RoLaCaRT-1: Robotic versus Laparoscopic Colon – a Randomized Trial
Purpose of the Study
Removal of the tumour is the most important treatment for colon cancer, giving the best likely health outcome and allowing treatment options that are available following surgery. RoLaCaRT-1 compares the use of robotic surgery with laparoscopic surgery for the surgical treatment of right-sided colon cancer, the study will aim to determine whether the newer robotic technology will allow greater operative advantages which translate to improved rates of “successful surgery” and better patient-oriented clinical outcomes.
- Adults aged >=18year of with adenocarcinoma (tumour or malignant polyp) of the caecum, ascending or proximal transverse colon. Disease must be confirmed by histological, radiological, endoscopic diagnosis.
- ECOG performance status 0-2.
- Life expectancy of at least 1 year.
- Surgery to be performed within 40 days of randomisation.
- Elective surgery performed with curative intent.
- Signed, written informed consent.
- Willing and able to comply with all study requirements, including treatment, timing and/or nature of required assessments.
- Evidence of T4 disease invading adjacent organs.
- Pre-operative surgical plan includes division of the middle colic vessels (extended right hemicolectomy) or any other more extensive colectomy procedure.
- Synchronous surgical procedure planned with right hemicolectomy.
- Urgent, unplanned or emergency surgery.
- Palliative surgical intent including non-resection, stoma formation, staging laparoscopy or open and close procedures.
- Prior formation of defunctioning ileostomy as part of treatment for this right colon cancer.
- No plan to create a surgical ileo-colonic anastomosis.
- Neoadjuvant chemotherapy administered to treat this cancer prior to resection.
- Known Crohn’s disease with active terminal ileal disease.
- History of any conditions that would preclude use of a minimally-invasive approach (e.g. multiple previous major laparotomies, severe adhesions, patient co-morbidity).
- Concurrent or previous abdominal or pelvic malignancy within five years prior to registration irrespective of treatment modality.
- Other co-morbidities or conditions that may compromise assessment of key outcomes.
- Significant metastatic disease which would be expected to impact life expectancy of at least 1 year.
- Evidence of systemic disease (cardiovascular, renal, hepatic, etc.)
- Pregnancy or lactation.
DETAILED INFORMATION AVAILABLE
Available online at the Australian New Zealand Clinical Trial Registry (ANZCTR) please click here.
Professor Andrew Stevenson
RoLaCaRT: Robotic versus Laparoscopic Colon – a Randomized Trial
The introduction of new surgical procedures, techniques and technology are often associated with significant increases in health cost both from the capital investment and disposables used per case. There has been a steady increase in the uptake of robotics in colorectal surgery in recent years. This may have important implications in terms of overall impact on healthcare costs to governments, private insurers and to patients. This study aims to determine whether the newer robotic technology will allow greater operative advantages which translate to improved rates of “successful surgery” and better patient-oriented clinical outcomes.
The aim of this study is to evaluate the clinical outcomes from performing right hemicolectomies robotically compared with routine laparoscopic colectomy in patients with adenocarcinoma (tumour or malignant polyp) of the caecum, ascending or proximal transverse colon.