Clinical trial · Observational
Rectal Cancer Anastomosis 4 Check Study
Rectal Cancer 4 Check Study
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
Anastomotic failure (AF), including anastomotic leakage (AL), increases morbidity and mortality after colorectal cancer (CRC) resection. An inadequate perfusion of the anastomosis or technical stapling defects may contribute to AF. Several studies evaluated the singular use of intraoperative near infrared (NIR) indocyanine green (ICG)-induced fluorescence angiography (FA) and air leak testing to assess the integrity and the perfusion levels of the colorectal anastomosis. So far, a combined use of these methodologies, although acknowledged has not yet been tested as an indicator of postoperative AF or of intra-operative anastomotic repair in a prospective setting. This study aims to implement the intraoperative anastomotic assessment in a prospective series of patients undergoing rectal resection plus primary anastomosis for rectal cancer with or without ostomy, using a semi-quantitative check of 4 items (4-check). The procedure will include NIR-ICG-induced FA (to assess perfusion), air leak test and evaluation of the anastomotic donuts (to assess for the presence of technical defects). Included patients will be those scheduled for elective rectal resection with total or partial mesorectal excision and primary colo-rectal anastomosis with/or without protective ostomy. Primary outcomes will be the overall incidence of intra-operative anastomotic repair and the rate of post-operative AF. Secondary outcomes will be the overall incidence of adverse events and serious complications, the estimation of costs and resources, the operative time, hospitalization and post-operative measurement of inflammatory markers.
Conditions
Conditions (1)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Rectal Cancer | Malignant Rectal Neoplasm | CURATED_EXACT | 0.92 |
Interventions
Interventions (3)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| Air Leak test | Diagnostic Test | — | UNRESOLVED |
| Evaluation of the anastomotic rings | Diagnostic Test | — | UNRESOLVED |
| intraoperative near infrared (NIR) indocyanine green (ICG)-induced fluorescence angiography (FA) and air leak testing to assess the integrity and the perfusion levels of the colorectal anastomosis | Combination Product | — | UNRESOLVED |
Design
Arms and outcomes
Arms (1)
- label
- REC4T study patients
- description
- Rectal adenocarcinoma or polyp with indication for resection and primary colo-rectal mechanical anastomosis using a circular stapler with/or without protective ostomy undergoing upfront surgery and patients undergoing neoadjuvant therapy followed by surgery (see Inclusion/Exclusion Criteria)
- interventionNames
- Combination Product: intraoperative near infrared (NIR) indocyanine green (ICG)-induced fluorescence angiography (FA) and air leak testing to assess the integrity and the perfusion levels of the colorectal anastomosis
- Diagnostic Test: Air Leak test
- Diagnostic Test: Evaluation of the anastomotic rings
Primary outcomes (2)
- measure
- intra-operative anastomosis repairs
- timeFrame
- 01/01/2021 to 31/12/2022
- description
- defined as additional suturing or re-do anastomosis
- measure
- Rate of 30 day-anastomotic failure (AF)
- timeFrame
Eligibility
Eligibility (as posted)
- Sex
- All
- Minimum age
- 18 Years
Show eligibility criteria text
Inclusion Criteria: * 18 years or older. * Rectal adenocarcinoma or benign polyp with indication for rectal resection with total or partial mesorectal excision and primary colo-rectal anastomosis with/or without protective ostomy. * Patients undergoing upfront surgery and patients undergoing neoadjuvant therapy followed by surgery. * Patients with adequate performance status (Eastern Cooperative Oncology Group Scale score of ≤2). * Patient must sign the Informed Consent Form (ICF) before any study procedures and agrees to attend all study visits. * Selection of the patient before inclusion. Exclusion Criteria: * • Patient pregnant or suspected pregnancy. * Patient with a comorbid illness or condition that would preclude the use of surgery. * Past medical history of Inflammatory Bowel Disease (IBD). * Synchronous cancers requiring extended sub-total or total colectomies. * Long lasting therapy with steroids to be continued in the peri-operative period (4 weeks previous and 4 weeks after surgery). * Use of antiplatelet drug (anti-aggregant) and/or oral anti-coagulant drug to be continued in the peri-operative period (1 week previous and 4 weeks after surgery). * Patients assessed as American Society of Anesthesiologists (ASA) physical status 4. * Patients with clinical stage of cT4b tumor after neoadjuvant theapy. * Metastatic disease (clinical Stage 4). * Patient undergoing emergency procedures. * Planned colonic surgery along with major concomitant procedures (i.e. liver resections, other intestinal resections). * Previous colon surgery (excluding appendectomy). * Non-restorative procedures (i.e. Miles or Hartman resection). * Colo-anal manual anastomosis.
References
Publications (0)
Data not yet available