NCT04712032

Brief Summary

Anastomotic leakage (AL) is one of the major complications after gastrointestinal surgery. Compromised tissue perfusion at the anastomosis site increases the risk of AL. Indocyanine green (ICG) combined with fluorescent near infrared imaging has proven to be a feasible and reproducible application for real-time intraoperative quantification of the tissue perfusion and cohort studies showed reduced leakage rate. Unfortunately, these studies were not randomized. Therefore, we propose a nationwide randomized controlled trial to identify the value of ICG for AL in colorectal anastomosis.

Trial Health

43
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
978

participants targeted

Target at P75+ for phase_3 colorectal-cancer

Timeline
Completed

Started Jul 2020

Shorter than P25 for phase_3 colorectal-cancer

Geographic Reach
1 country

1 active site

Status
unknown

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

July 1, 2020

Completed
7 months until next milestone

First Submitted

Initial submission to the registry

January 14, 2021

Completed
1 day until next milestone

First Posted

Study publicly available on registry

January 15, 2021

Completed
1.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 1, 2022

Completed
3 months until next milestone

Study Completion

Last participant's last visit for all outcomes

October 1, 2022

Completed
Last Updated

January 15, 2021

Status Verified

January 1, 2021

Enrollment Period

2 years

First QC Date

January 14, 2021

Last Update Submit

January 14, 2021

Conditions

Outcome Measures

Primary Outcomes (1)

  • 90-days Anastomotic Leakage (AL) rate

    Anastomotic leakage rate

    90 days

Secondary Outcomes (4)

  • 30-days Anastomotic Leakage ( AL) rate

    30 days

  • complication rate

    90 days

  • mortality

    90 days

  • days in hospital stay

    90 days

Study Arms (2)

Image Guided Bowel Anastomosis group

EXPERIMENTAL

ICG-guided perfusion assessment

Drug: ICG-guided bowel perfusion assessment

Conventional Bowel Anastomosis group

NO INTERVENTION

conventional perfusion assessment

Interventions

ICG will be injected prior to anastomosis creation, to assess perfusion status of the bowel.

Image Guided Bowel Anastomosis group

Eligibility Criteria

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

You may qualify if:

  • Scheduled for laparoscopic or robotic-assisted colorectal resection with primary anastomosis;
  • Patients aged over 18 years old;
  • Has the ability to communicate well with the Investigator in the Dutch language and willing to comply with the study restrictions;
  • Signed informed consent prior to any study-mandated procedure;

You may not qualify if:

  • Known allergy or history of adverse reaction to ICG, iodine or iodine dyes;
  • Severe liver or kidney insufficiency;
  • Hyperthyroidism or a benign thyroid tumour;
  • Pregnant or breastfeeding women;
  • Scheduled for palliative surgery or terminal ill
  • Scheduled for a diverting stoma
  • Any condition that the investigator considers to be potentially jeopardizing the patients well-being or the study objectives (following a detailed medical history and physical examination;
  • Subject taking phenobarbital, phenylbutazone, primidone, phenytoin, haloperidol, nitrofurantoin, probenecid;
  • Emergency surgery

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Leiden University Medical Center

Leiden, South Holland, 2333 ZA, Netherlands

RECRUITING

Related Publications (2)

  • Faber RA, Meijer RPJ, Droogh DHM, Jongbloed JJ, Bijlstra OD, Boersma F, Braak JPBM, Meershoek-Klein Kranenbarg E, Putter H, Holman FA, Mieog JSD, Neijenhuis PA, van Staveren E, Bloemen JG, Burger JWA, Aukema TS, Brouwers MAM, Marinelli AWKS, Westerterp M, Doornebosch PG, van der Weijde A, Bosscha K, Handgraaf HJM, Consten ECJ, Sikkenk DJ, Burggraaf J, Keereweer S, van der Vorst JR, Hutteman M, Peeters KCMJ, Vahrmeijer AL, Hilling DE. Indocyanine green near-infrared fluorescence bowel perfusion assessment to prevent anastomotic leakage in minimally invasive colorectal surgery (AVOID): a multicentre, randomised, controlled, phase 3 trial. Lancet Gastroenterol Hepatol. 2024 Oct;9(10):924-934. doi: 10.1016/S2468-1253(24)00198-5. Epub 2024 Aug 13.

  • Meijer RPJ, Faber RA, Bijlstra OD, Braak JPBM, Meershoek-Klein Kranenbarg E, Putter H, Mieog JSD, Burggraaf K, Vahrmeijer AL, Hilling DE; AVOID study group. AVOID; a phase III, randomised controlled trial using indocyanine green for the prevention of anastomotic leakage in colorectal surgery. BMJ Open. 2022 Apr 1;12(4):e051144. doi: 10.1136/bmjopen-2021-051144.

MeSH Terms

Conditions

Colonic NeoplasmsCrohn Disease

Condition Hierarchy (Ancestors)

Colorectal NeoplasmsIntestinal NeoplasmsGastrointestinal NeoplasmsDigestive System NeoplasmsNeoplasms by SiteNeoplasmsDigestive System DiseasesGastrointestinal DiseasesColonic DiseasesIntestinal DiseasesInflammatory Bowel DiseasesGastroenteritis

Study Officials

  • Alexander Vahrmeijer, MD, PhD

    LUMC

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Alexander Vahrmeijer, MD, PhD

CONTACT

Ruben Meijer, MD

CONTACT

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Masking Details
Intraoperative imaging is unable to blind the surgeon. Patient is only blinded preoperatively.
Purpose
PREVENTION
Intervention Model
PARALLEL
Model Details: National randomized controlled trial.
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

January 14, 2021

First Posted

January 15, 2021

Study Start

July 1, 2020

Primary Completion

July 1, 2022

Study Completion

October 1, 2022

Last Updated

January 15, 2021

Record last verified: 2021-01

Data Sharing

IPD Sharing
Will not share

Locations