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The CONSTRUCT registry

Acronym

The CONSTRUCT registry

Name of the study

Evidence-based treatment of patients with acute left-sided malignant colonic obstruction: Applying a clinical decision guideline.

Researchers and contact information

Coordinating investigator

Joyce Veld, PhD candidate
Department of Surgery & Department of Gastroenterology and Hepatology
Academic Medical Center, Amsterdam
Tel: +31 (0)20 5666464 / Email: j.v.veld@amc.uva.nl

Principal investigator

Dr. Jeanin van Hooft, gastroenterologist
Department of Gastroenterology & Hepatology
Academic Medical Center, Amsterdam
Tel: +31 (0)20 5667918 / Email: j.e.vanhooft@amc.uva.nl

Prof.dr. Pieter Tanis, surgeon
Academic Medical Center, Amsterdam
Email: p.j.tanis@amc.uva.nl

Prof. dr. Willem Bemelman, surgeon
Academic Medical Center, Amsterdam
Email: w.a.bemelman@amc.uva.nl

Dr. Frank ter Borg, gastroenterologist
Deventer Hospital, Deventer
Email: F.terBorg@dz.nl

Prof.dr. Esther Consten, surgeon
Meander Medical Center, Amersfoort
Email: ECJ.Consten@meandermc.nl

Prof. dr. Paul Fockens, gastroenterologist
Academic Medical Center, Amsterdam
Email: p.fockens@amc.uva.nl

Prof. dr. Peter Siersema, gastroenterologist
Radboud UMC, Nijmegen
Email: peter.siersema@radboudumc.nl

Dr. Edwin van der Zaag, surgeon
Gelre Hospitals, Apeldoorn
Email: e.van.der.Zaag@gelre.nl

Summary study

The CONSTRUCT registry is a nationwide, prospective validation of the implementation of the revised Dutch national guideline for the treatment of left-sided obstructing colonic cancer. Patients presenting with left-sided malignant colonic obstruction are treated according to a clinical decision guideline. By registering all eligible patients, we aim to get insight in the implementation of the clinical decision guideline in the whole patient population. In this way we will validate if the recommendations result in a reduction of the postoperative mortality in the elderly and frail patients (age ≥ 70 years or ASA ≥ 3) who will be treated by stent placement or colostomy as a bridge to an elective resection.

Intervention

Patients are treated according to the revised Dutch national guideline. Therefore the Medical Research Involving Human Subjects Act (Dutch: Wet Medisch-wetenschappelijk Onderzoek met Mensen) does not apply to this study.

Summary of treatment according to the clinical decision guideline, please find the complete algorithm at www.colonobstructie.nl:

  1. Young and fit patients (age < 70 years and ASA < 3) without incurable metastatic disease will have a surgical resection.
  2. The elderly and frail patients (age ≥ 70 years or ASA ≥ 3) without incurable metastatic disease will initially have a decompressing intervention either by stent placement or colostomy followed by elective resection (bridge to surgery treatment).
  3. Patients with extensive metastatic disease or patients who are unfit to undergo surgical resection will be treated palliatively by stent placement or a diverting colostomy.

Registering patients:

All patients with an acute left-sided malignant colonic obstruction can be included in the CONSTRUCT registry (www.colonobstructie.nl).

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