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Thérapie endoluminale sous vide pour prévenir les fuites anastomotiques après une œsophagectomie due à un cancer de l'œsophage (ESPY)

17 septembre 2026 mis à jour par: Aesculap AG

Étude prospective, multicentrique, exploratoire et observationnelle à un bras pour évaluer la thérapie sous vide endoluminale préventive afin de prévenir les fuites anastomotiques après une œsophagectomie due à un cancer de l'œsophage

A prospective, multi-centre, exploratory and observational one-arm study to evaluate preventive Endoluminal Vacuum Therapy(pEVT) to prevent anastomotic leakage after esophagectomy due to esophageal cancer. The main objective is to evaluate the potential protective effect of prophylactic preemptive endoluminal vacuum therapy on esophageal-gastric anastomosis dehiscence after esophagectomy.

Aperçu de l'étude

Statut

Actif, ne recrute pas

Intervention / Traitement

Description détaillée

Prospective, multi-centre, exploratory and observational one-arm study to evaluate preemptive endoluminal vacuum therapy to prevent anastomotic leakage after esophagectomy due to esophageal cancer.

The study comprises a maximum of 5 visits per protocol. At visit 0, informed consent will be obtained, and the patient will be checked for compliance with all inclusion criteria and no exclusion criteria in the study. Demographic characteristics, medical history and oncological parameters will be collected. At visit 1 ttMILE will be carry out and immediately (0-24h) after completion of the anastomosis, in patients who meet selection criteria, the Eso-SPONGE® will be placed endoscopically via an overtube, as usual clinical practice of the centre. The tube will be routed transnasally and then connected to a vacuum pump, generating a continuous negative pressure of 75 mmHg. The Eso-SPONGE system will be checked 6-hourly for leakage and dislocation. The sponge will be removed after 4-6 days (V2). After removal, the anastomosis and the gastric tube will be assessed endoscopically to exclude leakage and evaluate ischemia and stenosis, and the pylorus will be evaluated for spasm. The next visits (V3 and V4) will be carried out at 30 and 90 days after the intervention has been placed. Leakage, ischemia and stenosis will be clinically evaluated at each visit and a new endoscopy will be performed in patient who show symptoms.

Type d'étude

Observationnel

Inscription (Estimé)

44

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

    • Catalonia
      • Barcelona, Catalonia, Espagne, 08036
        • Hospital Clinic de Barcelona

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

Méthode d'échantillonnage

Échantillon non probabiliste

Population étudiée

Patients undergoing a total minimally invasive (laparoscopic or robotic and thoracoscopic) transthoracic Ivor Lewis esophagectomy (ttMILE) due to esophageal cancer and subsequent eso-SPONGE® application to prevent anastomotic leakage (AL)

La description

Inclusion Criteria:

  • Age ≥ 18 years
  • Scheduled for total minimally invasive (laparoscopic or robotic and thoracoscopic) transthoracic Ivor Lewis esophagectomy (ttMILE) due to esophageal cancer and subsequent eso-SPONGE application to prevent anastomotic leakage
  • Patients able to read and understand the Patient Information Sheet and sign, if accepted, the Informed Consent Form
  • Patients able, at the discretion of the investigator, to comply with the requirements of the study and without impediments to follow the instructions and assessments throughout the study.

Exclusion Criteria:

  • Patients undergoing transhiatal esophagectomy without reconstruction, open Ivor Lewis esophagectomy or other esophageal resections different to ttMILE.
  • Multi-organ resection during the esophagectomy.
  • Emergent-urgent esophagectomy.
  • Coloplasty or small bowel plasty.
  • Necrotic tissue/gangrene.
  • Blood clotting disorder.
  • Bleeding esophageal varices.
  • Sponge placement required directly on major vessels.
  • Patients with known sensitivities or allergies to its components
  • Participation in any other clinical trial and use of any drug or experimental device, currently or in the 4 weeks prior to inclusion in the study.
  • Women who are pregnant, suspected of being pregnant or breastfeeding.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Modèles d'observation: COHORT
  • Perspectives temporelles: PROSPECTIVE

Cohortes et interventions

Groupe / Cohorte
Intervention / Traitement
Eso-SPONGE®

endoluminal vacuum therapy to prevent anastomotic leakage after esophagectomy due to esophageal cancer

minimally invasive treatment and prevention of anastomotic leakages and perforations in the upper gastrointestinal tract (upper GIT)

Autres noms:
  • dispositif de thérapie sous vide endoluminale (EVT)

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Rate of patients with anastomotic leakage
Délai: throughout the duration of the study (until last follow-up at postoperative day 90)

Anastomotic leakage (AL) is a severe complication following gastric and esophageal surgery. Anastomotic leakage occurs in 5-30% of patients after esophagectomy and may be further complicated by mediastinitis, sepsis, multiple organ failure, or death. The primary objective of the study is to evaluate the potential protective effect of prophylactic preemptive endoluminal vacuum therapy on esophageal-gastric anastomosis dehiscence after esophagectomy.

throughout the duration of the study (until last follow-up at postoperative day 90)

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Comprehensive Complication Index
Délai: Postoperative day 30 and day 90

The Comprehensive Complication Index (CCI®) calculates the overall morbidity of a patient after any surgical intervention based on the complication grading by the "Clavien-Dindo Classification" (CDC). The Comprehensive Complication Index (CCI®) reflects the gravity of this overall complication burden on the patient on a scale from 0 (no complication) to 100 (death).

Postoperative day 30 and day 90
Description of Adverse Events
Délai: throughout the duration of the study (until last follow-up at postoperative day 90)

All the Adverse Events reported during the study will be described together with their characteristics, noting those related with the investigational device application.

throughout the duration of the study (until last follow-up at postoperative day 90)
Rate of postoperative ischemia
Délai: Postoperative day 30 and day 90

The different grades of postoperative ischemia at Visit 1, Visit 2 and Visit 3

Postoperative day 30 and day 90
Rate of postoperative mortality
Délai: Postoperative day 30 and day 90

The percentage of patients who died along the study will be described in terms of absolute and relative frequencies, as well as causes for death and time until death regarding investigational device application.

Postoperative day 30 and day 90
Rate of postoperative stenosis
Délai: throughout the duration of the study (until last follow-up at postoperative day 90)

The percentage of postoperative stenosis at Visit 1, Visit 2 and Visit 3, as well as along the study

throughout the duration of the study (until last follow-up at postoperative day 90)
Length of hospitalization
Délai: until discharge (approximately 10 days postoperatively)

time elapsed until reaching the "fit for discharge criteria" regarding investigational device application

until discharge (approximately 10 days postoperatively)
Re-admissions to hospital
Délai: throughout the duration of the study (until last follow-up at postoperative day 90)

The percentage of patients re-admitted along the study will be described; as well as the time elapsed until re-admission regarding investigational device application

throughout the duration of the study (until last follow-up at postoperative day 90)
Surgical reoperations
Délai: throughout the duration of the study (until last follow-up at postoperative day 90)

The percentage of patients with surgical reoperations along the study will be described; as well as the time elapsed until surgical reoperation regarding investigational device application

throughout the duration of the study (until last follow-up at postoperative day 90)
Anastomotic leakage free survival
Délai: throughout the duration of the study (until last follow-up at postoperative day 90)

Event free survival at 30 days and at 90 days will be analyzed using Kaplan-Meier method, considering the anastomotic leakage reported during the study. Patients with no anastomotic leakage during the analyzed period will be censored at last follow-up date

throughout the duration of the study (until last follow-up at postoperative day 90)
Rate of intraluminal hemorrhage
Délai: throughout the duration of the study (until last follow-up at postoperative day 90)

The percentage of patients with intraluminal hemorrhage along the study will be described in terms of absolute and relative frequencies; as well as the time elapsed until hemorrhage regarding investigational device application. Additionally, to see the distribution of the time until intraluminal hemorrhage Kaplan-Meier method will be performed at 90 days (patients with no intraluminal hemorrhage during the study will be censored at last follow-up date).

throughout the duration of the study (until last follow-up at postoperative day 90)

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Collaborateurs

Les enquêteurs

  • Chercheur principal: Dulce Momblán García, Dr., Hospital Clinic of Barcelona

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

7 octobre 2024

Achèvement primaire (Estimé)

1 octobre 2026

Achèvement de l'étude (Estimé)

1 décembre 2026

Dates d'inscription aux études

Première soumission

16 octobre 2023

Première soumission répondant aux critères de contrôle qualité

20 octobre 2023

Première publication (Réel)

24 octobre 2023

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

21 septembre 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

17 septembre 2026

Dernière vérification

1 septembre 2026

Plus d'information

Termes liés à cette étude

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Informations sur les médicaments et les dispositifs, documents d'étude

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Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

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