TissueLink Versus SeamGuard After Distal Pancreatectomy (PLATS)
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Purpose
The purpose of this research study is to find a lowest leak rate following a distal pancreatectomy (removal of the left side of your pancreas). Distal pancreatectomy is known to have a risk of pancreatic leaks (leakage of pancreatic fluid from the cut surface of the pancreas). We are studying two FDA approved devices to treat and prevent leaks at the end of the pancreas. These two methods are Tissuelink and Seamguard. The study may help us understand which treatment will have a lower leak rate.
| Condition | Intervention | Phase |
|---|---|---|
|
Distal Pancreatectomy |
Device: Seamguard with bioabsorbable staple Procedure: Tissuelink w/radiofrequency ablation |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Supportive Care |
| Official Title: | A Multicenter Mayo-initiated Randomized Controlled Trial Comparing Pancreatic Leaks After TissueLink vs SeamGuard After Distal Pancreatectomy (PLATS) |
- The development of a postoperative pancreatic duct leak at the resection margin (pancreatic fistula) within 90 days from the operation. [ Time Frame: 90 days from the operation ] [ Designated as safety issue: No ]
- Assessment of the severity of the leaks. [ Time Frame: 90 days post operative ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 400 |
| Study Start Date: | December 2009 |
| Estimated Study Completion Date: | December 2013 |
| Estimated Primary Completion Date: | July 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: Seamguard with bioabsorbable staple |
Device: Seamguard with bioabsorbable staple
In the Seamguard group, pancreatic resection and transection of the pancreatic body will be executed using an endoscopic linear stapling device
|
| Active Comparator: Tissuelink w/radiofrequency ablation |
Procedure: Tissuelink w/radiofrequency ablation
After pancreatic transection with the method of choice of the operating surgeon the pancreatic remnant will be treated with Tissuelink alone for an ablation depth (thickness) of approximately 7 mm
|
Detailed Description:
The primary objective of this trial is to compare the effectiveness of Tissuelink closure of pancreatic stump after distal pancreatectomy to Seamguard.
The secondary objective of this trial is to compare the severity of leaks in the two groups using the ISGPF grading system.
Distal pancreatectomy is performed for a broad variety of indications including benign and malignant conditions. Specifically, distal pancreatectomy refers to resection of the portion of pancreas to the left of the superior mesenteric vein/portal vein trunk, excluding the duodenum and distal bile duct. Pancreatic duct leak at the resection margin is one of the most common complications of distal pancreatectomy prolonging inpatient and outpatient care and resulting in clinically important increases in the financial burden of pancreatic surgery.
Thus, a randomized, prospective, human trial comparing Tissuelink vs Seamguard may help us answer the question of which method is best to treat the pancreatic stump.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion criteria:
- Age equal or above 18 years
- Accepted for elective distal pancreatectomy for any indication
Exclusion from randomization process:
- Thickness of pancreas on preoperative CT scan images > 2.5 cm at the site of expected transection in anterior-posterior diameter. This will be reviewed by the surgeon the day before the surgeon sees the patient to predetermine the appropriateness of the patient for the study.
General study exclusion criteria:
- Current immunosuppressive therapy
- Chemotherapy within 2 weeks before operation
- Bevacizumab (Avastin™) treatment not completed at least 6 weeks before operation
- Radiotherapy before operation
- Inability to follow the instructions given by the investigator
- Lack of compliance
- Persons unable or unwilling to give informed consent to participate in this study
- Pregnant women
- Prisoners
- Institutionalized individuals
Contacts and Locations| United States, Massachusetts | |
| Massachusettes General Hospital | |
| Boston, Massachusetts, United States, 02144 | |
| United States, Minnesota | |
| Mayo Clinic | |
| Rochester, Minnesota, United States, 55905 | |
| Principal Investigator: | Florencia G Que, M.D. S | Mayo Clinic, Rochester, MN |
More Information
No publications provided
| Responsible Party: | Florencia G. Que, MD S, Mayo Clinic |
| ClinicalTrials.gov Identifier: | NCT01051856 History of Changes |
| Other Study ID Numbers: | 09-000362 |
| Study First Received: | January 15, 2010 |
| Last Updated: | November 15, 2012 |
| Health Authority: | United States: Institutional Review Board |
ClinicalTrials.gov processed this record on May 16, 2013