Oral Anti-Infective Agent for Esophageal Anastomotic Leakage

The recruitment status of this study is unknown because the information has not been verified recently.

Verified July 2009 by National Taiwan University Hospital.
Recruitment status was Recruiting

Sponsor:

Information provided by:

National Taiwan University Hospital

ClinicalTrials.gov Identifier:

NCT00942526

First received: July 20, 2009

Last updated: NA

Last verified: July 2009

History: No changes posted

Purpose

Anastomotic leakage is still to be a major cause of considerable morbidity and mortality after esophagectomy and gastric pull up for esophageal carcinoma. Risk factor analyses of anastomotic leakage, including blood supply, graft tension, and comorbidity, have been performed, but few studies have produced strategies that have improved operative results. This study will be performed to identify prognostic variables that might be used to develop a strategy for optimizing outcomes after esophagogastrectomy.

Condition	Intervention	Phase
Anastomotic Leakage	Drug: Mycostatin oral suspension Other: Water	Phase 2


Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Factorial Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	The Correlation of Oral Anti-Infective Agent With Anastomotic Leakage in Reconstruction Surgery for Esophageal Cancer

Resource links provided by NLM:

MedlinePlus related topics: Esophageal Cancer

Drug Information available for: Nystatin

Genetic and Rare Diseases Information Center resources: Esophageal Cancer

U.S. FDA Resources

Further study details as provided by National Taiwan University Hospital:

Primary Outcome Measures:

all cause anastomotic leakage [ Time Frame: two years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Time variation of starting oral feeding and hospital stay [ Time Frame: two years ] [ Designated as safety issue: No ]


Estimated Enrollment:	120
Study Start Date:	June 2009
Estimated Study Completion Date:	December 2010
Estimated Primary Completion Date:	December 2010 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
No Intervention: 1 no intervention with perioperative oral anti-infective agent or water for gargling
Sham Comparator: 2 perioperative gargling with water	Other: Water perioperative gargling with water
Experimental: 3 perioperative oral gargling with oral anti-infective agent for seven days	Drug: Mycostatin oral suspension peroperative Mycostatin oral suspension ( 0.1MU/cc, 24cc/bt; 5cc qid)for 7 days

Detailed Description:

Goal:

The effect of oral hygiene on the occurrence of esophagogastric anastomotic leakage has not yet been studied for along time. We will use a random cohort study model and investigate the effect of perioperative oral anti-infective gargle agent on the esophagogastric anastomotic wound healing.

Method:

Design:

One hundred and twenty patients are divided into 3 groups and each group has 40 esophageal patients. Minimization stratified randomization will be applied. Oral anti-infective gargling agent, Mycostatin oral suspension, will be employed for one week before operation. The first groups will be treated without oral gargle agent; the second groups will be treated with gargling water; and the third groups will be treated with anti-infective gargling agent.

An end-to-side two-layer esophagogastric anastomosis will be constructed using interrupted sutures with metallic staple through cervical wound. On the other hand, the anastomotic leakage rates in different groups will be investigated.
Data Collection and Statistic Analysis:

The records of all patients, various biologic parameters, and the management of leakage are analyzed. Thirty-day morbidity and mortality are determined, and stepwise multivariable logistic regression analysis assesses the effect of preoperative and postoperative variables on anastomotic leakage. Time variation of starting oral feeding and hospital stay are compared using the Kaplan-Meier method.

Eligibility


Ages Eligible for Study:	40 Years to 85 Years (Adult, Senior)
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

carcinoma of the esophagus, operable stage I to III

Exclusion Criteria:

patients who were inoperable,
patients who had obvious impaired blood supply of gastric substitutes, and
patients who had non-cervical esophagogastrostomy.

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00942526

Contacts


Contact: Pei-Ming Huang, MD	+886-2-23123456 ext 63509	e370089@gmail.com

Locations


Taiwan
National Taiwan University Hospital	Recruiting
Taipei, Taiwan, 100
Contact: Pei-Ming Huang, MD +886-2-23123456 ext 63509 e370089@gmail.com
Principal Investigator: Pei-Ming Huang, MD

Sponsors and Collaborators

National Taiwan University Hospital

Investigators


Principal Investigator:	Pei-Ming Huang, MD	Department of Surgery, National Taiwan University Hospital

More Information

Additional Information:

National Taiwan University Hospital (NTUH) Research Ethics Committee (REC) This link exits the ClinicalTrials.gov site

Publications:

Liu K, Zhang GC, Cai ZJ. Avoiding anastomotic leakage following esophagogastrostomy. J Thorac Cardiovasc Surg. 1983 Jul;86(1):142-5.

Roy-Choudhury SH, Nicholson AA, Wedgwood KR, Mannion RA, Sedman PC, Royston CM, Breen DJ. Symptomatic malignant gastroesophageal anastomotic leak: management with covered metallic esophageal stents. AJR Am J Roentgenol. 2001 Jan;176(1):161-5.

Bardini R, Asolati M, Ruol A, Bonavina L, Baseggio S, Peracchia A. Anastomosis. World J Surg. 1994 May-Jun;18(3):373-8. Review.

Peracchia A, Bardini R, Ruol A, Asolati M, Scibetta D. Esophagovisceral anastomotic leak. A prospective statistical study of predisposing factors. J Thorac Cardiovasc Surg. 1988 Apr;95(4):685-91.

Dewar L, Gelfand G, Finley RJ, Evans K, Inculet R, Nelems B. Factors affecting cervical anastomotic leak and stricture formation following esophagogastrectomy and gastric tube interposition. Am J Surg. 1992 May;163(5):484-9.

Patil PK, Patel SG, Mistry RC, Deshpande RK, Desai PB. Cancer of the esophagus: esophagogastric anastomotic leak--a retrospective study of predisposing factors. J Surg Oncol. 1992 Mar;49(3):163-7.


Responsible Party:	Pei-Ming Huang, Department of Surgery, National Taiwan University Hospital
ClinicalTrials.gov Identifier:	NCT00942526 History of Changes
Other Study ID Numbers:	200806035R
Study First Received:	July 20, 2009
Last Updated:	July 20, 2009
Health Authority:	Taiwan: Department of Health

Keywords provided by National Taiwan University Hospital:


esophageal cancer anastomotic leakage Prevention of anastomotic leakage after esophageal surgery

Additional relevant MeSH terms:


Anastomotic Leak Postoperative Complications Pathologic Processes Anti-Infective Agents Nystatin	Anti-Bacterial Agents Antifungal Agents Ionophores Membrane Transport Modulators Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on September 30, 2016

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