Glue Application in the Treatment of Low-Output Fistulas

NCT ID: NCT01828892

Last Updated: 2015-06-10

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

2014-03-31

Study Completion Date

2017-12-31

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 enterocutaneous fistulas (ECFs). The primary objectives of this study are to compare the clinical efficacy, safety of autologous platelet-rich fibrin glue (PRFG), commercial fibrin glue, and control therapy in the management of patients with low-output volume ECFs.

Detailed Description

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* This is a prospective, randomized, multi-centered study clinical, safety and economic outcome of ECFs patients.
* Subjects are randomized to one of 3 groups:

* Group 1: Autologous PRFG-treatment \[PRFG + Standard of care (SOC)\]
* Group 2: Commercial FG-treatment \[FG + Standard of care (SOC)\]
* Group 3: Control (SOC only)
* Study will include three phases:

* Phase 1: Screening, consent and enrollment
* Phase 2: Patients will receive either PRFG, commercial FG, or SOC 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 PRFG 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.

Antibiotics (ceftazidime, cefotaxime, or meropenem, with or without vancomycin)

Intervention Type DRUG

Antibacterial therapy in 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

Control

Patients in this group only received standard of care when their fistula output \< 200ml/24h.

Group Type SHAM_COMPARATOR

Endoscopy exploration

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.

Antibiotics (ceftazidime, cefotaxime, or meropenem, with or without vancomycin)

Intervention Type DRUG

Antibacterial therapy in 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

Commercial FG

Commercial FG (Zhejiang Puji Porcine fibrin sealant) was applied to close fistulas.

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.

Antibiotics (ceftazidime, cefotaxime, or meropenem, with or without vancomycin)

Intervention Type DRUG

Antibacterial therapy in 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.

Intervention Type PROCEDURE

Endoscopy exploration

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.

Intervention Type PROCEDURE

Antibiotics (ceftazidime, cefotaxime, or meropenem, with or without vancomycin)

Antibacterial therapy in 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

Other Intervention Names

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ceftazidime, cefotaxime, or meropenem, with or without vancomycin

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

Principal Investigators

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Jianan Ren, MD

Role: PRINCIPAL_INVESTIGATOR

Jinling Hospital, China

Locations

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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, MD

Role: primary

862580860108

References

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Wu X, Ren J, Wang G, Wang J, Wang F, Fan Y, Li Y, Han G, Zhou Y, Song X, Quan B, Yao M, Li J. Evaluating the use of fibrin glue for sealing low-output enterocutaneous fistulas: study protocol for a randomized controlled trial. Trials. 2015 Oct 7;16:445. doi: 10.1186/s13063-015-0966-9.

Reference Type DERIVED
PMID: 26445823 (View on PubMed)

Other Identifiers

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20120819

Identifier Type: -

Identifier Source: org_study_id

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