative MDCT angiography
Intervention: Procedure: D3 resection
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
231
May 2017
May 2015   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Patients with histo-pathologically verified adeno-carcinoma of the right colon
  • Patients under the age of 75
  • Patients medically cleared by anesthesiologist for general anesthesia
  • Signed informed consent form

Exclusion Criteria:

  • Patients with recurrent cancer after previous surgery
  • Patients with distant metastasis
  • Patients who are not medically cleared to undergo anesthesia
  • Patients who do not sign the informed consent form
Both
20 Years to 75 Years
No
Contact: Dejan Ignjatovic, MD, PhD +4746681797 dexexer01@hotmail.com
Contact: Bojan Stimec, MD, PhD bojan.stimec@gmail.com
Norway
 
NCT01351714
D3 MDCT angio
Yes
Dejan Ignjatovic, University Hospital, Akershus
Sykehuset i Vestfold HF
  • University Hospital, Akershus
  • Haukeland University Hospital
Not Provided
Sykehuset i Vestfold HF
January 2013

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP