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An Open-label, Randomized, Prospective Study of the Effectiveness, Safety, and Clinical Outcomes of Stapled Anastomoses Versus Hand-Sutured Anastomoses in Patients Undergoing Gastrointestinal End to End or Side to Side Anastomoses (Tiger)

Primary Purpose

Gastrointestinal Disease, Colorectal Disease

Status
Completed
Phase
Not Applicable
Locations
India
Study Type
Interventional
Intervention
Advant 55 Linear Cutter/Stapler
Suturing
Sponsored by
Ethicon Endo-Surgery
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Gastrointestinal Disease focused on measuring Stapling, hand sutured anastamosis, colorectal disease

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:a.

  • Able to comprehend and sign or, if illiterate, leave their thumb impression on the study informed consent document
  • 18 years to 75 years (inclusive)
  • Admitted on an emergency or elective basis requiring a single gastrointestinal anastomosis
  • Willing to adhere to standard postoperative care, including ventilator support if required
  • Female subject is postmenopausal (for at least 2 years) or surgically incapable of child bearing (at least 3 months post-surgical sterilization, with appropriate documentation)
  • If female subject is capable of child bearing, must use an acceptable method of birth control (hormonal or IUD) for at least 3 months prior to surgery and continue use throughout the study; maintained normal menstrual pattern for the past three months and has a negative urine pregnancy test prior to day of surgical procedure
  • Absence of medical history of psychiatric disorders that could limit the subject's ability to understand the procedure, comply with medical, surgical, and/or behavioral recommendations.

Exclusion Criteria:

  • Women of childbearing potential who are pregnant at the time of screening or at the time of surgery
  • Subject is on treatment with Corticosteroid maintenance therapy (equivalent to > 10mg/day of Prednisone), immunosuppressive or chemotherapeutic agents within 14 days prior to enrollment; or likely to receive one of these drugs during study period
  • Subject has connective tissue disease, renal failure necessitating chronic hemodialysis or chronic ambulatory peritoneal dialysis as evidenced by serum creatinine of > 3mg/dL
  • Subject has liver failure as evidenced by CP category C
  • Immunocompromised subjects (hematological malignancies, history of bone marrow transplantation, splenectomized subjects, genetic disorders such as Lupus, severe combined immunodeficiency, etc.) or a positive HIV test result
  • Subject has extensive disseminated malignancy and unlikely to survive for more than 3 months based on investigator judgment
  • Any subject that the investigator determines is not likely to be compliant during the study period
  • Subjects determined or suspected to engage in substance abuse, or any subject who is currently, or has in the past 6 months, undergone substance abuse therapy
  • The investigator feels that the primary anastomosis is not feasible due to local conditions of the bowel or subject has unstable hemodynamic status requiring stoma
  • Participation in any other investigational device or drug study (non survey based trial) within 30 days of enrollment.

Sites / Locations

  • Govt General Hospital and Madras Medical College
  • Indira Gandhi Government Medical College
  • GB Pant Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Stapling

Suturing

Arm Description

4 layered hand-sutured anastomosis

Outcomes

Primary Outcome Measures

Time of Surgery (Skin Open to Skin Close)
Time of Anastomosis
Return to Bowel Activity

Secondary Outcome Measures

Full Information

First Posted
April 20, 2009
Last Updated
November 30, 2011
Sponsor
Ethicon Endo-Surgery
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1. Study Identification

Unique Protocol Identification Number
NCT00888849
Brief Title
An Open-label, Randomized, Prospective Study of the Effectiveness, Safety, and Clinical Outcomes of Stapled Anastomoses Versus Hand-Sutured Anastomoses in Patients Undergoing Gastrointestinal End to End or Side to Side Anastomoses
Acronym
Tiger
Official Title
An Open-label, Randomized, Prospective Study of the Effectiveness, Safety, and Clinical Outcomes of Stapled Anastomoses Versus Hand-Sutured Anastomoses in Patients Undergoing Gastrointestinal End to End or Side to Side Anastomoses
Study Type
Interventional

2. Study Status

Record Verification Date
November 2011
Overall Recruitment Status
Completed
Study Start Date
April 2009 (undefined)
Primary Completion Date
October 2010 (Actual)
Study Completion Date
February 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ethicon Endo-Surgery

4. Oversight

5. Study Description

Brief Summary
This study is being conducted to compare surgical and patient outcomes across stapled (Group II) versus hand-sutured (Group I) groups.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gastrointestinal Disease, Colorectal Disease
Keywords
Stapling, hand sutured anastamosis, colorectal disease

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
280 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Stapling
Arm Type
Experimental
Arm Title
Suturing
Arm Type
Active Comparator
Arm Description
4 layered hand-sutured anastomosis
Intervention Type
Procedure
Intervention Name(s)
Advant 55 Linear Cutter/Stapler
Intervention Description
Advant 55 Linear Cutter/Stapler
Intervention Type
Procedure
Intervention Name(s)
Suturing
Intervention Description
Suturing
Primary Outcome Measure Information:
Title
Time of Surgery (Skin Open to Skin Close)
Time Frame
Day 1
Title
Time of Anastomosis
Time Frame
Total time (minutes) from placement of stay suture to final anastomotic staple (Group II) or final anastomotic suture (Group I)
Title
Return to Bowel Activity
Time Frame
Number of days post-surgery to appearance of peristaltic movement

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:a. Able to comprehend and sign or, if illiterate, leave their thumb impression on the study informed consent document 18 years to 75 years (inclusive) Admitted on an emergency or elective basis requiring a single gastrointestinal anastomosis Willing to adhere to standard postoperative care, including ventilator support if required Female subject is postmenopausal (for at least 2 years) or surgically incapable of child bearing (at least 3 months post-surgical sterilization, with appropriate documentation) If female subject is capable of child bearing, must use an acceptable method of birth control (hormonal or IUD) for at least 3 months prior to surgery and continue use throughout the study; maintained normal menstrual pattern for the past three months and has a negative urine pregnancy test prior to day of surgical procedure Absence of medical history of psychiatric disorders that could limit the subject's ability to understand the procedure, comply with medical, surgical, and/or behavioral recommendations. Exclusion Criteria: Women of childbearing potential who are pregnant at the time of screening or at the time of surgery Subject is on treatment with Corticosteroid maintenance therapy (equivalent to > 10mg/day of Prednisone), immunosuppressive or chemotherapeutic agents within 14 days prior to enrollment; or likely to receive one of these drugs during study period Subject has connective tissue disease, renal failure necessitating chronic hemodialysis or chronic ambulatory peritoneal dialysis as evidenced by serum creatinine of > 3mg/dL Subject has liver failure as evidenced by CP category C Immunocompromised subjects (hematological malignancies, history of bone marrow transplantation, splenectomized subjects, genetic disorders such as Lupus, severe combined immunodeficiency, etc.) or a positive HIV test result Subject has extensive disseminated malignancy and unlikely to survive for more than 3 months based on investigator judgment Any subject that the investigator determines is not likely to be compliant during the study period Subjects determined or suspected to engage in substance abuse, or any subject who is currently, or has in the past 6 months, undergone substance abuse therapy The investigator feels that the primary anastomosis is not feasible due to local conditions of the bowel or subject has unstable hemodynamic status requiring stoma Participation in any other investigational device or drug study (non survey based trial) within 30 days of enrollment.
Facility Information:
Facility Name
Govt General Hospital and Madras Medical College
City
Chennai
ZIP/Postal Code
600003
Country
India
Facility Name
Indira Gandhi Government Medical College
City
Nagpur
ZIP/Postal Code
440018
Country
India
Facility Name
GB Pant Hospital
City
New Delhi
ZIP/Postal Code
110002
Country
India

12. IPD Sharing Statement

Citations:
PubMed Identifier
17636751
Citation
Choy PY, Bissett IP, Docherty JG, Parry BR, Merrie AE. Stapled versus handsewn methods for ileocolic anastomoses. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD004320. doi: 10.1002/14651858.CD004320.pub2.
Results Reference
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Learn more about this trial

An Open-label, Randomized, Prospective Study of the Effectiveness, Safety, and Clinical Outcomes of Stapled Anastomoses Versus Hand-Sutured Anastomoses in Patients Undergoing Gastrointestinal End to End or Side to Side Anastomoses

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