Evaluation of the SafeHeal Colovac+ anastomosis protection device after low anterior resection for rectal cancer : the safe anastomosis feasibility evaluation (SAFE) 2019 trial
© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature..
BACKGROUND: Protective ileostomy (PI) is the current standard of care to protect the anastomosis after low anterior resection (LAR) for rectal cancer, but is associated with significant morbidity. Colovac is an anastomosis protection device designed to shield the anastomosis from fecal content. A second version (Colovac+) was developed to limit the migration risk during the implantation period. The objective of this clinical trial was to evaluate the preliminary efficacy and safety of the Colovac+.
METHODS: This was a prospective, multicenter, pilot study aiming to enroll 15 patients undergoing LAR with Colovac+ placement. After 10 days, a CT scan was performed to evaluate the anastomosis and the Colovac+ was retrieved endoscopically. During the 10-day implantation and 3-month follow-up period, we collected data regarding predefined efficacy and safety endpoints. The primary endpoint was the rate of major (Clavien-Dindo III-V) postoperative complications related to the Colovac+ or LAR procedure.
RESULTS: A total of 25 patients were included (68% male), of whom 15 were consecutively treated with the Colovac+ and Vacuum Loss Alert System. The Colovac+ was successfully implanted in all 15 patients. No major discomfort was reported during the implantation period. The endoscopic retrieval was performed in 14/15 (93%) patients. The overall major postoperative morbidity rate was 40%, but none of the reported complications were related to the Colovac+. A device migration occurred in 2 (13%) patients, but these were not associated with AL or stoma conversion. Overall, Colovac+ provided effective fecal diversion in all 15 patients and was able to avoid the PI in 11/15 (73%) patients.
CONCLUSIONS: Colovac+ provides a safe and effective protection of the anastomosis after LAR, and avoids the PI in the majority (73%) of patients. The improved design reduces the overall migration rate and limits the clinical impact of a migration.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
|---|---|
| Enthalten in: |
Surgical endoscopy - 37(2023), 9 vom: 19. Sept., Seite 7385-7392 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
De Hous, Nicolas [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Anastomosis protection device |
|---|
| Anmerkungen: |
Date Completed 31.08.2023 Date Revised 10.09.2023 published: Print-Electronic ClinicalTrials.gov: NCT05180565 Citation Status MEDLINE |
|---|
| doi: |
10.1007/s00464-023-10272-x |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM359645372 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM359645372 | ||
| 003 | DE-627 | ||
| 005 | 20231226081323.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00464-023-10272-x |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1198.xml |
| 035 | |a (DE-627)NLM359645372 | ||
| 035 | |a (NLM)37464064 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a De Hous, Nicolas |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Evaluation of the SafeHeal Colovac+ anastomosis protection device after low anterior resection for rectal cancer |b the safe anastomosis feasibility evaluation (SAFE) 2019 trial |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 31.08.2023 | ||
| 500 | |a Date Revised 10.09.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT05180565 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. | ||
| 520 | |a BACKGROUND: Protective ileostomy (PI) is the current standard of care to protect the anastomosis after low anterior resection (LAR) for rectal cancer, but is associated with significant morbidity. Colovac is an anastomosis protection device designed to shield the anastomosis from fecal content. A second version (Colovac+) was developed to limit the migration risk during the implantation period. The objective of this clinical trial was to evaluate the preliminary efficacy and safety of the Colovac+ | ||
| 520 | |a METHODS: This was a prospective, multicenter, pilot study aiming to enroll 15 patients undergoing LAR with Colovac+ placement. After 10 days, a CT scan was performed to evaluate the anastomosis and the Colovac+ was retrieved endoscopically. During the 10-day implantation and 3-month follow-up period, we collected data regarding predefined efficacy and safety endpoints. The primary endpoint was the rate of major (Clavien-Dindo III-V) postoperative complications related to the Colovac+ or LAR procedure | ||
| 520 | |a RESULTS: A total of 25 patients were included (68% male), of whom 15 were consecutively treated with the Colovac+ and Vacuum Loss Alert System. The Colovac+ was successfully implanted in all 15 patients. No major discomfort was reported during the implantation period. The endoscopic retrieval was performed in 14/15 (93%) patients. The overall major postoperative morbidity rate was 40%, but none of the reported complications were related to the Colovac+. A device migration occurred in 2 (13%) patients, but these were not associated with AL or stoma conversion. Overall, Colovac+ provided effective fecal diversion in all 15 patients and was able to avoid the PI in 11/15 (73%) patients | ||
| 520 | |a CONCLUSIONS: Colovac+ provides a safe and effective protection of the anastomosis after LAR, and avoids the PI in the majority (73%) of patients. The improved design reduces the overall migration rate and limits the clinical impact of a migration | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Anastomosis protection device | |
| 650 | 4 | |a Colovac | |
| 650 | 4 | |a Low anterior resection | |
| 650 | 4 | |a Protective ileostomy | |
| 650 | 4 | |a Rectal cancer | |
| 700 | 1 | |a D'Urso, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Cadière, Guy-Bernard |e verfasserin |4 aut | |
| 700 | 1 | |a Cadière, Benjamin |e verfasserin |4 aut | |
| 700 | 1 | |a Rouanet, Philippe |e verfasserin |4 aut | |
| 700 | 1 | |a Komen, Niels |e verfasserin |4 aut | |
| 700 | 1 | |a Lefevre, Jérémie H |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Surgical endoscopy |d 1996 |g 37(2023), 9 vom: 19. Sept., Seite 7385-7392 |w (DE-627)NLM012660159 |x 1432-2218 |7 nnns |
| 773 | 1 | 8 | |g volume:37 |g year:2023 |g number:9 |g day:19 |g month:09 |g pages:7385-7392 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s00464-023-10272-x |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 37 |j 2023 |e 9 |b 19 |c 09 |h 7385-7392 | ||