Clinical Trial: Oral Anti-Infective Agent for Esophageal Anastomotic Leakage
Study Status: Recruiting
Recruit Status: Unknown status
Study Type: Interventional
Official Title: The Correlation of Oral Anti-Infective Agent With Anastomotic Leakage in Reconstruction Surgery for Esophageal Cancer
Brief Summary: Anastomotic leakage is still to be a major cause of considerable morbidity and mortality after esophagectomy and gastric pull up for esophageal carcinoma. Risk factor analyses of anastomotic leakage, including blood supply, graft tension, and comorbidity, have been performed, but few studies have produced strategies that have improved operative results. This study will be performed to identify prognostic variables that might be used to develop a strategy for optimizing outcomes after esophagogastrectomy.
Detailed Summary:
Goal:
The effect of oral hygiene on the occurrence of esophagogastric anastomotic leakage has not yet been studied for along time. We will use a random cohort study model and investigate the effect of perioperative oral anti-infective gargle agent on the esophagogastric anastomotic wound healing.
Method:
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Design:
One hundred and twenty patients are divided into 3 groups and each group has 40 esophageal patients. Minimization stratified randomization will be applied. Oral anti-infective gargling agent, Mycostatin oral suspension, will be employed for one week before operation. The first groups will be treated without oral gargle agent; the second groups will be treated with gargling water; and the third groups will be treated with anti-infective gargling agent.
An end-to-side two-layer esophagogastric anastomosis will be constructed using interrupted sutures with metallic staple through cervical wound. On the other hand, the anastomotic leakage rates in different groups will be investigated.
- Data Collection and Statistic Analysis:
The records of all patients, various biologic parameters, and the management of leakage are analyzed. Thirty-day morbidity and mortality are determined, and stepwise multivariable logistic regression analysis assesses the effect of preoperative and postoperative variables on anastomotic leakage. Time variation of starting oral feeding and hospital stay are compared using the Kaplan-Meier method.
Sponsor: National Taiwan University Hospital
Current Primary Outcome: all cause anastomotic leakage [ Time Frame: two years ]
Original Primary Outcome: Same as current
Current Secondary Outcome: Time variation of starting oral feeding and hospital stay [ Time Frame: two years ]
Original Secondary Outcome: Same as current
Information By: National Taiwan University Hospital
Dates:
Date Received: July 20, 2009
Date Started: June 2009
Date Completion: December 2010
Last Updated: July 20, 2009
Last Verified: July 2009
