Staple-line Reinforcement for Prevention of Pulmonary Air Leakage

NCT ID: NCT00925444

Last Updated: 2013-09-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

380 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-06-30

Study Completion Date

2013-03-31

Brief Summary

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The aim of this study is to compare the efficacy of FORESEAL with stapling alone or associated with tissue sealant or glue in terms of air leakage duration after lung resection for cancer.

Hypothesis: to show a significant difference of 1 day in the average duration of air leakage between the 2 groups with a standard deviation of 3 (α =0.05 and β=0.10).

Detailed Description

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Air leaks continue to be the most common complication after pulmonary resection even using a stapling device. Double chest tubes after lobectomy is a well established method for drainage of the pleural cavity to allow adequate expansion of the remaining lung.

FORESEAL has been developed to reduce air leaks by buttressing the staple line. It is a absorbable vegetal biopolymer in the form of sleeves, CE marked and indicated for prevention of air leakage after pulmonary resection with stapling device. It acts as a suture reinforcement as well as a sealant thanks to its jellification.

Sealants are also commonly used in addition to stapling to prevent air leakage. The aim of this study is to compare the efficacy of FORESEAL with stapling alone or associated with sealants.

This is a multi centre, prospective controlled and randomised clinical study.

Conditions

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Lung Neoplasms Pulmonary Surgical Procedures Surgical Staplers Tissue Adhesives Chest Tubes

Keywords

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Absorbable implants Humans Alginates Pneumonectomy/methods Pneumonectomy/instrumentation Surgical Stapling Thoracic surgery Tissue Adhesives Prospective studies

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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FOREseal

Group Type EXPERIMENTAL

FOREseal

Intervention Type DEVICE

a pair of alginate sleeves for linear cutting staplers used in lung surgery

Stapling

Group Type ACTIVE_COMPARATOR

Stapling

Intervention Type DEVICE

Stapling alon or associated with sealants

Interventions

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FOREseal

a pair of alginate sleeves for linear cutting staplers used in lung surgery

Intervention Type DEVICE

Stapling

Stapling alon or associated with sealants

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patient 18 years old or over.
* Patient that undergoes a lobectomy or bilobectomy for lung cancer,
* Patient presenting an incomplete fissure, requiring stapling of at least 50% of the fissure and/or an emphysematous lung at the fissure point, requiring stapling.
* Patient that has signed the informed consent before the operation.
* Patient that benefits from a social security regime.

Exclusion Criteria

* Patient with history of thoracotomy on the side operated on.
* Patient with severe pleural infection and/or infection of parenchyma.
* Presence of air leakage after liberation of lung in cases of pleural symphysis.
* Patient pregnant, giving birth or nursing.
* Patient presenting a contra indication to the aerostatic products used.
* Patient already participating in biomedical research.
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assistance Publique - Hôpitaux de Paris

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jean François REGNARD, PhD

Role: PRINCIPAL_INVESTIGATOR

Centre Hospitalier Hotel Dieu

Locations

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Assistance Publique Hopitaux de Paris

Paris, , France

Site Status

Countries

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France

References

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Fleisher AG, Evans KG, Nelems B, Finley RJ. Effect of routine fibrin glue use on the duration of air leaks after lobectomy. Ann Thorac Surg. 1990 Jan;49(1):133-4. doi: 10.1016/0003-4975(90)90371-c.

Reference Type BACKGROUND
PMID: 2297261 (View on PubMed)

Macchiarini P, Wain J, Almy S, Dartevelle P. Experimental and clinical evaluation of a new synthetic, absorbable sealant to reduce air leaks in thoracic operations. J Thorac Cardiovasc Surg. 1999 Apr;117(4):751-8. doi: 10.1016/S0022-5223(99)70296-5.

Reference Type BACKGROUND
PMID: 10096971 (View on PubMed)

Porte HL, Jany T, Akkad R, Conti M, Gillet PA, Guidat A, Wurtz AJ. Randomized controlled trial of a synthetic sealant for preventing alveolar air leaks after lobectomy. Ann Thorac Surg. 2001 May;71(5):1618-22. doi: 10.1016/s0003-4975(01)02468-7.

Reference Type BACKGROUND
PMID: 11383810 (View on PubMed)

Wain JC, Kaiser LR, Johnstone DW, Yang SC, Wright CD, Friedberg JS, Feins RH, Heitmiller RF, Mathisen DJ, Selwyn MR. Trial of a novel synthetic sealant in preventing air leaks after lung resection. Ann Thorac Surg. 2001 May;71(5):1623-8; discussion 1628-9. doi: 10.1016/s0003-4975(01)02537-1.

Reference Type BACKGROUND
PMID: 11383811 (View on PubMed)

Fabian T, Federico JA, Ponn RB. Fibrin glue in pulmonary resection: a prospective, randomized, blinded study. Ann Thorac Surg. 2003 May;75(5):1587-92. doi: 10.1016/s0003-4975(02)04994-9.

Reference Type BACKGROUND
PMID: 12735583 (View on PubMed)

Thomas P, Massard G, Porte H, Doddoli C, Ducrocq X, Conti M. A new bioabsorbable sleeve for lung staple-line reinforcement (FOREseal): report of a three-center phase II clinical trial. Eur J Cardiothorac Surg. 2006 Jun;29(6):880-5. doi: 10.1016/j.ejcts.2006.01.067. Epub 2006 May 3.

Reference Type BACKGROUND
PMID: 16675257 (View on PubMed)

Abolhoda A, Liu D, Brooks A, Burt M. Prolonged air leak following radical upper lobectomy: an analysis of incidence and possible risk factors. Chest. 1998 Jun;113(6):1507-10. doi: 10.1378/chest.113.6.1507.

Reference Type BACKGROUND
PMID: 9631785 (View on PubMed)

Stephan F, Boucheseiche S, Hollande J, Flahault A, Cheffi A, Bazelly B, Bonnet F. Pulmonary complications following lung resection: a comprehensive analysis of incidence and possible risk factors. Chest. 2000 Nov;118(5):1263-70. doi: 10.1378/chest.118.5.1263.

Reference Type BACKGROUND
PMID: 11083673 (View on PubMed)

Varela G, Jimenez MF, Novoa N, Aranda JL. Estimating hospital costs attributable to prolonged air leak in pulmonary lobectomy. Eur J Cardiothorac Surg. 2005 Feb;27(2):329-33. doi: 10.1016/j.ejcts.2004.11.005.

Reference Type BACKGROUND
PMID: 15691691 (View on PubMed)

Mouritzen C, Dromer M, Keinecke HO. The effect of fibrin glueing to seal bronchial and alveolar leakages after pulmonary resections and decortications. Eur J Cardiothorac Surg. 1993;7(2):75-80. doi: 10.1016/1010-7940(93)90184-d.

Reference Type BACKGROUND
PMID: 8442983 (View on PubMed)

Wong K, Goldstraw P. Effect of fibrin glue in the reduction of postthoracotomy alveolar air leak. Ann Thorac Surg. 1997 Oct;64(4):979-81. doi: 10.1016/s0003-4975(97)00820-5.

Reference Type BACKGROUND
PMID: 9354513 (View on PubMed)

Tansley P, Al-Mulhim F, Lim E, Ladas G, Goldstraw P. A prospective, randomized, controlled trial of the effectiveness of BioGlue in treating alveolar air leaks. J Thorac Cardiovasc Surg. 2006 Jul;132(1):105-12. doi: 10.1016/j.jtcvs.2006.02.022.

Reference Type BACKGROUND
PMID: 16798309 (View on PubMed)

Rami R, Mateu M. Surgical sealant for preventing air leaks after pulmonary resections in patients with lung cancer. Cochrane Database Syst Rev. 2001;(4):CD003051. doi: 10.1002/14651858.CD003051.

Reference Type BACKGROUND
PMID: 11687173 (View on PubMed)

Belboul A, Dernevik L, Aljassim O, Skrbic B, Radberg G, Roberts D. The effect of autologous fibrin sealant (Vivostat) on morbidity after pulmonary lobectomy: a prospective randomised, blinded study. Eur J Cardiothorac Surg. 2004 Dec;26(6):1187-91. doi: 10.1016/j.ejcts.2004.08.009.

Reference Type BACKGROUND
PMID: 15541982 (View on PubMed)

Other Identifiers

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IDRCB 2008-A01386-49

Identifier Type: -

Identifier Source: secondary_id

P080204

Identifier Type: -

Identifier Source: org_study_id