OBSiDiAN in a Stapled Circular Esophagogastric Anastomosis After Ivor Lewis Esophagectomy (Obsidian ph II)

September 16, 2026 updated by: University Hospital, Ghent

Evaluation of Effectiveness and Safety of Autologous BioMatrix OBSiDiAN to Enhance a Stapled Circular Esophagogastric Anastomosis After Ivor Lewis Esophagectomy, a Phase II Study.

Oesophagectomy is very invasive surgery. A leakage at the level of the connection between oesophagus and stomach made during surgery causes a lot more problems and can lead to death. Studies show that the leakage rate sometimes goes up to 40 per cent. The chance of dying if you develop a leak after surgery is 15%, while the overall chance of dying during hospitalisation for this procedure is about 4%. We want to investigate whether the use of this new type of 'glue' (Obsidian®) can reduce the number of leaks. We invite you to participate in a clinical trial with the aim of investigating whether Obsidian® is safe and can reduce the number of leaks after oesophageal surgery in patients with oesophageal cancer. We want to apply a new type of 'glue', Obsidian®, at the level of the new connection between oesophagus and stomach.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

STUDY PRODUCT Autologous BioMatrix: Obsidian (medical device class III)

STUDY POPULATION Subjects ≥ 18 years and ≤ 75 years of age scheduled for elective Ivor Lewis esophagectomy for esophageal cancer with a circular stapled intrathoracic esophagogastric anastomosis.

SAMPLE SIZE A total of 90 patients will be included in the study. ENROLEMENT PERIOD Based on an annual number of 70-80 esophagectomies in University Hospital Ghent, we predict an enrolment period of 3 years.

STUDY DURATON Considering a 3 years enrolment period and a 1 year follow up we predict a study duration of 4 years.

PRIMAIRY ANALYSIS

• Anastomotic leak within 30 days post operatively. Anastomotic leak type I, II and III is defined according to the Esophagectomy Complications Consensus Group (ECCG).

Study Type

Interventional

Enrollment (Estimated)

90

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • East-Flanders
      • Ghent, East-Flanders, Belgium, 9000
      • Ghent, East-Flanders, Belgium, 9000

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 75 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

  1. Inclusion criteria Preoperatively

    • Subjects ≥ 18 years and ≤ 75 years who are willing to participate and provide written informed consent prior to any study-related procedures.
    • Subjects with esophageal carcinoma (distal until Siewert II) scheduled for elective minimally invasive Ivor Lewis esophagectomy (cT1-4a,N0-3,M0).

    Intra-operatively

    - Intrathoracic circular stapled esophagogastric anastomosis

  2. Exclusion criteria preoperatively

    • Female patients who are pregnant or nursing
    • Participation in another study involving investigational drugs or devices.
    • Use of Avastin within 30 days prior to surgery
    • ASA IV (patient with severe systemic disease that is a constant threat to life)
    • Patients with other malignancies
    • Patients with previous esophageal or gastric surgery
    • Known hypersensitivity to batroxobin and tranexamic acid.
    • HB level < 8 g/dL
    • Patients on medicine containing acetylsalicylic acid not able to stop using the medicine for medical reasons minimum 3 days before taking the blood sampling.
    • Patients on clopidogrel not able to stop clopidogrel for medical reasons 7 days before blood sampling
    • Patients on other platelet aggregation inhibitor therapies not able to stop using the platelet aggregation inhibitor therapies for 3 days before taking the blood sample.

Intra-operatively

  • Intra-operative findings that may preclude conduct of the study procedures, such as pleural metastasis, tumor invasion in other organs, …
  • Anastomosis preformed differently than the standard of care
  • Excessive bleeding (>500 ml) prior to anastomosis

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: study group

For the study group, a unit of autologous BioMatrix OBSiDiAN will be produced. Blood sample (120ml) will be taken after randomization at the ending of the abdominal phase of the surgery. The surgeon will create an esophagogastric anastomosis, after ruling out tension or torsion. Around 1-2ml of autologous BioMatrix OBSiDiAN will be applied on the distal/or proximal resection stump before the stapled anastomose will be created. After firing the standard circular device and creation of a functional anastomosis, a further 2.5-3ml OBSiDiAN must be applied circumferentially on the outside on the anastomosis. Once application is completed, a 30 seconds waiting period is required before putting the esophagus back into the surgical field (study specific). A methylene blue leakage test or other leakage test is performed (standard of care). If there is a leak, the anastomosis will be corrected or the completed procedure has to be done again.

To create OBSiDiAN BioMatrix, 120 ml of the the patient's blood is added to the processing unit. The Vivostat® processor unit heats, separates, centrifugates to get the plasma. Batroxobin is added. After again processing, the result is an OBSiDian syringe filled with BioMatrix Obsidian®ASG. This will be applied on the anastomosis

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Anastomotic leak
Time Frame: Absence of anastomotic leak within 30 days post operatively

Anastomotic leak defined according to the ECCG guidelines type I: local defect requiring no change in therapy or treated medicallly or with dietary modifications type II: localized defect requiring interventional but not surgical therapy, for example, interventional radiology drain, stent or bedside opening and packing or incision type III: localized defect requiring surgical therapy

Absence of anastomotic leak within 30 days post operatively

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
mortality
Time Frame: from surgery until 30 days post operative

in hospital mortality

from surgery until 30 days post operative
sepsis
Time Frame: from surgery until 30 day post operative

in hospital sepsis

from surgery until 30 day post operative
pneumonia
Time Frame: from surgery until 30 day post operative

in hospital pneumonia

from surgery until 30 day post operative
late anastomotic leakage
Time Frame: from surgery until 90 days post operative

late anastomotic leakage (ECCG type I, II and III)

from surgery until 90 days post operative
stricture
Time Frame: from surgery until 1 year post operative

stricture of the esophagogastric anastomosis

from surgery until 1 year post operative
inflammation WBC
Time Frame: from date of randomisation to postoperative day 5

post operative inflammation (WBC)

from date of randomisation to postoperative day 5
inflammation CRP
Time Frame: from date of randomisation to postoperative day 5

post operative inflammation (CRP)

from date of randomisation to postoperative day 5
ICU stay
Time Frame: from surgery until discharge or until the date of death from any cause, whichever came first, assessed up to 3 months

length of ICU stay

from surgery until discharge or until the date of death from any cause, whichever came first, assessed up to 3 months
hospital stay
Time Frame: from surgery until discharge or until the date of death from any cause, whichever came first, assessed up to 3 months

total hospital stay

from surgery until discharge or until the date of death from any cause, whichever came first, assessed up to 3 months
thoracic drainage volume
Time Frame: from surgery until removal of thoracic drain within the first week postoperative

Volume of thoracic drain

from surgery until removal of thoracic drain within the first week postoperative
thoracic drainage duration
Time Frame: from surgery until removal of thoracic drain within the first week postoperative

duration of thoracic drain

from surgery until removal of thoracic drain within the first week postoperative
intra-operative checklist
Time Frame: peroperative
  • Hb > 8 g/dL
  • No tension on the anastomosis
  • No torsion on the anastomosis
  • Complete visibility of the anastomosis
  • Dry operation area
  • Application on the gastric stump
  • Application area of 2 cm proximal and distal of the anastomosis
  • Application completely covering the anastomosis
  • Visible white layer of fibrin sealant
  • Dry for 30 seconds
peroperative

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Piet Pattyn, UZ Gent

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 1, 2025

Primary Completion (Estimated)

January 1, 2027

Study Completion (Estimated)

January 1, 2027

Study Registration Dates

First Submitted

November 8, 2021

First Submitted That Met QC Criteria

February 1, 2023

First Posted (Actual)

February 6, 2023

Study Record Updates

Last Update Posted (Actual)

September 21, 2026

Last Update Submitted That Met QC Criteria

September 16, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • BC-09974

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.