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Slow Transit ConstipationNCT05352074

STOPS Trial: Total vs Subtotal Colectomy for Slow Transit Constipation

A study testing Total colectomy with ileorectal anastomosis and Subtotal colectomy with cecal-rectal anastomosis in people with Slow Transit Constipation and Surgery, run by Third Military Medical University at 14 sites in China.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

Total colectomy with ileorectal anastomosis is a traditional surgical option for slow transit constipation (STC). Subtotal colectomy with caecorectal anastomosis have been reported to be a potential alternative approach. Thus, the optimal surgical option for STC is controversial. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Slow Transit Constipation, Surgery
What is being tested?
Total colectomy with ileorectal anastomosis and Subtotal colectomy with cecal-rectal anastomosis
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
252 participants
Where
14 sitesChina
Study dates
27 Mar 2022to 1 May 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients (≥18 years of age) of either sex
  • Patients with conditions in agreement with the Roman IV criteria of functional constipation
  • Patients have less than one complete spontaneous bowel movement per week
  • Patients rely on laxatives to assist defecation for a long time
  • More than 20% the radio-paque markers localized in the colon after 72 hours based on colonic transit studies
  • Patients were refractory to conservative treatment for more than 1 year
  • Patients with a strong desire for surgery

Who cannot join

  • Pregnant or breast-feeding women
  • Patients with megacolon, megarectum,severe spastic constipation, severe rectocele, rectal prolapse (Oxford Grade IV or above)
  • Patients with colorectal neoplasms
  • Patients with small intestinal slow transit
  • Patients with constipation-predominant irritable bowel syndrome
  • Patients with inflammatory bowel disease
  • Patients with ileostomy
  • Patients with severe psychiatric disease

Trial locations and contacts

14 sites in 1 country.

14 sites in 1 country

China14 sites
  • Chengdu Analrectal Hospital

    Chengdu, Sichuan, 610017

  • The General Hospital of Western Theater Command

    Chengdu, Sichuan, 610036

  • Zhejiang Provincial People's Hospital

    Hangzhou, Zhejiang, 310014

  • No. 940 Hospital of Joint Logistics Support Force of Chinese People's Liberation Army

    Lanzhou, Gansu, 730050

  • General Hospital of the Eastern Theater Cammand of the PLA

    Nanjing, Jiangsu, 210002

  • Renji Hospital, Shanghai Jiaotong University

    Pudong, Shanghai Municipality, 200127

  • Shanghai Pudong New Area People's Hospital

    Pudong, Shanghai Municipality, 201299

  • Qingdao Municipal Hospital

    Qingdao, Shandong, 266011

  • The First Hospital of China Medical University

    Shengyang, Liaoning, 110001

  • Renmin Hospital of Wuhan University

    Wuhan, Hubei, 430060

  • Zhongnan Hospital of Wuhan University

    Wuhan, Hubei, 430062

  • Xijing Hospital

    Xi’an, Shanxi, 710032

  • The Second People's Hospital of Yibin

    Yibin, Sichuan, 644000

  • Army Medical Center (Daping Hospital)

    Yuzhong, Chongqing Municipality, 400042

Other trials in China

About this study

Official title: STOPS Trial: A Multicentre Prospective Randomised Clinical Trial Comparing Total Colectomy With Ileorectal Anastomosis Versus Subtotal Colectomy With Cecal-rectal Anastomosis for Slow Transit Constipation

Total colectomy with ileorectal anastomosis is a traditional surgical option for slow transit constipation (STC). Subtotal colectomy with caecorectal anastomosis have been reported to be a potential alternative approach. Thus, the optimal surgical option for STC is controversial.

Read the detailed description

Constipation, a prevalent gastrointestinal disorder, affects 10%-15% of adults in the United States and approximately 8.2% of China's general population. Slow transit constipation (STC), accounting for 15%-42% of constipation cases, is characterized by impaired colonic motility. For patients refractory to conservative therapies who experience chronic, intractable symptoms and diminished quality of life (QoL), surgical intervention becomes the last-resort treatment. The primary surgical approach for STC has historically been total colectomy with ileorectal anastomosis (TC-IRA). Over the past two decades, however, subtotal colectomy with cecorectal anastomosis (SC-CRA) has garnered growing interest within the surgical community due to its potential to mitigate postoperative diarrhea. Despite this benefit, SC-CRA raises concerns about an elevated risk of recurrent constipation. The debate regarding the superiority of these approaches remains unresolved. This study aims to address this controversy through a comparative analysis of TC-IRA and SC-CRA, evaluating their therapeutic efficacy and safety profiles in refractory STC.

Being tested
Total colectomy with ileorectal anastomosis, Subtotal colectomy with cecal-rectal anastomosis
Keywords
Slow Transit Constipation, Total Colectomy with Ileorectal Anastomosis, Subtotal Colectomy with Caecorectal Anastomosis, Defecation Function, Quality of Life, Randomized Controlled Trial

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Total colectomy with ileorectal anastomosisProcedure or surgery

    Following complete colonic mobilization without preservation of the ileocolic vascular pedicle, the surgical specimen was extracted by extending the right lower quadrant trocar incision to approximately 4-5 cm. A resection of ileum, 2-3 cm proximal to the ileocecal junction, will be conducted by stapler. The anvil of a 29-mm circular stapler was inserted into the proximal ileal lumen and repositioned intra-abdominally. Ileorectal anastomosis was performed by transanal insertion of the circular stapler, aiming to achieve a tension-free, contamination-minimized reconstruction. Finally, a closed suction drain was placed in the rectouterine pouch (Douglas pouch), and all abdominal incisions were closed in layers.

  • Subtotal colectomy with cecal-rectal anastomosisProcedure or surgery

    Following complete colonic mobilization with preservation of the ileocolic vascular pedicle and its branches, the surgical specimen was extracted by extending the right lower quadrant trocar incision to 4-5 cm. After insertion of the anvil from a 29-mm circular stapler through the ascending colon resection margin, a resection about 3 cm distal to the ileocecal junction will be conducted. The cecum was then positioned in the pelvis without rotational torsion, and an antiperistaltic cecorectal anastomosis was created between cecal fundus (after appendectomy) and the rectal stump. The anastomosis was performed via transanal insertion of the circular stapler to ensure tension-free, contamination-controlled reconstruction. Finally, a closed suction drain was placed in the rectouterine pouch (Douglas pouch), and all abdominal incisions were closed in a layered fashion.

Study groups in NCT05352074
Study groupRoleWhat they receive
Total colectomy with ileorectal anastomosisActive comparatorTotal colectomy with ileorectal anastomosis (TC-IRA) serves as the standard surgical treatment for slow transit constipation.
Receives: Procedure: Total colectomy with ileorectal anastomosis
Subtotal colectomy with cecal-rectal anastomosisExperimentalSubtotal colectomy with cecorectal anastomosis (SC-CRA) is selectively employed for slow transit constipation.
Receives: Procedure: Subtotal colectomy with cecal-rectal anastomosis

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Wexner Constipation Score

    The Wexner Constipation Score will be recorded in terms of scores. Questions examine constipation in its clinical expressions. Each question is answered on a scale of 0 to 4. The scale ranges from 0 (best) to 30 (worst)

    Measured: From the pre-operation to 36 months following surgery

Secondary outcomes (12)
  1. Gastrointestinal Quality of Life Index

    Gastrointestinal Quality of Life Index will be recorded in terms of scores. There are The four possible answers to every question, scored from 0 points (worst) to 4 points (best). The final sum ranges from 0(worst) to 144(best).

    Measured: From the pre-operation to 36 months following surgery

  2. 36-item short-form health survey

    There are eight spheres in the SF-36 survey, including physical function, role physical, role emotional, physical pain, vitality, mental health, social function and general health. Results of each sphere will be recorded in terms of scores. Once the questionnaire was applied to the patients, a summary calculation and a linear transformation were performed to obtain a score within a scale from 0(worst) to 100(best).

    Measured: From the pre-operation to 36 months following surgery

  3. The incidence of complications

    Postoperative complications includes short-term and long-term complications, such as ileus, anastomotic leak, small intestinal obstruction, constipation recurrence and so on. Number of Participants with complications will be recorded.

    Measured: From the pre-operation to 36 months following surgery

  4. The number of bowel movements per week

    The number of bowel movements will be recorded in terms of times per week.

    Measured: From the pre-operation to 36 months following surgery

  5. Wexner's incontinence score

    The Wexner's incontinence score will be recorded in terms of scores. the sacles have 5 items to quantify incontinence grade and frequency and its effect on ordinary life. Each question is answered on a scale of 0 to 4, the global score ranging from 0 (best) to 20 (worst).

    Measured: From the pre-operation to 36 months following surgery

  6. The incidence of abdominal pain

    The incidence of abdominal pain will be recorded in terms of percent. no special measurement is needed.

    Measured: From the pre-operation to 36 months following surgery

  7. The incidence of bloating

    The incidence of bloating will be recorded in terms of percent

    Measured: From the pre-operation to 36 months following surgery

  8. The incidence of diarrhea

    The incidence of diarrhea will be recorded in terms of percent.

    Measured: From the pre-operation to 36 months following surgery

  9. The incidence of straining

    The incidence of straining will be recorded in terms of percent.

    Measured: From the pre-operation to 36 months following surgery

  10. The incidence of laxative use

    The incidence of laxative use will be recorded in terms of percent.

    Measured: From the pre-operation to 36 months following surgery

  11. The incidence of enema use

    The incidence of enema use use will be recorded in terms of percent.

    Measured: From the pre-operation to 36 months following surgery

  12. Intraoperative measures

    Operation time (minutes), blood loss (mL), complications (classified according to Clavien-Dindo) for both study groups.

    Measured: Perioperative period

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Apr 2022
  2. Study start27 Mar 2022
  3. Primary completion1 May 2025
  4. Study completion1 May 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
252 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05352074
Sponsor's protocol ID
20211114
Status last verified
Apr 2026
First submitted
3 Apr 2022
Last updated
14 Apr 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Macha MR. The feasibility of laparoscopic subtotal colectomy with cecorectal anastomosis in community practice for slow transit constipation. Am J Surg. 2019 May;217(5):974-978. doi: 10.1016/j.amjsurg.2019.03.018. Epub 2019 Mar 26.

    PubMed 30948148
  • Wei D, Cai J, Yang Y, Zhao T, Zhang H, Zhang C, Zhang Y, Zhang J, Cai F. A prospective comparison of short term results and functional recovery after laparoscopic subtotal colectomy and antiperistaltic cecorectal anastomosis with short colonic reservoir vs. long colonic reservoir. BMC Gastroenterol. 2015 Mar 18;15:30. doi: 10.1186/s12876-015-0257-7.

    PubMed 25887580
  • Perivoliotis K, Baloyiannis I, Tzovaras G. Cecorectal (CRA) versus ileorectal (IRA) anastomosis after colectomy for slow transit constipation (STC): a meta-analysis. Int J Colorectal Dis. 2022 Mar;37(3):531-539. doi: 10.1007/s00384-022-04093-y. Epub 2022 Jan 12.

    PubMed 35020001
  • Knowles CH, Grossi U, Horrocks EJ, Pares D, Vollebregt PF, Chapman M, Brown S, Mercer-Jones M, Williams AB, Yiannakou Y, Hooper RJ, Stevens N, Mason J; NIHR CapaCiTY working group; Pelvic floor Society and; European Society of Coloproctology. Surgery for constipation: systematic review and practice recommendations: Graded practice and future research recommendations. Colorectal Dis. 2017 Sep;19 Suppl 3:101-113. doi: 10.1111/codi.13775.

    PubMed 28960922
  • Deng XM, Zhu TY, Wang GJ, Gao BL, Li RX, Wang JT. Laparoscopic total colectomy with ileorectal anastomosis and subtotal colectomy with antiperistaltic cecorectal anastomosis for slow transit constipation. Updates Surg. 2023 Jun;75(4):871-880. doi: 10.1007/s13304-023-01458-y. Epub 2023 Mar 14.

    PubMed 36914915
  • Guo M, Li F, Bu F, Cui Z, Lan H, Ni L, Gao F, Wang Y, Zhou J, Fu T, Liu W, Xu D, Liu X, Gao H, Huang B, Wang L, Zhang L, Wu M, Jiang C, Jiang J, Gong W, Tong W; STOPS Study Group. Subtotal Colectomy vs Total Colectomy for Slow-Transit Constipation: 1-Year Outcomes of the STOPS Randomized Clinical Trial. JAMA Surg. 2026 Oct 21:e264932. doi: 10.1001/jamasurg.2026.4932. Online ahead of print.

    PubMed 42905730
  • Tian Y, Guo M, Bu F, Ni L, Liu W, Gao F, Lan H, Cui Z, Fu T, Wang Y, Li F, Xu D, Gao H, Zhang L, Liu X, Huang B, Wang L, Jiang C, Jiang J, Gong W, Tong W. Total colectomy with ileorectal anastomosis versus subtotal colectomy with cecal-rectal anastomosis for slow transit constipation: protocol for a multicenter randomized controlled trial (STOPS trial). Trials. 2025 Oct 10;26(1):402. doi: 10.1186/s13063-025-09049-5.

    PubMed 41074220

Questions about this trial

What is this clinical trial studying?

A study testing Total colectomy with ileorectal anastomosis and Subtotal colectomy with cecal-rectal anastomosis in people with Slow Transit Constipation and Surgery, run by Third Military Medical University at 14 sites in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 14 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 14 sites in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Wexner Constipation Score (time frame: From the pre-operation to 36 months following surgery). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05352074, which also lists 7 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Apr 2026.

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