Prevention of septic complications in low anterior resection for rectal carcinoma: the role of Platelet Derived Growth Factors. A pilot study

In Holland there is an increasing incidence of rectal cancer. Surgical
treatment of rectal cancer is a total mesorectal excision (TME). Within the
TME, an abdominoperineal resection (APR) of a low anterior resection (LAR) can
be performed. Concerning LAR, the continuity of the colon is restored by
establishing a low anastomosis. The most important problems after LAR are
septic complications as anastomotic leakage, abdominal or pelvic abscesses,
wound infections and and persisting presacral sinus.
The incidence of septic complications after LAR varies between 10 and 20
percent. Anastomotic leakage occurs in around 10 percent of the cases and goes
hand in hand with significant morbidity and mortality. The mortality rate for
an anastomotic leak is around 30 percent. To this day a proper solution for the
prevention of septic complications after LAR for rectal cancer still remains to
be found.
Promising results have been published concerning the role of Leucocytes -
Platelet Rich Plasma (L-PRP) in the process of wound healing. Our hypothesis is
that this will also be the case in the healing of the low anastomosis after low
anterior resection, and thus that L-PRP will help to prevent septic
complications from occuring in these patients.

To investigate the feasibility of using L-PRP on anastomosis to prevent septic
complications from occuring.

Pilot study

- The application of L-PRP in a single dose, applied onto the anastomosis

All patients will undergo the standardized low anterior resection with
omentoplasty. In all patients, a single dose of L-PRP will be applied onto the
anastomosis which has no additional risks. All patients will get the standard
follow-up after low anterior resection.