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Diverting Loop Ileostomy: With or Without Rod (ROLLI)

I

Insel Gruppe AG, University Hospital Bern

Status

Terminated

Conditions

Rectal Neoplasms
Ileostomy

Treatments

Procedure: Diverting loop ileostomy with rod
Procedure: diverting loop ileostomy without rod

Study type

Interventional

Funder types

Other

Identifiers

Details and patient eligibility

About

Diverting ileostomies are created to protect a rectal anastomosis or in situations with a risk of intestinal perforation. Currently, the application of a rod to hinder slippage of the loop is an established technique to perform a diverting loop ileostomy. However, various "rod-less" techniques have been described and are performed with similar success. The aim of this study is to determine, whether a modification (without rod) of the current standard method of protective loop ileostomy formation (with rod) could improve ileostomy specific morbidity. Secondary endpoints include stoma care, determinants of quality of life and stoma function.

Full description

Background

For rectal anastomoses within 6 cm of the anal verge, leakage rates are up to 15%. Here liberal use of protective stomas is widely accepted. Fecal diversion by loop ostomy may also be performed after extended adhesiolysis with serosal lesions and risk of intestinal perforation, in patients with obstructing rectal tumours requiring neoadjuvant radio-chemotherapy or in patients with complex anorectal injuries or fistulas. Generally, diverting loop ileostomies are secured at skin level by means of a supporting device in order to prevent retraction of the loop ileostomy into the abdomen. Nevertheless, due to the supporting rod, difficulties may occur in applying a stoma bag correctly and leakage of feces onto the skin may occur even with correct eversion of the afferent limb. Despite easier application of stoma bags and therefore reduced risk of skin irritation, none of these alternative techniques are established. In various non-randomized studies rodless loop ileostomies were described with an overall morbidity between 3 and 39%. However definition of morbidity varies significantly in these studies and randomised controlled trials are missing so far.

Objective

The aim of this study is to determine, whether a modification (without rod) of the current standard method of protective loop ileostomy formation (with rod) could improve ileostomy specific morbidity. Secondary endpoints include stoma care, determinants of quality of life and stoma function.

Methods

The study is designed as multi-institutional, randomized controlled, two-armed study. Patients scheduled for a protective loop ileostomy and meeting the eligibility criteria will be randomized to creation of a loop ileostomy with or without sustaining rod.

Enrollment

121 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

  • patients scheduled for planned protective loop ileostomy

Exclusion Criteria

  • patients with long-term use of corticosteroids (> 15 mg prednisolone equivalent)
  • immunosuppressive agent rapamune

Trial design

Primary purpose

Treatment

Allocation

Non-Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

121 participants in 2 patient groups

A
Other group
Description:
diverting loop ileostomy with rod
Treatment:
Procedure: Diverting loop ileostomy with rod
B
Other group
Description:
diverting loop ileostomy without rod
Treatment:
Procedure: diverting loop ileostomy without rod

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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