NCT03179358

Brief Summary

In colorectal surgery, hand suturing and stapling are routine methods for performing intestinal anastomoses, and these methods appear to be similar in terms of clinical safety. Despite several years of experience with surgical procedures as well as improvements to the medical devices, problems with disturbed anastomotic healing leading to leakage and stenosis after colorectal surgery remain a significant challenge for surgeons. In addition, preoperative radiotherapy has been shown to increase the risk of anastomotic leakage even further. The methods that are used today to detect leakages are unfortunately inaccurately and limited to monitoring symptoms, temperature, CRP (C-reactive protein)-levels, and performing abdominal examinations and CT-scans. These clinical signs and parameters usually become apparent several days after onset of the leakage, which leads to a delayed diagnosis. Anastomotic leakage is not only a significant cause of increased morbidity of complications and mortality in patients, but also associated with increased risk of local recurrence and poor prognosis. Moreover, when reoperation is required to fix the leakage, a permanent stoma may be made at the level of the sigmoid colon and this procedure impacts quality of life negatively. Based on the above considerations, a novel, adaptive anastomotic method has been developed by CarpoNovum to achieve a safer anastomosis. The method's working name is C-REX Ring-locking Procedure (C-REX is referred to our Colorectal anastomotic rings for Re-join the intestinal ends and validate the anastomosis, with function of Extract samples for analysis and conduct X-ray through connected catheters). The novel adaptive anastomotic medical devices, C-REX LapAid and C-REX DMH/DMHC are easy to use, with unique possibility to control the anastomosis during and after surgery. The previous successful preclinical study encourages a clinical verification in patients undergoing colonic resection to evaluate the safety and performance of C-REX Ring-locking Procedure by use of C-REX LapAid and C-REX DMH/DMHC.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
20

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Sep 2016

Shorter than P25 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

September 29, 2016

Completed
8 months until next milestone

First Submitted

Initial submission to the registry

May 28, 2017

Completed
10 days until next milestone

First Posted

Study publicly available on registry

June 7, 2017

Completed
3 days until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 10, 2017

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 10, 2017

Completed
Last Updated

January 17, 2018

Status Verified

January 1, 2018

Enrollment Period

8 months

First QC Date

May 28, 2017

Last Update Submit

January 15, 2018

Conditions

Outcome Measures

Primary Outcomes (1)

  • Time to evacuation of the short-term implant

    The subject informs the clinical investigator and hand over the expelled short-term implant

    About 2 weeks after surgery

Secondary Outcomes (7)

  • Time to first intestinal sounds

    Up to 30 days after surgery

  • Time to first passage of gas

    Up to 30 days after surgery

  • Time to first defecation

    Up to 30 days after surgery

  • Number of postoperative interventions related to the device

    Up to 30 days after surgery

  • Integrity pressure

    The operation day

  • +2 more secondary outcomes

Other Outcomes (4)

  • Hemoglobin

    Up to 30 days after surgery, when needed

  • WBC (white blood cell)

    Up to 30 days after surgery, when needed

  • Physical examination

    Up to 30 days after surgery

  • +1 more other outcomes

Study Arms (1)

C-REX group

EXPERIMENTAL

After resection of the disease in colon, the intestinal ends will be anastomosed by the investigational device, i.e. C-REX LapAid and C-REX DMH/DMHC included in the C-REX Ring-locking Procedure.

Device: C-REX Ring-locking Procedure

Interventions

The C-REX Ring-locking Procedure is a method based on adaptive anastomosis, in which intestinal ends adapt to each other after resection due to tumor, injury, or other disease. The investigational devices comprised of two components, i.e. C-REX LapAid and C-REX DMH/DMHC

C-REX group

Eligibility Criteria

Age18 Years - 70 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Male or female age ≥ 18 years and ≤ 70 years.
  • Planned resection due to benign or malign disease in the left colon (descending colon and sigmoid) or the upper rectum (15 cm above the anal rim).
  • Cognitive ability to take part in the study and understand the information he/she receives about participating in the study.
  • Sign the informed consent form.

You may not qualify if:

  • Urgent medical condition requiring immediate care.
  • Current surgical conditions, such as intestinal obstruction or perforation, local or systemic infections, peritonitis, intestinal ischemia or dissemination (metastases) of cancer.
  • Stenosis or other obstructions in the anal passage.
  • Previous major abdominal surgery, previous radiation therapy to organs in abdomen or pelvis.
  • Health condition classified as ASA (American Society of Anesthesiologists) score III - VI.
  • Albumin level less than 35 g/l.
  • Inflammatory bowel disease (IBD) (ulcerative colitis or Crohn´s disease).
  • Disease that requires more than one anastomosis during the surgical procedure.
  • Treatment with cortisone and/or other immunosuppressive medications less than one month before surgery.
  • Contraindications to general anesthesia.
  • Perioperative detection of extreme variants of intestinal diameters or wall thickness.
  • Cognitive ability that limits the patient's ability to take part in the study and understand the information he/she received about participating in the study, or the patient does not agree to join the study.
  • BMI \> 35.
  • Heart attack ≤ 6 months or sever heart disease.
  • Severe embolic disease.
  • +1 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

The First Affiliated Hospital of Xiamen University

Xiamen, Fujian, 361003, China

Location

MeSH Terms

Conditions

Colonic NeoplasmsColonic Polyps

Condition Hierarchy (Ancestors)

Colorectal NeoplasmsIntestinal NeoplasmsGastrointestinal NeoplasmsDigestive System NeoplasmsNeoplasms by SiteNeoplasmsDigestive System DiseasesGastrointestinal DiseasesColonic DiseasesIntestinal DiseasesIntestinal PolypsPolypsPathological Conditions, AnatomicalPathological Conditions, Signs and Symptoms

Study Officials

  • Qi Luo

    The First Affiliated Hospital of Xiamen University

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 28, 2017

First Posted

June 7, 2017

Study Start

September 29, 2016

Primary Completion

June 10, 2017

Study Completion

June 10, 2017

Last Updated

January 17, 2018

Record last verified: 2018-01

Data Sharing

IPD Sharing
Will not share

Locations