Efficacy and Safety of Sangustop® as Haemostatic Agent Versus a Carrier-Bound Fibrin Sealant During Liver Resection (ESSCALIVER)
Status and phase
Conditions
Treatments
Details and patient eligibility
About
This is a multi-centre, patient-blinded, intra-operatively randomised controlled trial. A total of 126 patients planned for an elective liver resection will be enrolled in 9 surgical centres. The primary objective of this study is to show that the collagen based haemostatic device Sangustop® is not inferior to a carrier-bound fibrin sealant (Tachosil®) in achieving haemostasis after hepatic resection.
Full description
During liver resection the control of bleeding is a major concern. The liver is predisposed to diffuse bleeding because of its extreme vascularity. Locally applicable agents (haemostats) are in use in order to achieve control over parenchymatic diffuse bleeding from the resection surface and to prevent intraperitoneal complications attributed to bleeding. These haemostats include bone wax, gelatine, collagen, oxidized regenerated cellulose, fibrin sealant glues, and synthetic glues. A composite product with well documented efficacy is Tachosil®. It consists of a collagen fleece carrying the fibrin glue components human fibrinogen and human thrombin. It was shown in a RCT to be superior in obtaining intraoperative haemostasis over argon beamer in liver resection. A new haemostat product is Sangustop®. It is indicated for local haemostasis of capillary bleeding and bleeding of parenchymal organs. Sangustop® is composed of native absorbable collagen fibrils without any blood serum products or any pharmaceutical activity. The felt structure being rich in surface gives a framework for the adhesion of blood platelets, thus provides an additional impetus to clotting. The aim of this study is to show that the new microfibrillar collagen hemostat Sangustop® is not inferior to the carrier-bound fibrin sealant Tachosil® with regards to haemostatic efficacy.
Enrollment
Sex
Ages
Volunteers
Inclusion and exclusion criteria
Inclusion:
- Age: > 18 years
- Gender: male / female
- Patients with an indication for liver resection (segmental or non-segmental)
- Willing and able to complete the clinical trial procedures, as described in the protocol
- Signed written informed consent to participate in this clinical trial
Exclusion:
- Presence or sequelae of coagulation disorder, liver cirrhosis, Klatskin tumor
- Concurrent participation in another clinical trial with a medical device or medicinal product or with interfering endpoints
- Concurrent or previous therapy with systemic pharmacologic agents promoting blood clotting including but not limited to tranexamix acid, activated factor VII, and aprotinine
- Known allergy or hypersensitivity to a component of the investigational treatments Sangustop® or TachoSil®, to riboflavin or to proteins of bovine origin
- Pregnancy or breast feeding
- Inability to understand the nature and the extent of the trial and the procedures required
- Missing signed written informed consent to participate in the study
Exclusion criteria to be checked during surgery (liver resection):
- Resection area estimated by operating surgeon < 16cm2
- Infected wound area
- Persistant major bleeding after primary haemostasis
- No bleeding after resection
Trial design
Primary purpose
Allocation
Interventional model
Masking
128 participants in 2 patient groups
Trial contacts and locations
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Data sourced from clinicaltrials.gov
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