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Replacement Gastrostomy Tubes: Technical and Clinical Comparison of Five Commercial Models

This study has been completed.
Sponsor:
ClinicalTrials.gov Identifier:
NCT01698827
First Posted: October 3, 2012
Last Update Posted: October 3, 2012
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by (Responsible Party):
Joel Faintuch, University of Sao Paulo
  Purpose
Multiple models of replacement tubes for percutaneous endoscopic gastrostomy are available in the market, however durability is variable. In a prospective randomized study, five commercial devices available in the market will be tested in 20 consecutive patients each. Tube performance will be observed during 6 months and durability will be assessed by Kaplan-Meier curves as well as Cox regression analysis.It is hypothesized that tube design and material will influence outcome.

Condition Intervention
Gastrostomy Tube Rupture Gastrostomy Tube Durability Gastrostomy Tube Convenience Other: Tube assessment visits

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Prospective
Official Title: Replacement Gastrostomy Tubes: Technical and Clinical Comparison of Five Commercial Models

Further study details as provided by Joel Faintuch, University of Sao Paulo:

Primary Outcome Measures:
  • Tube durability [ Time Frame: 6 months ]
    Durability of the tube will be calculated as days in use till need for replacement, within the time frame of 6 months of observation. 180 days of continuous use will correspond to 100% durability, and 18 days of use as 10% durability.


Secondary Outcome Measures:
  • Tube rupture [ Time Frame: 6 months ]
    Causes for replacement within the 6 months will be documented, with emphasis on tube or ballooon rupture


Other Outcome Measures:
  • Number of previous tube changes [ Time Frame: 6 months ]
    Tube outcome will be analyzed in the light of number of previous tube changes in the patients (first tube/no previous change vs. patients on long-term treatment with multiple tube changes)


Enrollment: 100
Study Start Date: January 2012
Study Completion Date: August 2012
Primary Completion Date: August 2012 (Final data collection date for primary outcome measure)
Groups/Cohorts Assigned Interventions
Kangaroo
20 patients managed by "Kangaroo" gastrostomy tubes. Patients will be submitted to initial screening and tube replacement, followed tube assessment visits every two months, till 6 months.
Other: Tube assessment visits
Patients will return every 2 months for clinical questionnaire about leaks, obstructions or other dysfunctions of the tube. Objective tube examination for cracks, rupture, obstruction or dislodgement, along with replacement if necessary, will be carried out (total of 3 visits/6 months)
Cook
20 patients receiving "Wilson Cook" gastrostomy tubes.Patients will be submitted to initial screening and tube replacement, followed tube assessment visits every two months, till 6 months.
Other: Tube assessment visits
Patients will return every 2 months for clinical questionnaire about leaks, obstructions or other dysfunctions of the tube. Objective tube examination for cracks, rupture, obstruction or dislodgement, along with replacement if necessary, will be carried out (total of 3 visits/6 months)
Silmag
20 patients managed by "Silmag" gastrostomy tubes.Patients will be submitted to initial screening and tube replacement, followed tube assessment visits every two months, till 6 months.
Other: Tube assessment visits
Patients will return every 2 months for clinical questionnaire about leaks, obstructions or other dysfunctions of the tube. Objective tube examination for cracks, rupture, obstruction or dislodgement, along with replacement if necessary, will be carried out (total of 3 visits/6 months)
Freka
20 patients carrying "Freka" gastrostomy tubes.Patients will be submitted to initial screening and tube replacement, followed tube assessment visits every two months, till 6 months.
Other: Tube assessment visits
Patients will return every 2 months for clinical questionnaire about leaks, obstructions or other dysfunctions of the tube. Objective tube examination for cracks, rupture, obstruction or dislodgement, along with replacement if necessary, will be carried out (total of 3 visits/6 months)
Bard
20 patients using the "Bard" gastrostomy tube. Patients will be submitted to initial screening and tube replacement, followed tube assessment visits every two months, till 6 months.
Other: Tube assessment visits
Patients will return every 2 months for clinical questionnaire about leaks, obstructions or other dysfunctions of the tube. Objective tube examination for cracks, rupture, obstruction or dislodgement, along with replacement if necessary, will be carried out (total of 3 visits/6 months)

Detailed Description:
Multiple models of replacement tubes for percutaneous endoscopic gastrostomy are available in the market, however durability is variable. In a prospective randomized study, five commercial devices available in the market will be tested in 20 consecutive patients each,in patients submitted to long-term outpatient nutritional support. Tube performance will be observed during 6 months and durability will be assessed by Kaplan-Meier curves as well as Cox regression analysis.It is hypothesized that tube design and material will influence outcome.This study is important because tube dysfunction and unscheduled changes are expensive troubles that disrupt the nutritional protocol and are responsible for multiple inconveniences to the patient and the caretaker.
  Eligibility

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 90 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population
Adults on long-term nutritional care requiring prolonged gastrostomy feeding via percutaneous endoscopic gastrostomy
Criteria

Inclusion Criteria:

  • Adults undergoing long-term home enteral nutrition via percutaneous endoscopic gastrostomy due to neurologic conditions or dysphagia.
  • registered at the outpatient endoscopy service
  • clinical stable and with the possibility of returning for scheduled visits
  • expected duration of enteral feeding > 6 months

Exclusion Criteria:

  • Sepsis,
  • shock,
  • coma,
  • other types of digestive access (surgical gastrostomy, jejunostomy)
  • terminal disease,
  • lack of cooperation,
  • refusal to participate in the protocol
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01698827


Locations
Brazil
Hospital das Clinicas- Central Institute ICHC- 9th Floor Rm 9077
Sao Paulo, Brazil, 05403-900
Hospital das Clinicas
Sao Paulo, Brazil, 05403900
Sponsors and Collaborators
University of Sao Paulo
Investigators
Study Chair: Joel Faintuch, MD, PhD Hospital das Clinicas, Sao Paulo, Brazil
Study Director: Paulo Sakai, MD, PhD Hospital das Clinicas, Sao Paulo, Brazil
Principal Investigator: Emanuele L Villela, MD Hospital das Clinicas, Sao Paulo, Brazil
  More Information

Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Joel Faintuch, Associate Professor, Department of Gastroenterology, University of Sao Paulo
ClinicalTrials.gov Identifier: NCT01698827     History of Changes
Other Study ID Numbers: Gastrotubes5A
First Submitted: September 22, 2012
First Posted: October 3, 2012
Last Update Posted: October 3, 2012
Last Verified: September 2012

Keywords provided by Joel Faintuch, University of Sao Paulo:
gastrostomy
tube
endoscopic
replacement
tube rupture
durability
tube loss
balloon rupture

Additional relevant MeSH terms:
Rupture
Wounds and Injuries