Partially Covered Versus Uncovered Pyloro-duodenal Stents for Unresectable Malignant Gastric Outlet Obstruction. A Double Blinded Randomised Controlled Trial.

NCT ID: NCT03223831

Last Updated: 2020-11-10

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

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

116 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-08-01

Study Completion Date

2020-11-01

Brief Summary

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To compare the efficacy of a novel partially covered (PC) versus uncovered (UC) pyloro-duodenal stents (DS) in unresectable malignant gastric outlet obstruction. We hypothesize that the use of PCDS could reduce the re-intervention rates when compared to UCDS.

Detailed Description

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This would be a prospective multi-centred double-blinded randomised controlled study including all patients suffering from malignant gastric outlet obstruction due unresectable primary gastro-duodenal or pancreatico-biliary malignancies. Five international institutions in Hong Kong, Singapore and India would participate in the study.

The procedure would be performed under conscious sedation or monitored anaesthesia. The patients would be randomised PCDS or UCDS after cannulation of the obstruction site is achieved with the guide-wire. The patients or assessors would be blinded to the type of stent that is inserted.

Conditions

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Unresectable Malignant Gastric Outlet Obstruction

Keywords

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unresectable malignant gastric outlet obstruction Partially covered pyloro-duodenal stents uncovered pyloro-duodenal stents

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Recruited patients would be randomized to receive either uncovered duodenal stents or partially covered duodenal stents.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants
Recruited patients would not be informed of the type of stent that was inserted

Study Groups

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Partially covered duodenal stent (PCDS)

The PCDS used in the current study is a partially covered metallic pyloro-duodenal stent. It consists of two portions. The stent is 2cm in diameter and the proximal 2cm of the stent is uncovered and flared. The remaining of the stent is covered, where a polytetrafluoroethylene (PTFE) membrane is held between two nitinol mesh.

Group Type ACTIVE_COMPARATOR

Partially covered pyloro-duodenal stent

Intervention Type OTHER

The PCDS (Niti-S COMVITM - Flare, Taewoong, Gyeonggi-do, South Korea) used in the current study is a partially covered metallic pyloro-duodenal stent. It consists of two portions (Figure 1). The stent is 2cm in diameter and the proximal 2cm of the stent is uncovered and flared. This is designed to provide anchorage of the stent to surrounding tissue and reduce the risk of migration. The remaining of the stent is covered, where a polytetrafluoroethylene (PTFE) membrane is held between two nitinol mesh to prevent the risk of tumour ingrowth into the stent. The stents come in lengths of 6, 8, 10 \& 12cm.

Uncovered duodenal stent (UDS)

The UCDS used in the current study is an uncovered stent made of nitinol wire, with a diameter of 20mm. This stent is an unfixed-cell braided stent with low axial force, high flexibility and good conformability.

Group Type ACTIVE_COMPARATOR

Uncovered pyloro-duodenal stents

Intervention Type OTHER

The UCDS (Niti-S pyloric-duodenal D stent, Taewoong, Gyeonggi-do, South Korea) used in the current study is an uncovered stent made of nitinol wire, with a diameter of 20mm and length of 6,8,10,12cm. This stent is an unfixed-cell braided stent with low axial force, high flexibility and good conformability.

Interventions

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Partially covered pyloro-duodenal stent

The PCDS (Niti-S COMVITM - Flare, Taewoong, Gyeonggi-do, South Korea) used in the current study is a partially covered metallic pyloro-duodenal stent. It consists of two portions (Figure 1). The stent is 2cm in diameter and the proximal 2cm of the stent is uncovered and flared. This is designed to provide anchorage of the stent to surrounding tissue and reduce the risk of migration. The remaining of the stent is covered, where a polytetrafluoroethylene (PTFE) membrane is held between two nitinol mesh to prevent the risk of tumour ingrowth into the stent. The stents come in lengths of 6, 8, 10 \& 12cm.

Intervention Type OTHER

Uncovered pyloro-duodenal stents

The UCDS (Niti-S pyloric-duodenal D stent, Taewoong, Gyeonggi-do, South Korea) used in the current study is an uncovered stent made of nitinol wire, with a diameter of 20mm and length of 6,8,10,12cm. This stent is an unfixed-cell braided stent with low axial force, high flexibility and good conformability.

Intervention Type OTHER

Other Intervention Names

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PCDS UCDS

Eligibility Criteria

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Inclusion Criteria

* Consecutive patients ≥ 18 years old
* Confirmed unresectable gastro-duodenal or pancreatico-biliary malignancies
* Suffering from gastric outlet obstruction with a gastric outlet obstruction score of ≤ 1 (appendix 1) 19
* Performance status ECOG ≤3 (appendix 2)

Exclusion Criteria

* Prior metallic stent placement
* Severe comorbidities precluding the endoscopic procedure (such as cardiopulmonary disease, sepsis, or a bleeding disorder)
* Life expectancy of less than 1 month
* History of gastric surgery
* Linitus plastica
* Coagulation disorders
* Pregnancy
* Unable to give informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National University Hospital, Singapore

OTHER

Sponsor Role collaborator

Singapore General Hospital

OTHER

Sponsor Role collaborator

Changi General Hospital

OTHER

Sponsor Role collaborator

Baldota Institute of Digestive Diseases, Mumbai, India.

UNKNOWN

Sponsor Role collaborator

Chinese University of Hong Kong

OTHER

Sponsor Role lead

Responsible Party

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Anthony Teoh

Honorary Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Anthony Teoh, FRCSEd(Gen

Role: PRINCIPAL_INVESTIGATOR

[email protected]

Locations

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Chinese University of Hong Kong

Hong Kong, Hong Kong, China

Site Status

Countries

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China

Other Identifiers

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CRE2016.701-T

Identifier Type: -

Identifier Source: org_study_id