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Resorbable Barrier for the Prevention of Abdominal and Peri-hepatic Adhesion Formation

Phase 2
Completed
Conditions
Colorectal Cancer
Interventions
Procedure: - use of resorbable membrane Seprafilm
Procedure: without resorbable barrier (seprafilm)
Registration Number
NCT01262417
Lead Sponsor
Centre Leon Berard
Brief Summary

The purpose of this study is to evaluate the efficiency of a resorbable barrier membrane for the prevention of abdominal and peri-hepatic adhesion in patients with colorectal cancer requiring two-stage surgery for the resection of hepatic metastases.

Eligible patients will be randomly assigned to one of 2 arms:

* Seprafilm group (receiving resorbable barrier membrane during the first surgery)

* No-treatment control group (without seprafilm barrier during the first surgery)

The primary objective is to establish, in patients with colorectal cancer requiring two-stage surgery for the resection of hepatic metastases, the efficiency of a resorbable barrier membrane (Seprafilm) for limiting abdominal and peri-hepatic adhesion during the second operation.

This study is a prospective multicentric phase II, controlled, randomized and non comparative trial.

A total of 60 patients will be enrolled: 45 will receive Seprafilm whereas 15 will be assigned to the no-treatment control group. The inclusion period should be approximately 18 months. The follow up period after the second surgery will be 3 years.

Detailed Description

The secondary objectives of the study are:

During and after the 1st surgical procedure To evaluate immediate complications (during surgery), early complications (during post-surgery hospitalization) and late complications (between 1st and 2nd surgeries) in relation with operating procedure and use of resorbable membrane.

During and after the 2nd surgical procedure

* To evaluate abdominal and peri-hepatic adhesion (at the site of the 1st surgery), with qualitative and quantitative description.

* To evaluate intestinal adhesion (in the small intestine), with quantitative description.

* To evaluate immediate complications (during surgery), early complications (during post-surgery hospitalization) and late complications (in the month following the intervention) in relation with operating procedure.

* To evaluate post-operative rehabilitation

* To assess tumour evolution in patients over a period of 3 years after the 2nd surgery.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
60
Inclusion Criteria
  • Women and men aged ≥ 18 years
  • Colorectal cancer with synchronous or metachronous hepatic metastases
  • Patients requiring two-stage surgery with laparotomy for the resection of hepatic metastases
  • The 2 operations should be scheduled in the same centre
  • The 2 operations should be scheduled at an interval of 1 to 6 months
  • Patient affiliated with social security
  • Patient able to read and write French
  • Written, voluntary, informed consent
Exclusion Criteria
  • Patient with previous hepatic or biliary surgery through supra-umbilical incision (except biliary surgery with laparotomy more than 6 months previously)
  • Patient with previous major surgery except colorectal surgery for resection of primitive tumour
  • Metastasis removable in one surgical procedure
  • Non resectable metastasis
  • Follow-up impossible for social, geographical, familial or psychological reasons
  • Patient deprived of freedom
  • Patient enrolled in another experimental surgery trial
  • Pregnant or lactating woman

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
- Seprafilm group- use of resorbable membrane Seprafilmpatients receiving resorbable barrier membrane during the first surgery
- No-treatment control groupwithout resorbable barrier (seprafilm)patients without seprafilm barrier during the first surgery
Primary Outcome Measures
NameTimeMethod
abdominal and peri-hepatic adhesion during the second operationTime to liberate liver (t0: incision and t1: liberation)
Secondary Outcome Measures
NameTimeMethod
immediate complications during the first surgical procedure in relation with operating procedure and use of resorbable membraneduring the surgery
early complications (after the 1st surgical procedure)in relation with operating procedure and use of resorbable membraneduring post-surgery hospitalization
late complications (after the 1st surgical procedure)in relation with operating procedure and use of resorbable membranebetween 1st and 2nd surgeries (2 operations should be scheduled at an interval of 1 to 6 months)
abdominal and peri-hepatic adhesion (at the site of the 1st surgery), with qualitative and quantitative descriptionat the beginning of the 2nd surgical procedure
intestinal adhesion (in the small intestine), with quantitative descriptionat the beginning of the second surgical procedure
immediate complications in relation with operating procedure.during the 2nd surgical procedure
early complications (after 2ng operation) in relation with operating procedure.during post-surgery hospitalization
late complications in relation with operating procedure.in the month following the 2nd intervention
post-operative rehabilitationduring post-surgery hospitalization
tumour evolution in patientsover a period of 3 years after the 2nd surgery

Trial Locations

Locations (17)

Institut Bergonié

🇫🇷

Bordeaux, France

Hôpital Antoine Béclère

🇫🇷

Clamart, France

CHU Clermont Ferrand

🇫🇷

Clermont Ferrand, France

Centre Hospitalier Lyon Sud

🇫🇷

Lyon, France

CHU Grenoble

🇫🇷

Grenoble, France

Centre Léon Bérard

🇫🇷

Lyon, France

Hôpital de La Croix Rousse

🇫🇷

Lyon, France

CHU La conception

🇫🇷

Marseille, France

Institut Paoli Calmettes

🇫🇷

Marseille, France

Hôpital de Brabois CHU

🇫🇷

Nancy, France

CHU Nice-Hôpital de l'Archet II

🇫🇷

Nice, France

Hôpital Cochin

🇫🇷

Paris, France

Hôpital Beaujon

🇫🇷

Clichy, France

Centre Val d'Aurelle Paul Lamarque

🇫🇷

Montpellier, France

Centre Alexis Vautrin

🇫🇷

Nancy, France

Hôpital Charles Nicolle - CHU Rouen

🇫🇷

Rouen, France

Institut Gustave Roussy

🇫🇷

Villejuif, France

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