Mid-low rectal cancer
Conditions
Interventions
IMA-LN sweeping group:Cleansing of lymph nodes at the start of the IMA
IMA-LN Reserved Group:No clearance of lymph nodes in the root of the inferior mesenteric artery
Sponsors
Zhongshan Hospital, Fudan University
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1.Age greater than 18 and less than or equal to 80 years old; 2.Colonoscopic biopsy pathology confirms diagnosis of rectal adenocarcinoma; 3.Tumour less than or equal to 10cm from anal verge; 4.No root lymph node metastasis to the inferior mesenteric artery and no lateral lymph node metastasis as determined by ultrasound, enhanced CT and/or PET-CT (diagnosis of metastatic lymph nodes based on CSCO Guidelines 2024 edition); 5.Absence of distant metastases (including pelvic, peritoneal, hepatic, pulmonary, cerebral, skeletal, and distant lymph node metastases) as determined by ultrasound, enhanced CT and/or PET-CT, etc. 6.Pelvic MRI and/or transrectal intraluminal ultrasonography to determine that the tumour is cT1-T3 N0-1, or ycT1-T3 Nx after neoadjuvant therapy (preoperative radiotherapy, chemotherapy, immunotherapy, targeted therapy, etc.); 7.No history of other malignant disease (except appropriately treated basal cell carcinoma of the skin or carcinoma in situ of the cervix); 8.Suitable for robotic surgery; 9.informed consent;
Exclusion criteria
Exclusion criteria: 1.Complete clinical remission of the tumour after radiotherapy, chemotherapy, immunotherapy, targeted therapy, etc. 2.cT1N0 suitable for local excision; 3.Emergency surgery for acute intestinal obstruction, bleeding, perforation, etc; 4.Multiple primary colorectal malignancies; 5.Familial adenomatous polyposis (FAP), Lynch syndrome, inflammatory bowel disease; 6.Other conditions requiring simultaneous colectomy; 7.American Society of Anaesthesiologists (ASA) classification greater than III; 8.Pregnancy and lactation; 9.Preoperative short course radiotherapy; 10.Inability of the patient or family to understand the conditions and objectives of the study;
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 3-year relapse-free rate; | — |
Secondary
| Measure | Time frame |
|---|---|
| Quality of life;Short-term postoperative rehabilitation outcomes;Pathological findings;Long-term survival outcomes;End of Health Economics;Quality of surgery; | — |
Countries
China
Contacts
Public ContactJianmin Xu
Zhongshan Hospital, Fudan University
Outcome results
None listed