The Section of Colon and Rectal Surgery participates in numerous clinic trials and registries that provide our patients with access to the most current medical and surgical therapy. Here is just a sample of collaborative research occurring within the section.
The Intestinal Microbiome and the Pathogenesis of Anastomotic Leak and Inflammatory Bowel Disease
We are participating in a study led by Dr. John Alverdy, executive vice chair of the Department of Surgery, examining the role of the microbiome in the pathogenesis of anastomotic leak. Dr. Alverdy's hypothesis is that in patients who leak, the normally-protective microbiota is changed into a virulent phenotype with pathogens capable of impairing anastomotic healing, such as those expressing the enzyme collagenase than can break down healing tissue. Translation of this research may ultimately help reduce anastomotic leak rates, and multiple high-volume and distinguished colorectal units have been recruited to participate in a potentially paradigm-changing multicenter clinical trial. Numerous bench top studies are ongoing and in the planning phases to study the impact of the intestinal microbiome on anastomotic healing and inflammatory bowel disease.
Rectal Cancer and Colon Cancer Trials
We take every opportunity to inform our colon and rectal cancer patients about ongoing clinical trials occurring within the University of Chicago Center for Gastrointestinal Oncology. Currently we are an accrual center for a number of clinical trials.
One trial (Phase II: Protocol 12-213) examines whether additional systemic chemotherapy given before surgery, before or after chemoradiation, is more effective than traditional therapy and may be able to spare select patients with appropriate clinical response from surgery. Another trial (Phase II/III: Protocol 12-087) is examining whether neoadjuvant systemic chemotherapy may allow for more selective use of chemoradiotherapy in rectal cancer patients. Clinicians are also utilizing genotype analysis to guide dosing of certain chemotherapeutics in combination regimens for gastrointestinal cancer (Phase I: Protocol 12-0033). Finally, researchers are studying chemoprevention with certain drugs to reduce adenoma formation and recurrence rates (Phase II: Protocol 09-001758)
Gastro-Intestinal Research Foundation
The Gastro-Intestinal Research Foundation, or GIRF, is a nonprofit organization dedicated to clinical and laboratory research at the University of Chicago Medicine. It is led by Dr. David Rubin, Chief of the Section of Gastroenterology, Hepatology, and Nutrition. The faculty within the Section of Colon and Rectal Surgery collaborate with the Digestive Diseases Center to collect retrospective and prospectively maintained databases to study outcomes in inflammatory bowel disease and other disorders.
We have recently initiated a proposal to develop a registry comprised of all our fecal ostomates, those patients with ileostomies and colostomies. The purpose of this registry is to capture targeted metrics in order to improve patient outcomes and quality of life, and reduce stoma complications. In addition, the registry will provide opportunity for prospective bio-banking within the Digestive Diseases Center.