Prospective, Multicenter, Randomized Controlled Phase III Trial of Biological Mesh for Alimentary Tract Reconstruction in Digestive Surgery

The goal of the Phase III clinical trial is to evaluate whether using a biological mesh helps improve the efficacy and safety of alimentary tract reconstruction surgery. In digestive surgery, bleeding or leakage at the surgical connection (anastomosis) remains a significant clinical challenge. This study explores whether reinforcing the anastomosis with a biological mesh can effectively reduce these risks and significantly enhance the reliability of the surgical procedure.

The main objectives of this study are:

To evaluate the effectiveness of the biological mesh in reducing bleeding points at the surgical site during the procedure.

To assess the role of the mesh in lowering the risk of postoperative complications, such as anastomotic leaks or stenosis, within 90 days after surgery.

Study Groups:

Experimental Group: Participants who undergo alimentary tract reconstruction with biological mesh reinforcement during surgery.

Control Group: Participants who undergo conventional surgical procedures without the use of mesh.

Participant Flow:

Participants will undergo a health evaluation before surgery to confirm they meet the study criteria. Following the procedure, participants will receive standard postoperative care and return for follow-up clinic visits 30 and 90 days after surgery to monitor their recovery.

Study Overview

• Status: Recruiting
• Conditions: Postoperative Hemorrhage; Digestive System Surgical Procedures; Anastomosis, Surgical; Anastomotic Leaks
• Intervention / Treatment: Device: Biological Mesh for Digestive Surgery; Procedure: Conventional Stapling

• Study Type: Interventional
• Enrollment (Estimated): 144
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Yanfeng Hu; Phone Number: +86 13632494551; Email: yfenghu@qq.com

Study Locations

• China
  • Guangdong
    • Guangzhou, Guangdong, China, 510515
      • Recruiting
      • Nanfang Hospital, Southern Medical University
      • Contact: Medical Ethics committee of NanFang Hospital; Phone Number: 020-62787238; Email: nfyyec@163.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Aged 18 to 75 years (inclusive).

2. Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1.

3. American Society of Anesthesiologists (ASA) physical status classification of Grade I, II, or III.

4. Scheduled for laparoscopic or open surgery involving gastrointestinal-related anastomosis.

5. Participants must meet the following laboratory criteria:

   1. Hemoglobin (Hb) ≥ 90 g/L;
   2. White Blood Cell (WBC) count ≥ 3 × 10^9/L and ≤ 12 × 10^9/L;
   3. Platelet (PLT) count ≥ 100 × 10^9/L;
   4. Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) ≤ 2 × Upper Limit of Normal (ULN);
   5. Total Bilirubin (T-Bil) ≤ 1.5 × ULN;
   6. Serum Creatinine (Cr) ≤ 1 × ULN;
   7. Serum Albumin ≥ 30 g/L.

6. Able to understand and sign the informed consent form.

Exclusion Criteria:

1. Pregnant or lactating women, or women of childbearing potential with a positive pregnancy test.
2. Patients with coagulation disorders.
3. Severe liver disease (e.g., cirrhosis), kidney disease, respiratory disease, or uncontrolled chronic systemic diseases such as diabetes or hypertension.
4. Clinically significant cardiac diseases, including congestive heart failure, symptomatic coronary artery disease, cardiac arrhythmias or hypertension poorly controlled by medication, myocardial infarction within the past 6 months, or cardiac insufficiency.
5. Presence of severe uncontrolled recurrent infections.
6. Known allergy or hypersensitivity to collagen or bovine-derived materials.
7. Current participation in other clinical trials for drugs or medical devices that have not yet reached the primary endpoint time point.
8. Any other medical condition (including follow-up and compliance issues) that, in the investigator's opinion, may or will interfere with the study process.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental Group: Biological Mesh Reinforcement; Participants in this group will undergo alimentary tract reconstruction using a linear stapler with biological mesh reinforcement. During the procedure, researchers will record intraoperative raw data, including the number of bleeding points per unit length within 10 minutes after stapling, among other related clinical indicators. Following the surgery, participants will receive standard postoperative care. A 90-day monitoring period will be conducted to track anastomotic-related complications, specifically focusing on postoperative bleeding, leakage, stenosis, and other related conditions.	Device: Biological Mesh for Digestive Surgery; A biological mesh specifically designed for reinforcement during alimentary tract reconstruction. It is used in conjunction with linear stapling devices during the surgical procedure to enhance the integrity of the anastomosis. The mesh provides mechanical support to the staple line, aiming to improve surgical outcomes by reducing intraoperative bleeding and the risk of postoperative complications, including leaks and stenosis, among other related conditions.
Active Comparator: Control Group: Conventional Stapling; Participants in this group will undergo conventional alimentary tract reconstruction using a linear stapler alone. Identical intraoperative raw data regarding bleeding points and other related clinical indicators will be recorded for baseline comparison. Following the surgery, participants will receive standard postoperative care. Consistent with the experimental group, a 90-day monitoring period will track anastomotic-related complications, such as postoperative bleeding, leakage, stenosis, and other related conditions.	Procedure: Conventional Stapling; Participants will undergo conventional alimentary tract reconstruction using a linear stapler alone, without the use of reinforcing mesh.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of bleeding points per unit length	The number of bleeding points on the staple line or anastomosis that require clinical hemostasis or suture reinforcement within 10 minutes after stapler firing, divided by the total length of the line. Observation sites include: gastric resection margins, duodenal closure margins, intestinal closure margins, gastrointestinal anastomosis, esophagogastric anastomosis, esophagojejunal anastomosis, enteroenteric anastomosis, and others.	Intraoperatively (within 10 minutes after stapling)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of arterial pulsatile bleeding points per unit length	The number of arterial pulsatile bleeding points per unit length on the staple line or anastomosis requiring clinical hemostasis within 10 minutes after firing. Observation sites are consistent with the primary outcome.	Intraoperatively (within 10 minutes after stapling)
Time required for hemostatic management	The total duration (in minutes) spent on performing additional hemostasis or reinforcement procedures for bleeding points at the anastomosis or staple line.	During the surgical procedure
Total operative time	The total duration of the surgery.	From the start of surgery to the end of surgery
Incidence of anastomotic-related complications	The percentage of participants experiencing complications specifically related to the surgical connection, including anastomotic bleeding, anastomotic leakage, and anastomotic stenosis.	Up to 90 days post-surgery

Collaborators and Investigators

• Sponsor: Nanfang Hospital, Southern Medical University

Study record dates

Study Major Dates

• Study Start (Actual): May 6, 2026
• Primary Completion (Estimated): December 31, 2027
• Study Completion (Estimated): December 31, 2027

Study Registration Dates

• First Submitted: November 2, 2026
• First Submitted That Met QC Criteria: November 2, 2026
• First Posted (Actual): November 6, 2026

Study Record Updates

• Last Update Posted (Actual): November 6, 2026
• Last Update Submitted That Met QC Criteria: November 2, 2026
• Last Verified: November 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Postoperative Complications; Pathologic Processes; Hemorrhage; Pathological Conditions, Signs and Symptoms; Anastomotic Leak; Postoperative Hemorrhage
• Other Study ID Numbers: NFEC-2025-248

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No