Hernia Incisional, Neoplasms Malignant, Rectal Cancer, Surgery
Conditions
Keywords
Rectal cancer, mesh, stoma-site hernia, prevention, surgery
Brief summary
The goal of this clinical trial is to compare the efficacy of using polypropylene mesh for hernia prevention after stoma closure in patients with colorectal cancer and non-mesh repair. The main question it aims to answer is: can mesh help prevent hernia? Participants will be divided into 2 groups: with and without mesh using. They must be followed up for 2 years after enrollment in the study. Researchers will compare mesh and non-mesh groups to evaluate the benefits and harms of mesh using in hernia prevention.
Detailed description
This clinical trial is prospective randomized phase III study of the efficacy of polypropylene mesh for hernia prevention after stoma closure in patients with colorectal cancer. We will include in the study group 71 patients with colorectal cancer with ileo- and colostomy. In these patients we will do sublay/interoblique repair in prevention incisional hernias using polypropylene mesh. Our hypothesis is to reduce parastomal hernias rate from 30% to 10% over 2 years. Stratification will be used for patients with \>5 cm vs \<5 cm stoma-site hernia. The control group will include 71 patients with similar parameters who will undergo stoma closure with layered ligature suturing of the abdominal wall without mesh implantation. Additional endpoints are the wound infection rate, the complication rate (Clavien-Dindo), the rate of the repeated surgery for hernia at the site of stoma closure. We'll assess the quality of life by HerQLes (Hernia-Related Quality of Life Survey) scale.
Interventions
PROCEDUREmesh
We'll use mesh repair for prevention of stoma-site hernias in the study group.
PROCEDUREnon-mesh
We'll use the layered ligature suturing of the abdominal wall without mesh implantation in the control group.
Sponsors
Blokhin's Russian Cancer Research Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
1:1 electronic randomisation
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Signed informed consent * Absence of distant metastases (M0) * ECOG (Eastern Cooperative Oncology Group) status 0-2 * completed course of adjuvant treatment * Absence of acute inflammatory parastomal complications * Integrity of colorectal anastomosis
Exclusion criteria
* Inability to obtain consent to participate * Synchronous and metachronous malignant neoplasms * Clinically significant diseases of the cardiovascular system, liver, kidney, central nervous system * Parastomal inflammation and other conditions that increase the risk of postoperative complications * Pregnancy * HIV infection
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| hernia rate | 2 years | The rate of parastomal hernias after stoma closure for 2 years. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 90 day surgical morbidity | 90 days | Complications after stoma closure including hernias |
| Quality of life indicators by HerQLes scale | 2 years | Quality of life as assessed by Hernia-Related Quality of Life Survey scale (HerQLes) at 30 days, 1 year and 2 years after stoma closure (higher scores are worse) |
Countries
Russia
Contacts
Primary ContactSergey Gordeyev, D.Sc.
Outcome results
None listed