A Phase 3 interventional study of Sennosides colonic preparation and Oral Gentamycin in Colon Cancer, sponsored by Assistance Publique - Hôpitaux de Paris. Terminated at 1 site in France. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-05-17.
Sponsored by Assistance Publique - Hôpitaux de Paris · Phase 3, Interventional, and Prevention
This study aims to demonstrate that a preoperative combination of mechanical bowel preparation and oral antibiotics, before elective laparoscopic colon cancer surgery, is associated with a reduction of postoperative surgical site infection rate, as compared to mechanical bowel preparation alone, oral antibiotics alone, or no colonic preparation.
Our Hypothesis is that a preoperative colonic preparation including a combination of mechanical bowel preparation and oral antibiotics before elective laparoscopic colon cancer surgery is associated with a reduced rate of 30-day postoperative surgical site infection, as compared to mechanical bowel preparation alone, oral antibiotics alone, or no colonic preparation.
Preoperative mechanical bowel preparation (MBP) has been proposed in an attempt to reduce the colonic fecal load and to limit the risk of surgical site contamination, thus theoretically limiting the risk of postoperative SSI. However, several randomized-controlled trials (RCT) and meta-analyses, have suggested the absence of benefit, in term of postoperative morbidity, of preoperative MBP before elective colon cancer surgery. A meta-analysis of RCT, comparing MBP to no-MBP before elective colon cancer surgery, even suggested that MBP could be associated with an increased SSI rate, as compared to no-MBP. These results led the latest French surgical guidelines of the Société Française de Chirurgie Digestive (SFCD) to recommend the absence of MBP before elective colon cancer surgery.
However, recent studies suggested that the adjunction of oral antibiotics during MBP could help efficiently reduce the risk of postoperative SSI. Indeed, a recent meta-analysis of RCT have suggested that patients preoperatively receiving both MBP and oral antibiotics were exposed to a significantly reduced risk of postoperative SSI, as compared to patients receiving only preoperative MBP. This result was confirmed in a recent RCT which compared preoperative MBP and oral antibiotics versus MBP alone in a heterogeneous population of patients who underwent laparoscopic colonic or rectal surgery. This latter study reported a 50% reduction of SSI rate in the "MBP and oral antibiotics" group, as compared to the "MBP alone" group. Finally, three recent large retrospective registry studies compared the outcomes of four different strategies of preoperative colonic preparation before colorectal surgery: 1) MBP and oral antibiotics, 2) MBP alone, 3) Oral antibiotics alone, and 4) No colonic preparation. However, to date, no RCT has compared the "No preparation" group, which is the gold standard according to the international and French guidelines, to the "MBP and oral antibiotics" group.
The present study is therefore the first double-blinded RCT to compare the SSI rate for 4 types of colonic preparation before elective laparoscopic colonic surgery: 1) MBP and oral antibiotics, 2) MBP alone, 3) Oral antibiotics alone, and 4) No preparation.
2,457 studies on the registry are indexed under Colonic Neoplasms; 458 are open to participants now.
This study's enrollment of 193 is above the median of 75 across 1,711 interventional studies indexed under Colonic Neoplasms.
Browse Colonic Neoplasms studies →Assistance Publique - Hôpitaux de Paris is the lead sponsor of 3,592 studies on the registry; 1,033 are open to participants now.
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Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.
A score of how well the liver works in people with liver disease such as cirrhosis: class A is mild, B moderate and C severe.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Contraindication
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
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Excipients
The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.
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Child-Pugh class
A score of how well the liver works in people with liver disease such as cirrhosis: class A is mild, B moderate and C severe.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Sennosides colonic preparation Oral Gentamycin Oral Ornidazole * Sennosides colonic preparation (X-PREP) : 1 per day, on day -2 and day -1. * Gentamycin : 80 mg, 4 per day, on day -2 and day -1; Liquid forms in individual vials. * Ornidazole : 1. g per day (2 tablet per day), on day -2 and day -1; In tablets.
Drug: Sennosides colonic preparation · Drug: Oral Gentamycin · Drug: Oral Ornidazole
Sennosides colonic preparation Oral placebo Gentamycin Oral placebo Ornidazole * Sennosides colonic preparation (X-PREP) : 1 per day, on day -2 and day -1. * Placebo for oral gentamycin: Same presentation as oral gentamycin x4 per day on day -2 and day -1. - Placebo for oral ornidazole : Same presentation as oral ornidazole 1g per day (2 tablet per day) on day -2 and day -1.
Drug: Sennosides colonic preparation · Drug: Oral placebo Gentamycin · Drug: Oral placebo Ornidazole
Oral Gentamycin Oral Ornidazole * Gentamycin : 80 mg, 4 per day, on day -2 and day -1; Liquid forms in individual vials. * Ornidazole : 1. g per day (2 tablet per day), on day -2 and day -1; In tablets.
Drug: Oral Gentamycin · Drug: Oral Ornidazole
Oral placebo Gentamycin Oral placebo Ornidazole - Placebo for oral gentamycin : Same presentation as oral gentamycin x4 per day on day -2 and day -1 - Placebo for oral ornidazole : Same presentation as oral ornidazole 1g per day (2 tablet per day) on day -2 and day -1
Drug: Oral placebo Gentamycin · Drug: Oral placebo Ornidazole
Mechanical bowel preparation : Sennosides colonic preparation (X-PREP) 1 per day, on day -2 and day -1
Gentamycin 80 mg, 4 per day, on day -2 and day -1; Liquid forms in individual vials
Oral Ornidazole : Ornidazole 1 g per day (2 tablet per day), on day -2 and day -1; In tablets
Placebo for oral gentamycin : Same presentation as oral gentamycin x4 per day on day -2 and day -1
Placebo for oral Ornidazole : Same presentation as oral ornidazole 1g per day (2 tablet per day) on day -2 and day -1
Postoperative 30-day surgical site infection (SSI).
SSI will be defined and classified as superficial, deep and/or organ-space infection on the basis of validated and well-defined criteria developed by the Centers for Disease Control and Prevention (CDC), validated in French by the Comité technique des infections nosocomiales et des infections liées aux soins
Time frame: 30 days
Overall postoperative morbidity
Including all postoperative complications occurring within 30 days after surgery, defined and classified according to the Clavien-Dindo classification.
Time frame: 30 days
Severe postoperative morbidity
Including all complications graded 3 or more according to the Clavien-Dindo classification, and occurring within 30 days after surgery.
Time frame: 30 days
Postoperative mortality
Including all deaths occurring within 30 days after surgery.
Time frame: 30 days
Postoperative anastomotic leakage
Defined as the passing of any intra-colonic content (air, liquid, intestinal content, or radiological contrast) through an anastomosis or by an peri-anastomotic abscess, even in the absence of intra-colonic content leak through the anastomosis, observed in drainages, surgical incision, vagina, during a surgical procedure or on a radiological examination, occurring within 90 days after surgery.
Time frame: 90 days
Postoperative length of hospital stay
Calculated from the day of surgery to the day of hospital discharge.
Time frame: Day of hospital discharge
Unplanned hospitalization
Defined as any unplanned hospitalization between surgery and postoperative day 90.
Time frame: 90 days
Tolerance of the colonic preparation
Evaluated using a dedicated tolerance of the colonic preparation questionnaire performed the evening before surgery.
Time frame: The day before surgery
Clostridium difficile colitis occurrence
Defined as clinical symptoms of clostridium difficile colitis with at least 1 stool sample positive for Clostridium difficile toxin A/B as detected by enzyme-linked immunosorbent assay within 30 days after surgery.
Time frame: 30 days
Rate of multi-resistant bacteria carriage
Defined as rate of multi-resistant bacteria carriage
Time frame: The day before or the day of surgery
Date of adjuvant chemotherapy beginning
If indicated
Time frame: During 90 days
Plan to share: No — There is not a plan to make IPD available
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This study is terminated, as verified in May 2022. You cannot join it, but the record below documents what was studied.
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Studies of the drugs tested here: Gentamicins · Ornidazole
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