TES RCT Fleet Enema vs Oral Mechanical Bowel Prep

Trial statusRecruiting
Trial phasePhase 4
Trial typeInterventional
Biological sexAll
Age18-75
SponsorNova Scotia Health Authority

About this trial

There is no consensus about the best bowel preparation prior to transanal endoscopic surgery TES). Cleanliness and visibility in the rectosigmoid and rectum are of utmost importance, possibly even more so than during colonoscopy, to facilitate safe, precise and efficient resection of the rectal lesion and potentially adequate closure of the defect. Both Fleet enemas and oral mechanical bowel preparation are considered standard of care in preparation for TES. This single center two arm single blinded randomized controlled trial will compare the effectiveness of Fleet enemas in comparison to Pico Salax oral mechanical bowel preparation in cleansing the rectum as measured by a modified version of the Ottawa Bowel Prep Scale.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

undergoing transanal endoscopic surgery at the QEII Health Sciences Center in Halifax by one of the colorectal trained surgeons

Disqualifiers

chronic constipation not well controlled with diet or stool softening agents

previous pelvic radiation

inflammatory bowel disease

repeat transanal surgery for the same lesion

Trial design

Design model

Parallel

Treatments tested in this trial

  • Fleet Enema

    Drug

    standard pre-op application, see arm description

  • Pico-Salax

    Drug

    standard pre-op application, see arm description

Treatment groups

66 Participants
are divided into 2 treatment groups
Group A: Fleet EnemaActive comparator 1 intervention
Group B: Pico SalaxActive comparator 1 intervention

Trial outcomes

Primary outcomes

1

Quality of bowel preparation

Measurement of the quality of cleanse of the rectum, expressed as a score on a modified version of the Ottawa Bowel Prep Scale (OBPS). The OBPS will be used to assess the one segment of the bowel visualized during TES surgery (rectosigmoid) using the segmental scale 0-4, where 0 is the best score and 4 is inadequate.

Time frame
A one-time intra-operative assessment for each patient

Secondary outcomes

1

Validation of the modified version of the Ottawa Bowel Prep Scale

validation of the modified version of the OBPS as it applies to the use of Fleet enema and Pico Salax oral bowel prep in the rectosigmoid segment specifically for use in preparation for TES

Time frame
A one-time intra-operative assessment for each patient by a second blinded surgeon
2

Time spent cleaning operating field

A measure of the time spent cleansing the operating field by the surgeon as per review of recording of the surgery

Time frame
A one-time intra-operative assessment for each patient
3

Ability to close the surgical defect

An assessment as to whether the surgical wound in the rectum was left open or sutured closed

Time frame
A one-time intra-operative assessment for each patient
4

Patient tolerability of preparation

An assessment of the patients tolerability of the prep, symptoms associated with the prep, whether they were able to complete the prep, satisfaction and willingness to take the same prep in the future, performed using a questionnaire. In the questionnaire, the severity of the symptoms associated with the prep can be selected from mild, moderate, severe, and intolerable.

Time frame
A one-time pre-op assessment for each patient the morning of surgery

Other outcomes

Sponsors and contacts

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