Evaluation of the Respiratory Impact After Conventional or Minimally Invasive Esophageal Atresia Surgery

NCT ID: NCT04136795

Last Updated: 2019-12-20

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

Total Enrollment

500 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-01-01

Study Completion Date

2020-12-31

Brief Summary

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Right thoracotomy, conventional approach to esophageal atresia repair, leads to up to 60% radiological chest wall sequelae anomalies. The impact of these anomalies on the patient's respiratory function remains unknown. Minimally invasive thoracic surgery considerably reduces this rate.

The primary objective of this study is to assess the occurrence of restrictive lung disease in patients with type III esophageal atresia depending on the type of surgical approach (Conventional or minimally invasive).

The primary endpoint will be he occurrence of restrictive lung disease , objectified by pulmonary function tests (PFTs), carried out according to the current national guidelines (PNDS = protocole national de diagnostic et de soins).

Detailed Description

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Right thoracotomy, conventional approach to esophageal atresia repair, leads to up to 60% radiological chest wall sequelae anomalies. The impact of these anomalies on the patient's respiratory function remains unknown. Minimally invasive thoracic surgery considerably reduces this rate.

The primary objective of this study is to assess the occurrence of restrictive lung disease in patients with type III esophageal atresia depending on the type of surgical approach (Conventional or minimally invasive).

The primary endpoint will be the occurrence of restrictive lung disease, as assessed by pulmonary function tests (PFTs), carried out according to the current national guidelines (PNDS = protocole national de diagnostic et de soins).

The secondary endpoints will be to measure the severity of the restrictive disease, to look for other respiratory alterations, to correlate radiological chest wall sequelae anomalies with the impact on respiratory function and to look for a causal relationship between the surgical technique used and the respiratory impact.

The methodology used will be a retrospective non interventional study on the cohort of patients included in the national esophageal atresia registry (CRACMO, Lille University Hospital) between the 1st of january 2008 and the 31st of December 2013.

All the patients included in the national esophageal atresia registry (CRACMO) having had an operation for type III esophageal atresia (long gap esophageal atresia excluded), as defined by the Ladd Classification, will be included in this study.

The exclusion criterion will be patients lost to follow up or deceased, patients having had no pulmonary function tests (PFTs) or no thoracic X-Ray during the first 6 to 9 years of follow up and patients having had thoracic surgery before the esophageal atresia repair.

The number of patients expected in the national esophageal atresia registry over the 6 years excedes 500. The number of thoracoscopy repairs should be about 50.

This study should allow us to determine if minimally invasive surgery is beneficial on mid-term respiratory function in children, related to possible post-operative chest wall sequelae.

The results obtained from this study should lead to recommendations concerning the surgical approach to esophageal atresia repair to improve the prognosis of chest wall anomalies and respiratory function in these patients. It should also help to identify patient subgroups which would benefit from a reinforced respiratory follow up. This could then lead to a hospital clinical research program (PHRC)

Conditions

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Esophageal Atresia Oesophageal Atresia Restrictive Lung Disease Chest Wall Anomaly

Keywords

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esophageal atresia thoracoscopy rib fusion scoliosis Respiratory function

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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Conventional surgery

Patients having had esophageal atresia (type III, long gap excluded) repair by conventional surgery (right thoracotomy) or patients having had minimally invasive surgery converted to thoracotomy between the 1st of january 2008 and the 31st of December 2013 and registered on the national esophageal atresia registry (CRACMO, Lille university hospital)

No interventions assigned to this group

Minimally invasive surgery

Patients having had esophageal atresia (type III, long gap excluded) repair through minimally invasive surgery between the 1st of january 2008 and the 31st of December 2013 and registered on the national esophageal atresia registry (CRACMO, Lille university hospital)

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Patients included in the national esophageal atresia registry (CRACMO)
* Operation for type III esophageal atresia (Ladd classification)
* Between 01/01/2008 and 31/12/2013.

Exclusion Criteria

* Long gap esophageal atresia
* Patients lost to follow up
* Deceased
* No PFTs or X-rays between 6 and 9 years of follow up
* Patients having had thoracic surgery before the esophageal atresia repair
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institut de Recherche en Santé, Environnement et le Travail, France

OTHER

Sponsor Role collaborator

Filière des Maladies Rares Abdomino-THOraciques : FIMATHO

UNKNOWN

Sponsor Role collaborator

University Hospital, Angers

OTHER_GOV

Sponsor Role lead

Responsible Party

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DENISE JOLIVOT

Dr Françoise Schmitt

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Françoise Schmitt, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University Hospital of Angers

Locations

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CRACMO - centre de référence des atrésies de l'oesophage

Lille, , France

Site Status

Countries

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France

Central Contacts

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François Bastard, MD

Role: CONTACT

Phone: +33 2 41 35 42 90

Email: [email protected]

Facility Contacts

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Rony Sfeir, MD

Role: primary

References

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Bastard F, Bonnard A, Rousseau V, Gelas T, Michaud L, Irtan S, Piolat C, Ranke-Chretien A, Becmeur F, Dariel A, Lamireau T, Petit T, Fouquet V, Le Mandat A, Lefebvre F, Allal H, Borgnon J, Boubnova J, Habonimana E, Panait N, Buisson P, Margaryan M, Michel JL, Gaudin J, Lardy H, Auber F, Borderon C, De Vries P, Jaby O, Fourcade L, Lecompte JF, Tolg C, Delorme B, Schmitt F, Podevin G. Thoracic skeletal anomalies following surgical treatment of esophageal atresia. Lessons from a national cohort. J Pediatr Surg. 2018 Apr;53(4):605-609. doi: 10.1016/j.jpedsurg.2017.07.013. Epub 2017 Jul 21.

Reference Type RESULT
PMID: 28778692 (View on PubMed)

Other Identifiers

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49RC19_0185

Identifier Type: -

Identifier Source: org_study_id