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COLOR IV:一项多中心随机临床试验,比较腹腔镜右半结肠癌切除术后体内与体外回结肠吻合术。

COLOR IV: a multicenter randomized clinical trial comparing intracorporeal and extracorporeal ileocolic anastomosis after laparoscopic right colectomy for colon cancer.

作者信息

Wu Si, Wei Pengyu, Gao Jiale, Shu Wenlong, Zhao Hanzheng, Bonjer Hendrik, Tuynman Jurriaan, Yao Hongwei, Zhang Zhongtao

机构信息

State Key Lab of Digestive Health, Department of General Surgery, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing, 100050, China.

Department of Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands.

出版信息

Surg Endosc. 2025 Feb;39(2):1182-1190. doi: 10.1007/s00464-024-11412-7. Epub 2024 Dec 28.

Abstract

INTRODUCTION

Right-sided colon cancer is a prevalent malignancy. The standard surgical treatment for this condition is laparoscopic right hemicolectomy, with ileocolic anastomosis being a crucial step in the procedure. Recently, intracorporeal ileocolic anastomosis has garnered attention for its minimally invasive benefits. However, there remains a paucity of rigorously designed, large-scale, international multicenter randomized controlled trials to definitively assess the safety and efficacy of intracorporeal ileocolic anastomosis in laparoscopic right hemicolectomy for right-sided colon cancer.

METHODS

This study is an international, multicenter, randomized, controlled, open-label, non-inferiority trial designed to compare the safety and efficacy of intracorporeal versus extracorporeal ileocolic anastomosis in patients with right-sided colon cancer undergoing right hemicolectomy. The primary endpoint is the anastomotic leakage rate within 30 days post-surgery. The main secondary endpoint is the 3-year disease-free survival rate post-surgery. A comprehensive quality assurance protocol will be established before the trial begins, including CT review, pathological evaluation, and the standardization and assessment of surgical techniques.

DISCUSSION

This study aims to evaluate the safety and efficacy of intracorporeal ileocolic anastomosis following right hemicolectomy in patients with right-sided colon cancer. The anticipated outcome is that intracorporeal ileocolic anastomosis will show an anastomotic leakage rate and a 3-year disease-free survival rate comparable to those of extracorporeal anastomosis, while offering the added benefit of faster postoperative recovery.

摘要

引言

右侧结肠癌是一种常见的恶性肿瘤。针对这种疾病的标准手术治疗方法是腹腔镜右半结肠切除术,回结肠吻合术是该手术的关键步骤。最近,体内回结肠吻合术因其微创优势而受到关注。然而,目前仍缺乏设计严谨、大规模的国际多中心随机对照试验,以明确评估体内回结肠吻合术在腹腔镜右半结肠切除治疗右侧结肠癌中的安全性和有效性。

方法

本研究是一项国际多中心随机对照开放标签非劣效性试验,旨在比较右侧结肠癌患者在接受右半结肠切除术时,体内与体外回结肠吻合术的安全性和有效性。主要终点是术后30天内的吻合口漏率。主要次要终点是术后3年无病生存率。在试验开始前将建立全面的质量保证方案,包括CT复查、病理评估以及手术技术的标准化和评估。

讨论

本研究旨在评估右侧结肠癌患者右半结肠切除术后体内回结肠吻合术的安全性和有效性。预期结果是,体内回结肠吻合术的吻合口漏率和3年无病生存率将与体外吻合术相当,同时还具有术后恢复更快的额外优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abdb/11794397/c24142588a2e/464_2024_11412_Fig1_HTML.jpg

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