The SMART Trial: Modified Single-Stapled Anastomosis in Laparoscopic or Robotic Low Anterior Resection for Rectal Cancer

The goal of this clinical trial is to learn whether a modified single-stapled anastomosis (MST) can reduce anastomotic leakage compared with the conventional double-stapled technique (DST) in adult patients undergoing laparoscopic or robotic low anterior resection for rectal cancer. The main questions it aims to answer are: * Does MST lower the incidence of anastomotic leakage after rectal cancer surgery? * Does MST improve short-term surgical outcomes compared with DST? Researchers will compare the MST group with the DST group to see if MST leads to fewer anastomotic leaks and safer postoperative recovery. Participants will: Receive either MST or DST during minimally invasive rectal cancer surgery Undergo routine postoperative CT scans within one month after surgery to check for symptomatic or asymptomatic anastomotic leakage Attend scheduled follow-up visits and standard postoperative assessments as part of routine rectal cancer care

NCT Number	NCT07376980
Lead Sponsor	Korea University Anam Hospital Collaborators: Kyunghee University Medical Center, Seoul National University Hospital, Kyungpook National University Chilgok Hospital, Saint Vincent's Hospital, Korea, Sinchon Severance Hospital, Yonsei University College of Medicine
Conditions	Rectal Neoplasms, Rectal Neoplasms Malignant, Rectal Cancer, Rectal Cancer Surgery
Enrollment	450 participants
Start Date	2025-12-20
Primary Completion	2027-12-30 (estimated)
Study Completion	2030-12-30 (estimated)
Updated on ClinicalTrials.gov	2026-01-29