Does Icodextrin Reduce the Risk of Small Bowel Obstruction?

NCT ID: NCT02318888

Last Updated: 2020-03-31

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

1808 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-12-31

Study Completion Date

2022-12-31

Brief Summary

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The study aims at investigating if icodextrin 4% instilled in abdominal cavity during surgery can reduce the risk of surgery and hospitalisation for small bowel obstruction in patients with colorectal cancer. Follow-up data is collected from the Swedish national colorectal cancer registry.Patients are followed for 5 years postoperatively.The study is a randomized Swedish multicenter study and planned to include 1,800 patients. A safety control is planned after 300 included patients.

Detailed Description

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Icodextrin 7.5% is used in peritoneal dialysis. In animal models and in gynecological surgery a 4% solution of Icodextrin has been tested as a possible agent of reducing adhesions by acting as a barrier between peritoneal surfaces. Some data support a reduction af adhesions (van den Tool et al., Brown et al.). However, is not known whether icodextrin reduces the need for surgery or hospitalisation for small bowel obstruction.This study aims to study these parameters as well as complications and survival.

Patients with colorectal cancer and scheduled for surgery with curative intent will be (after patients acceptance) randomized to have icodextrin 4% instilled in the abdominal cavity or not. Patients allocated to icodextrin arm will have 100 ml of icodextrin 4% instilled every 30 minutes during surgery and at end of operation further 1000 ml instilled in the abdominal cavity. Postoperative care is performed according to each hospital praxis.

Follow-up data will be collected from the Swedish National Colorectal cancer registry. Data 30 days postoperatively will be analysed for early small bowel obstruction and other early complications. The study ends 5 years postoperatively with analysis of surgery and hospitalization for small bowel obstruction as well as survival and longterm complications.

A safety analysis is planned after the first 300 randomized patients with respect to early (30 days) complications. These data will analysed blindly by external reviewers.

Randomization (1:1) will be performed at the Regional Cancer Centrum in the Uppsala-Örebro region. The study aims to randomise 1800 patients.

Conditions

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Surgical Adhesions

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Surgery and Icodextrin

Icodextrin 4% instilled every 30 minutes during surgery and 1000 ml instilled before closure of abdomen

Group Type EXPERIMENTAL

Surgery

Intervention Type PROCEDURE

Icodextrin

Intervention Type DRUG

Surgery

No instillations during surgery

Group Type ACTIVE_COMPARATOR

Surgery

Intervention Type PROCEDURE

Interventions

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Surgery

Intervention Type PROCEDURE

Icodextrin

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Colorectal cancer
* Curative surgery planned
* Informed consent
* Age 18-85

Exclusion Criteria

* Local surgery planned
* Generalized disease
* Other malignancy
* Not informed consent
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Uppsala University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Urban Karlbom, PhD

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Uppsala

Lars Påhlman, Professor

Role: STUDY_DIRECTOR

University Hospital

Locations

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Eskilstuna Hospital

Eskilstuna, , Sweden

Site Status

Falun Hospital

Falun, , Sweden

Site Status

Gävle Hospital

Gävle, , Sweden

Site Status

Jönköping Hospital

Jönköping, , Sweden

Site Status

Karlstad Hospital

Karlstad, , Sweden

Site Status

Lidköping Hospital

Lidköping, , Sweden

Site Status

Luleå Hospital

Luleå, , Sweden

Site Status

Mora Hospital

Mora, , Sweden

Site Status

Norrrköping Hospital

Norrköping, , Sweden

Site Status

Nyköping Hospital

Nyköping, , Sweden

Site Status

Torsby Hospital

Torsby, , Sweden

Site Status

University Hospital

Uppsala, , Sweden

Site Status

Västerås Hospital

Västerås, , Sweden

Site Status

Countries

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Sweden

References

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van den Tol P, ten Raa S, van Grevenstein H, Marquet R, van Eijck C, Jeekel H. Icodextrin reduces postoperative adhesion formation in rats without affecting peritoneal metastasis. Surgery. 2005 Mar;137(3):348-54. doi: 10.1016/j.surg.2004.06.001.

Reference Type BACKGROUND
PMID: 15746791 (View on PubMed)

Brown CB, Luciano AA, Martin D, Peers E, Scrimgeour A, diZerega GS; Adept Adhesion Reduction Study Group. Adept (icodextrin 4% solution) reduces adhesions after laparoscopic surgery for adhesiolysis: a double-blind, randomized, controlled study. Fertil Steril. 2007 Nov;88(5):1413-26. doi: 10.1016/j.fertnstert.2006.12.084. Epub 2007 Mar 26.

Reference Type BACKGROUND
PMID: 17383643 (View on PubMed)

Sakari T, Sjodahl R, Pahlman L, Karlbom U. Role of icodextrin in the prevention of small bowel obstruction. Safety randomized patients control of the first 300 in the ADEPT trial. Colorectal Dis. 2016 Mar;18(3):295-300. doi: 10.1111/codi.13095.

Reference Type DERIVED
PMID: 26934850 (View on PubMed)

Other Identifiers

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Dnr 2009/123

Identifier Type: -

Identifier Source: org_study_id

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