Intraoperative Indocyanine Green Fluorescence Angiography in Colorectal Surgery to Prevent Anastomotic Leakage: a Single-blind Phase III Multicenter Randomized Controlled Trial (Intergroup FRENCH-GRECCAR Trial)

Who is this study for? Adults scheduled to undergo elective left colectomy or high rectal resection for cancer with intraperitoneal anastomosis
What treatments are being studied? FLUO+
Status: Recruiting
Location: See all (32) locations...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 3
SUMMARY

Colorectal cancer (CRC) is the fourth most commonly diagnosed cancer in the world and the third in France. Its incidence is steadily rising in developing nations. Anastomotic leak (AL) is a major problem in colorectal surgery affecting at least 7% of patients operated on for left colonic cancer. It is the most feared complication after colorectal anastomosis, associated with mortality, prolonged hospitalization, impaired health related quality of life (HRQoL) and increased health care costs. Intraoperative fluorescence angiography (IOFA) with indocyanine green (ICG) may help preventing AL. Available studies on the effects of IOFA with ICG are heterogeneous and randomized controlled trial are scarce. Our aim is to demonstrate that IOFA with ICG could lead to a reduction of AL rate after left-sided or low anterior resection with anastomosis for CRC. The FLUOCOL-1 study is the first national, multicenter, single blind, randomized, 2-arm, phase III superiority clinical trial. The primary endpoint is the occurrence of an AL 90 days post-operation. AL is defined as any anastomotic dehiscence with leakage into the pelvic cavity diagnosed upon imaging or at surgical exploration or any isolated pelvic organ-space infection with no evidence of fistula as defined by the International Study Group of Rectal Cancer. The study population will be made of adult patients with left-sided or high rectal cancer scheduled to undergo elective left colectomy or high rectal resection (by open, laparoscopy or robotic surgery) and with expected stapled or hand-sewn intraperitoneal anastomosis. The exclusion criteria are mainly an emergent surgery; rectal cancer requiring total mesorectal excision and anastomosis expected below the peritoneal reflection; CRC requiring total or subtotal colectomy; CRC requiring transverse colectomy; recurrent CRC and locally advanced colorectal cancer requiring multi-visceral excision. A total of 1010 patients will be necessary (39 patients in each centre during 36 months). An interim analysis for efficacy and futility is scheduled when half of the participants will have been recruited. In case of positive results favoring IOFA, this study would define the use of IOFA as a standard of care in colorectal surgery. At the patient level, a significantly lower rate of AL will reduce hospital stay and stoma rate, and will ensure improved postoperative recovery, faster return to normal activity and better long-term oncologic outcomes.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Adult patients (age \>18 years)

• Scheduled to undergo elective left colectomy or high rectal resection for cancer with intraperitoneal anastomosis.

• Signed consent

• Affiliated to the French social security system (CMU included).

Locations
Other Locations
France
Centre Hospitalier Universitaire Amiens-Picardie
RECRUITING
Amiens
CH Annecy
RECRUITING
Annecy
Centre Hospitalier Universitaire de Besançon
RECRUITING
Besançon
Centre Hospitalier Bourgoin-Jallieu
RECRUITING
Bourgoin
Centre Georges François Leclerc
RECRUITING
Dijon
University Hospital of Dijon
RECRUITING
Dijon
Centre Hospitalier Universitaire de Grenoble
RECRUITING
La Tronche
Centre Hospitalier Universitaire de Lille
RECRUITING
Lille
Centre Hospitalier Lyon-Sud
RECRUITING
Lyon
Centre lyonnais de chirurgie digestive
RECRUITING
Lyon
Hôpiatl Européen
RECRUITING
Marseille
Hôpital La Timone
RECRUITING
Marseille
Hôpital Nord AP-HM
RECRUITING
Marseille
Hôpital St Joseph Marseille
RECRUITING
Marseille
Institut Paoli Calmettes
NOT_YET_RECRUITING
Marseille
CHU de Nancy
RECRUITING
Nancy
Hôpital Bicêtre
RECRUITING
Paris
Hôpital Cochin
RECRUITING
Paris
Hôpital Européen Georges Pompidou
RECRUITING
Paris
Hôpital Saint Antoine
RECRUITING
Paris
Hôpital Saint Louis
RECRUITING
Paris
Centre Hospitalier de Pontoise
RECRUITING
Pontoise
Hôpital Robert Debré
RECRUITING
Reims
Ch Pontchaillou
RECRUITING
Rennes
Centre Hospitalier Universitaire de Rouen
RECRUITING
Rouen
Santé Atlantique
RECRUITING
Saint-herblain
Centre Hospitalier Universitaire de Strasbourg
NOT_YET_RECRUITING
Strasbourg
CHU de Toulouse
RECRUITING
Toulouse
Clinique TIVOLI
RECRUITING
Toulouse
Centre Hospitalier de Tours
RECRUITING
Tours
Institut cancérologie de Lorraine
RECRUITING
Vandœuvre-lès-nancy
Gustave Roussy
RECRUITING
Villejuif
Contact Information
Primary
Zaher Lakkis, MD, PhD
zlakkis@chu-besancon.fr
+33 3 81 66 83 41
Backup
Jean-Baptiste Pretalli, PhD
jbpretalli@chu-besancon.fr
+33 3 81 21 81 27
Time Frame
Start Date: 2022-09-26
Estimated Completion Date: 2025-10-31
Participants
Target number of participants: 1010
Treatments
Experimental: FLUO+
Experimental arm = surgery with IOFA.~In the experimental arm, cancer resection and anastomosis will be performed after assessment of descending colon perfusion using intravenous injection of indocyanine green 0.1ml/kg.
No_intervention: FLUO-
Control arm = Surgery without IOFA.~In the control arm, cancer resection and anastomosis will be performed without intraoperative fluorescence angiography.
Related Therapeutic Areas
Sponsors
Leads: Centre Hospitalier Universitaire de Besancon

This content was sourced from clinicaltrials.gov

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