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Evaluation of the Effectiveness and Security of TenaTac® in the Prevention of Air Leaks in Thoracic Surgery

Not Applicable
Not yet recruiting
Conditions
Lung Surgery
Interventions
Device: Intraoperative use of TenaTac in lung surgery
Device: Intraoperative use of usual sealant in lung surgery
Registration Number
NCT06597604
Lead Sponsor
Hopitaux Prives de Metz, Groupe UNEOS
Brief Summary

Lung surgery remains a high-risk procedure, with serious adverse events that can occur later, including postoperative bleeding or hemothorax, pneumopathy or surgical site infection but also ... per- and post-operative air leaks. Majority the air leaks resolve spontaneously within 48 hours but certain cases persist within several days which known as prolonged air leaks, or PAL. Several safe and effective sealing agents are used to contain and or reduce the intensity and incidence of postoperative air leaks, and the time required for drain removal. This protocol assesses the effectiveness of an innovative gelatin-based medical device named TenaTac® (Selentus Science, UK) in preventing air leak after major lung resection.

Detailed Description

Thoracic surgery is a specialty dedicated to the management (diagnosis and treatment...) of conditions and lesions of the thoracic cage and its organs, excluding the heart, aorta and esophagus. It is based on 2 surgical techniques: open (by posterolateral thoracotomy) or minimally invasive endoscopic (with or without robot-assisted surgery).

Lobectomy is the most common pulmonary resection, however, regardless of the surgical option chosen, lung surgery remains a high-risk procedure, with serious adverse events that can occur later, including postoperative bleeding or hemothorax, pneumopathy or surgical site infection, pulmonary alveolar collapse, acute respiratory distress syndrome, pleural or pericardial effusion, lobar torsion or multi-organ failure, bronchial or esophageal fistulas, transient arrhythmia due to vagus nerve damage, pulmonary embolism, venous ischemia, ... and, per- and post-operative air leaks. Air leak has been reported in 25-75% of patients, which makes it the most common incident after elective lung surgery.

Although the majority of these air leaks resolve spontaneously within 48 hours (by continuous pleural drainage), certain cases persist for several days (more than 5 days). These are known as prolonged air leaks, or PAL.

The literature describes several sealing agents used to contain air leaks. The preventive use of sealants at the lung resection site seems safe and effective, since it significantly reduces the intensity and incidence of postoperative air leaks, and the time required for drain removal, Pharmaceutical gelatin-based medical devices, used for decades for their hemostatic properties, have recently been suggested for sealing pulmonary defects and preventing air leaks. Regarding the results obtained, gelatin appears to be a therapeutically effective biomaterial in lung surgery. We therefore hypothesize the effectiveness of the innovative medical device TenaTac® (Selentus Science, UK) in preventing air leak after major lung resection.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
154
Inclusion Criteria
  • Patients hospitalized in the thoracic surgery departments of the investigating centers, for elective surgery,
  • Lobectomy surgery requiring the use of a sealing agent,
  • Adult patients (>18 years),
  • Patients who have given written consent to participate in the study,
  • Patients registered within the social security insurance in France.
Exclusion Criteria
  • Patients hospitalized in emergency,
  • Patients with gelatin allergy,
  • Patients undergoing other biomedical research likely to interfere with the evaluation criteria of this study
  • Patients under tutorship and/or curatorship,
  • Patients unable to follow the planned post-operative follow-up,
  • Patients whose life expectancy is less than 1 year,
  • Pregnant or breast-feeding patients.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Experimental GroupIntraoperative use of TenaTac in lung surgeryThoracic Surgeons will apply the experimental device TenaTac® after major lung resection
Control GroupIntraoperative use of usual sealant in lung surgeryThoracic Surgeons will apply other (usual) sealing device after major lung resection
Primary Outcome Measures
NameTimeMethod
To compare the effectiveness of the TenaTac® patch on the duration of thoracic drainage for each patient (regardless of their degree of emphysema) compared to sealing devices routinely used by thoracic surgeons for the same indication4 weeks

Assess the effectiveness of the TenaTac® patch in terms of duration of thoracic drainage, compared with sealing devices routinely used by thoracic surgeons for the same indication.

Secondary Outcome Measures
NameTimeMethod
To assess the effectiveness of the TenaTac® patch in preventing postoperative air leaks throughout the hospital stay, and more specifically in PALs (beyond the 5th day).4 weeks

Assess the effectiveness of the TenaTac® patch in terms of PAL rates decrease compared to those measured with the other sealants routinely used by thoracic surgeons for the same indication and in the same circumstances

Effectiveness of the TenaTac® patch in reducing hospital stay4 weeks

Assess the effectiveness of the TenaTac® patch in reducing hospital stay, compared to those obtained with the other sealants routinely used by thoracic surgeons for the same indication and in the same circumstances

Effectiveness of the TenaTac® patch in preventing (immediate and medium term) postoperative complications4 weeks

Assess the effectiveness of the TenaTac® patch in preventing (immediate and medium term) postoperative complications, compared to those declared with the other sealants routinely used by thoracic surgeons for the same indication and in the same circumstances

Trial Locations

Locations (2)

Hôpital Robert Schuman_Groupe UNEOS

🇫🇷

Metz, Grand-Est, France

Centre Hospitalier de la Côte Basque (Bayonne)

🇫🇷

Bayonne, France

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