Glue Sealing for Patients With Low-Output ECFs

NCT ID: NCT01672593

Last Updated: 2014-03-11

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-05-31

Study Completion Date

2014-12-31

Brief Summary

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Adjuvant use of fibrin glue (FG) in the fistula tract has been shown to promote closure of low-output ECFs. The primary objectives of this study are to compare the clinical efficacy, safety of autologous platelet-rich fibrin glue (PRFG) and a commercially available fibrin sealant Bioseal® in the management of patients with low-output volume ECFs.

Detailed Description

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* This is a prospective, randomized, single-centered study clinical, safety and economic outcome of ECFs patients.
* Subjects are randomized to one of 2 groups:

* Group 1: Autologous PRFG-treatment (PRFG + SOC)
* Group 2: Commercial FG-treatment (Bioseal® + SOC)
* Study will include three phases:

* Phase 1: Screening, consent and enrollment
* Phase 2: Patients will receive either PRFG, or Bioseal only for 14 days
* Phase 3: Follow up: for patients with closed fistula within 14 days, we will follow up them for 6 months. For patients whose fistulas were still open will be treated with other therapeutic option and follow up for 6 months after closure.

Conditions

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Low-output External Gastrointestinal Fistula

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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PRFG treatment

As described in our previous study, platelet-rich cryoprecipitate and thrombin were obtained from 300-400ml whole blood of each patient enrolled in the autologous PRFG(platelet-rich fibrin glue) group and then frozen at -20°C for storage. Prior to application, frozen cryoprecipitate and thrombin stored were thawed in a 37°C water bath. Aminomethylbenzoic Acid (1ml: 1mg, Sigma-Aldrich, St Louis, MO) was added into the cryoprecipitate in the volume ratio of 1:10.

Group Type EXPERIMENTAL

Endoscopy exploration and glue application

Intervention Type PROCEDURE

A forward-viewing fistula-fiberscope (EndoView, Outai Medical Equipment, Shanghai, China), with 15cm length and 5mm width of fiber optical wire, was inserted into the fistula tract to accomplish endoscopic visualization. Briefly, the fistula-fiberscope assisted procedure was carried out percutaneously, allowing the exposure of internal hole and the whole tracts, followed by insertion of this catheter with distal mixing device. Upon injection, two components, fibrinogen and thrombin, were mixed together in the mixing reservoir and yield a gelatin-like glue. This procedure was repeated in patients up to 3 times within 14-day FG treatment period.

Anti-Bacterial Agents

Intervention Type DRUG

Antibacterial therapy was given to patients with signs of systemic sepsis or local inflammation with pain.

Nutrition support

Intervention Type DIETARY_SUPPLEMENT

Nutritional replacement and bowel rest via enteral or parenteral nutrition.

PRFG preparation

Intervention Type PROCEDURE

As described in our previous work, platelet-rich cryoprecipitate and thrombin were obtained from 300-400ml whole blood of each patient enrolled in the PRFG group and then frozen at -20°C for storage.

Bioseal treatment

The commercial fibrin sealants used in the study were purchased from Guangzhou Bioseal Biotech Co. Ltd, Guangzhou, China. Upon application, two components, fibrinogen and thrombin, were placed separately in two syringes which were joined by a Y-shaped connector. The trunk of the Y-shaped connecter was connected to a single lumen catheter.

Group Type ACTIVE_COMPARATOR

Endoscopy exploration and glue application

Intervention Type PROCEDURE

A forward-viewing fistula-fiberscope (EndoView, Outai Medical Equipment, Shanghai, China), with 15cm length and 5mm width of fiber optical wire, was inserted into the fistula tract to accomplish endoscopic visualization. Briefly, the fistula-fiberscope assisted procedure was carried out percutaneously, allowing the exposure of internal hole and the whole tracts, followed by insertion of this catheter with distal mixing device. Upon injection, two components, fibrinogen and thrombin, were mixed together in the mixing reservoir and yield a gelatin-like glue. This procedure was repeated in patients up to 3 times within 14-day FG treatment period.

Anti-Bacterial Agents

Intervention Type DRUG

Antibacterial therapy was given to patients with signs of systemic sepsis or local inflammation with pain.

Nutrition support

Intervention Type DIETARY_SUPPLEMENT

Nutritional replacement and bowel rest via enteral or parenteral nutrition.

Interventions

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Endoscopy exploration and glue application

A forward-viewing fistula-fiberscope (EndoView, Outai Medical Equipment, Shanghai, China), with 15cm length and 5mm width of fiber optical wire, was inserted into the fistula tract to accomplish endoscopic visualization. Briefly, the fistula-fiberscope assisted procedure was carried out percutaneously, allowing the exposure of internal hole and the whole tracts, followed by insertion of this catheter with distal mixing device. Upon injection, two components, fibrinogen and thrombin, were mixed together in the mixing reservoir and yield a gelatin-like glue. This procedure was repeated in patients up to 3 times within 14-day FG treatment period.

Intervention Type PROCEDURE

Anti-Bacterial Agents

Antibacterial therapy was given to patients with signs of systemic sepsis or local inflammation with pain.

Intervention Type DRUG

Nutrition support

Nutritional replacement and bowel rest via enteral or parenteral nutrition.

Intervention Type DIETARY_SUPPLEMENT

PRFG preparation

As described in our previous work, platelet-rich cryoprecipitate and thrombin were obtained from 300-400ml whole blood of each patient enrolled in the PRFG group and then frozen at -20°C for storage.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients with a single tubular ECF
* Low output volume (\<200 ml/24h)
* Tract length \>2cm
* Tract diameter \< 1cm

Exclusion Criteria

* Cancer-infiltrated fistula
* Abscess
* Foreign bodies
* Distal bowel obstruction
* Inflammatory bowel disease
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Jinling Hospital, China

OTHER

Sponsor Role lead

Responsible Party

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Jianan Ren

Vice president of department of surgery, Jinling Hospital

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Department of Surgery, Jinling Hospital

Nanjing, Jiangsu, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Jianan Ren, MD

Role: CONTACT

862580860108

XIUWEN WU

Role: CONTACT

862580860008

Facility Contacts

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Jianan Ren, M.D.

Role: primary

862580860108

Other Identifiers

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20120818

Identifier Type: -

Identifier Source: org_study_id

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