- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT07670754
ORASIS in Breast Reconstruction
ORASIS and Microsurgical Anastomosis Outcomes in DIEP Flap Breast Reconstruction: A Crossover Randomized Controlled Trial
Přehled studie
Postavení
Podmínky
Intervence / Léčba
Typ studie
Zápis (Odhadovaný)
Fáze
- Nelze použít
Kontakty a umístění
Studijní kontakt
- Jméno: Joey Liang
- Telefonní číslo: 4252097705
- E-mail: joey.liang@duke.edu
Studijní záloha kontaktů
- Jméno: Ash Patel, MB ChB
- E-mail: ash.patel@duke.edu
Studijní místa
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North Carolina
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Durham, North Carolina, Spojené státy, 27710
- Duke University Medical Center
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Kontakt:
- Joey Liang
- Telefonní číslo: 425-209-7705
- E-mail: joey.liang@duke.edu
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Raleigh, North Carolina, Spojené státy, 27609
- Duke Raleigh Hospital
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Kontakt:
- Joey Liang
- Telefonní číslo: 425-209-7705
- E-mail: joey.liang@duke.edu
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dospělý
- Starší dospělý
Přijímá zdravé dobrovolníky
Popis
Inclusion:
- Female DIEP flap breast reconstruction patients who have received a prior mastectomy (either unilateral or bilateral) on the breast undergoing reconstruction
- Patients who received mastectomies for oncologic or prophylactic indications
- Patients receiving either immediate or delayed DIEP flap breast reconstruction
- Age 18 or older at the time of patient consent and DIEP flap surgery
Exclusion:
- History of any prior tissue expander placement or breast reconstruction on the breast undergoing DIEP flap reconstruction
- Patients receiving DIEP flap breast reconstruction for indications other than oncologic or prophylactic post-mastectomy breast reconstruction
- Under the age of 18 at the time of patient consent or DIEP flap surgery
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Crossover Assignment
- Maskování: Singl
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
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Žádný zásah: Control Arm
In the control arm, surgeons will perform two microsurgical anastomoses without the use of ORASIS in either bilateral or unilateral DIEP flap reconstruction.
If bilateral DIEP flap reconstruction is performed in the control arm, only the first microsurgical anastomosis for each bilateral DIEP flap reconstruction will be assessed.
In both study arms, surgeons will perform end-to-end anastomosis using current standard-of-care techniques.
This will include the formation of anastomoses between the deep inferior epigastric artery (DIEA) and internal mammary artery (IMA) in the antegrade direction of blood flow using 8-0 nylon sutures.
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Experimentální: ORASIS Arm
In the ORASIS arm, surgeons will perform two microsurgical anastomoses with the use of ORASIS in either bilateral or unilateral DIEP flap reconstruction.
If bilateral DIEP flap reconstruction is performed in the treatment arm, ORASIS will only be used in the first microsurgical anastomosis performed in each bilateral DIEP flap reconstruction; only the breast reconstructed with the use of ORASIS will be assessed.
In both study arms, surgeons will perform end-to-end anastomosis using current standard-of-care techniques.
This will include the formation of anastomoses between the deep inferior epigastric artery (DIEA) and internal mammary artery (IMA) in the antegrade direction of blood flow using 8-0 nylon sutures.
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The study intervention is the use of the ORASIS device during microsurgical anastomosis formation in DIEP flap breast reconstruction procedures.
ORASIS is a dual irrigation and suction device that can be placed in the surgical field during the formation of microsurgical anastomoses.
The device was previously registered with the FDA under registration number 878.4200; the device is currently not registered with the FDA as it is pending renewal.
The device is manufactured by a partner company (Spectroplast/Ricoh UK) with demonstrated compliance to international quality standards.
The manufacturer has successfully implemented the ISO 9001 Quality Management System across all operational areas following a comprehensive audit process, that supports compliance with FDA cGMP requirements (21 CFR Part 820) for Class I medical devices.
Spectroplast/Ricoh UK is certified under FDA ISO 10993 standards for biological evaluation of medical devices.
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Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Mean anastomosis time (minutes)
Časové okno: From first suture placement to anastomosis completion
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Total anastomosis time will be defined as the number of minutes from first suture placement to anastomosis completion.
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From first suture placement to anastomosis completion
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Mean ischemia time (minutes)
Časové okno: From pedicle transection to anastomosis completion
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Total ischemia time will be defined as the number of minutes from flap division to flap reperfusion.
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From pedicle transection to anastomosis completion
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Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Mean number of interruptions per procedure
Časové okno: From beginning of microsurgical anastomosis to end of microsurgical anastomosis
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Interruptions will be defined as instances where the surgeon pauses for suction/irrigation in the control arm vs. automatic suction/irrigation in the ORASIS arm.
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From beginning of microsurgical anastomosis to end of microsurgical anastomosis
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Mean NASA-TLX (Task Load Index) score
Časové okno: From beginning of microsurgical anastomosis to end of microsurgical anastomosis
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The NASA-TLX is a validated tool to measure cognitive and physical workload for surgeons, reported as a score between 0 to 100.
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From beginning of microsurgical anastomosis to end of microsurgical anastomosis
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Mean Surgical Assessment Metric Scale (SAMS) overall scores
Časové okno: From beginning of microsurgical anastomosis to end of microsurgical anastomosis
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SAMS is a validated tool that assesses proficiency across key technical metrics such as suture placement, knot quality, and overall flow of the procedure on a scale of 1-5.
Performed anastomoses will be recorded by the digital microscope, and the quality and precision of the anastomosis will be assessed by a blinded rater using the previously validated SAMS score checklist.
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From beginning of microsurgical anastomosis to end of microsurgical anastomosis
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Surgeon Survey
Časové okno: Within 1 month after conclusion of DIEP flap surgery procedure
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A post-procedure survey (Likert scale) will be administered after each procedure assessing ease of use, surgeon perception of precision, and overall satisfaction with the ORASIS device.
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Within 1 month after conclusion of DIEP flap surgery procedure
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Incidence of postoperative complications 0-48 hours after procedure
Časové okno: Within 48 hours after DIEP flap surgery
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Notable complications include flap failure, re-operation/take-back and wound dehiscence, seroma, hematoma, and surgical site infection.
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Within 48 hours after DIEP flap surgery
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Další výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Estimated cost difference per case (economic impact metrics)
Časové okno: During the entirety of the DIEP flap procedure
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Based on average OR time cost for plastic surgery procedures at Duke (dollars per minute).
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During the entirety of the DIEP flap procedure
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Number of surgeons per case
Časové okno: During the entirety of the DIEP flap procedure
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Number of surgeons per case, stratified by level of training (i.e. 1 vs 2 microsurgeons required +/- residents).
For example, allowing a microsurgeon to perform the anastomosis alone as opposed to a co-surgeon case would reduce operative costs.
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During the entirety of the DIEP flap procedure
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Spolupracovníci a vyšetřovatelé
Sponzor
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Odhadovaný)
Primární dokončení (Odhadovaný)
Dokončení studie (Odhadovaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
- Pro00118006
Plán pro data jednotlivých účastníků (IPD)
Plánujete sdílet data jednotlivých účastníků (IPD)?
Popis plánu IPD
Confidentiality of subject data will be ensured by de-identification of subject data. During data collection, subject identifiers and relevant data elements will be recorded in the database. Then, study-specific identification numbers will be assigned to each subject. Prior to dissemination of any information in this database beyond the DUMC's secure servers or firewall, all identifiers will be stripped from the database and data will only be referenced by the study-specific identification numbers.
The adequacy of the Duke Research Data Lifecycle will be evaluated and approved by the Surgery CRU and IT personnel prior to study conduct. Any publications or presentations that result from this research will not identify any subjects individually and will present data in aggregate form only. Data collected as part of this study will not be submitted to the FDA; data collected will only be used for publication as part of an assessment of device efficacy.
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
produkt vyrobený a vyvážený z USA
Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .
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