This is a prospective, randomized controlled study. The study population will include 220 subjects scheduled to undergo laparoscopic radical resection of rectal carcinoma with preventive ileostomy (Phase 1 operation). During the Phase 1 operation, when the definite decision to create a temporary ostomy is made, patients will be randomized in 1:1 ratio to either the treatment arm (INTERCEED™) or the control arm (standard of care treatment: no adhesion barrier, no placebo). In subjects assigned to the treatment arm, the INTERCEED™ must be applied beneath the target incision site (the midline incision mainly for the removal specimen). The subjects will return 3-9 months after the phase 1 operation (colorectal resection with temporary ileostomy) for phase 2 operation, to have their diverting ostomy taken down (ileostomy reversal). During the phase 2 operation (ileostomy reversal), the incidence, extent and severity of adhesions will be evaluated through the laparoscope.
This is a prospective, randomized controlled study. The study population will include 220 subjects scheduled to undergo laparoscopic radical resection of rectal carcinoma with preventive ileostomy (Phase 1 operation). During the Phase 1 operation, when the definite decision to create a temporary ostomy is made, patients will be randomized in 1:1 ratio to either the treatment arm (INTERCEED™) or the control arm (standard of care treatment: no adhesion barrier, no placebo). In subjects assigned to the treatment arm, the INTERCEED™ must be applied beneath the target incision site (the midline incision mainly for the removal specimen). The subjects will return 3-9 months after the phase 1 operation (colorectal resection with temporary ileostomy) for phase 2 operation, to have their diverting ostomy taken down (ileostomy reversal). During the phase 2 operation (ileostomy reversal), the incidence, extent and severity of adhesions will be evaluated through the laparoscope. An ad-hoc interim analysis is proposed based on feedback received from the investigators who observed very low rate of adhesions at the second procedure for ostomy reversal. The ad-hoc interim analysis is planned to be performed while at least 61% of the total number of participants with evaluable primary endpoints are available. If the conditional power (CP) is ≤ 60%, the observed adhesion rate difference magnitude is much less than the assumed difference magnitude of 0.25, therefore, the study will be terminated due to low adhesion rate and small effect size between INTERCEED and control arms. Otherwise, the study will continue until the study completion as planned.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
175
when the definite decision to create a temporary ostomy is made, patients will be randomized in 1:1 ratio to either the treatment arm (INTERCEED™) or the control arm (standard of care treatment: no adhesion barrier, no placebo). In subjects assigned to the treatment arm, the INTERCEED™ must be applied beneath the target incision site (the midline incision mainly for the removal specimen)
During the Phase 1 operation, when the definite decision to create a temporary ostomy is made, patients will be randomized in 1:1 ratio to either the treatment arm (INTERCEED™) or the control arm (standard of care treatment: no adhesion barrier, no placebo).
Peking University People's Hospital
Beijing, Beijing Municipality, China
First affiliated hospital of zhengzhou university
Zhengzhou, Henan, China
Xiangya Hospital Central South University
Changsha, Hunan, China
The 2nd affiliated Hospital of Zhongnan University
Changsha, Hunan, China
The affiliated Hospital of Xuzhou Medical University
Xuzhou, Jiangsu, China
The First Affiliated Hospital of Nanchang University
Nanchang, Jiangxi, China
The First Hospital of Jilin University
Changchun, Jilin, China
Shanghai Jiaotong University School of Medcine, Ruijin Hospital
Shanghai, Shanghai Municipality, China
Shanghai Tenth People's Hospital
Shanghai, Shanghai Municipality, China
Chinese PLA General Hospital
Beijing, China
...and 2 more locations
Percentage of Participants Free of Adhesions at the Target Incision Site
Percentage of participants free of adhesions at the target incision site in each study group based on evaluation through laparoscopy at ileostomy reversal were reported.
Time frame: 3 to 9 months after phase 1 operation
Number of Participants With Extent of Adhesions at Target Incision Site in Phase 2 Operation
Number of participants with extent of adhesions at target incision site in Phase 2 operation were reported. The extent of adhesions (percentage of the area covered by adhesion) was evaluated based on Grade 1: mild, covering up to 25 percent (%) of the total area and length; Grade 2: moderate, covering 26%-50% of the total area and length; and Grade 3: severe, covering over 50% of the total area and length.
Time frame: 3 to 6 months after phase 1 operation
Number of Participants With Severity of Adhesions at Target Incision Site in Phase 2 Operation
Number of participants with severity of adhesions at target incision site in Phase 2 operation were reported. The severity of adhesions was evaluated based on Grade 1: filmy thickness, avascular; Grade 2: moderate thickness, limited vascularity and Grade 3: dense thickness, vascularized.
Time frame: 3 to 9 months after phase 1 operation
Number of Participants With Extent of Adhesions at Four Abdominal Quadrants in Phase 2 Operation
Number of participants with extent of adhesions at four abdominal quadrants in Phase 2 operation were reported. The abdominal cavity was divided into four abdominal quadrants as: Right upper abdominal quadrant, Left upper abdominal quadrant, Right lower abdominal quadrant and Left lower abdominal quadrant and the extent of adhesions (percentage of the area covered by adhesion) was evaluated based on Grade 1: mild, covering up to 25% of the total area and length; Grade 2: moderate, covering 26%-50% of the total area and length; and Grade 3: severe, covering over 50% of the total area and length. One participant may have multiple sites of adhesion.
Time frame: 3 to 9 months after phase 1 operation
Number of Participants With Severity of Adhesions at Four Abdominal Quadrants in Phase 2 Operation
Number of participants with severity of adhesions at four abdominal quadrants in Phase 2 operation were reported. The abdominal cavity was divided into four abdominal quadrants as: Right upper abdominal quadrant, Left upper abdominal quadrant, Right lower abdominal quadrant and Left lower abdominal quadrant and the severity of adhesions was evaluated based on Grade 1: filmy thickness, avascular; Grade 2: moderate thickness, limited vascularity and Grade 3: dense thickness, vascularized. One participant may have multiple sites of adhesion.
Time frame: 3 to 6 months after phase 1 operation
Number of Participants With Mechanical Ileus
Number of participants with mechanical ileus were reported. Incidence of mechanical ileus was defined as the mechanical ileus judged by investigators, which occurred 1 week after Phase 1 operation. Incidence of mechanical ileus was reported based on three categories: Post-Phase 1 operation through 7 days after Phase 1 operation (less than or equal to \[\<=\] 7 days) (for participants underwent Phase 1 operation), 7 days after Phase 1 operation through pre-Phase 2 operation (for participants underwent Phase 1 operation) and Post-Phase 2 operation (for participants underwent Phase 2 operation).
Time frame: Up to 9 months after phase 1 operation
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