LIRRH Trial for the Right-sided Colon Cancer

Summary

The aim of this clinical trial is to compare the short- and long-term outcomes of laparoscopic ileocecal reconstruction right hemicolectomy (LIRRH) with those of traditional laparoscopic right hemicolectomy (TRH) for ascending and proximal transverse colon cancer.

Eligibility

Inclusion Criteria:

* Age 18-75 years
* ASA physical status ≤ III
* Endoscopy and biopsy-proven colon adenocarcinoma
* Contrast-enhanced abdominal CT showing primary tumor located in the ascending colon or proximal transverse colon (proximal one-third)
* Pre-operative clinical stage: TanyNanyM0
* Able to understand the study protocol, willing to participate, and provide written informed consent

Exclusion Criteria:

* History of hypertensive crisis or hypertensive encephalopathy.
* Severe cardiopulmonary insufficiency or any other contraindication to surgery.
* Uncorrectable electrolyte disturbances (e.g., potassium, calcium, magnesium).
* Evidence of significant bleeding diathesis or high hemorrhagic risk:
* Prior intracranial or intraspinal hemorrhage.
* Tumor invading major vessels with obvious bleeding risk.
* Thrombotic or embolic event within 6 months before study treatment, or significant vascular disease (e.g., surgical-repair aortic aneurysm).
* Clinically relevant hemoptysis or tumor bleeding of any cause within 1 month before screening.
* Therapeutic-dose anticoagulation within 2 weeks before study treatment (except low-molecular-weight heparin).
* Antiplatelet therapy within 10 days before study treatment (e.g., aspirin \> 325 mg/day, clopidogrel \> 75 mg/day, dipyridamole, ticlopidine, cilostazol).
* Active tuberculosis.
* Any active autoimmune disease or history of autoimmune disease with expected recurrence (including but not limited to SLE, RA, autoimmune hepatitis, uveitis, enteritis, hepatitis, hypophysitis, vasculitis, nephritis, hyper- or hypothyroidism, asthma requiring bronchodilators).
* Pre-operative evidence of synchronous multiple primary colorectal cancers or other conditions requiring additional bowel resection.
* Pre-operative imaging or intra-operative findings showing:
* Tumor infiltration into adjacent organs requiring multi-visceral resection;
* Distant metastasis;
* Unresectable (unable to achieve R0) disease.
* Other malignancies within the past 5 years, or familial adenomatous polyposis; except cured carcinoma in situ of the cervix, basal-cell carcinoma, papillary thyroid carcinoma, or cutaneous squamous-cell carcinoma.
* Intestinal obstruction, perforation, or bleeding requiring emergency surgery.
* Patient unsuitable or unable to tolerate laparoscopic surgery.
* Pregnant or lactating women.
* History of psychiatric disorders precluding compliance.
* Prior neoadjuvant therapy.
* Multidisciplinary team (MDT) decision that the patient is not appropriate for the study.
* Patient unable to understand the study conditions/objectives and refuses to give informed consent.

Conditions3

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