Eso-Sponge Registry

Leakage After Esophagectomy Clinical Trial

Official title:

International, Prospective, Multicenter Registry Designed to Collect Clinical Evidence for Endoscopic Vacuum Treatment Using Eso-SPONGE® for Anastomotic Leakage After Esophageal Resection or Iatrogenic or Spontaneous Esophageal Perforation.

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT02662777
• Other study ID #: AAG-O-H-1317
• Status: Recruiting
• Start date: January 2015
• Est. completion date: December 2025

Study information

• Verified date: April 2024
• Source: Aesculap AG
• Contact: Petra Baumann, Dr.
• Phone: +49-7461-95
• Email: petra.baumann[@]aesculap.de
• Is FDA regulated: No
• Study type: Observational [Patient Registry]

Clinical Trial Summary

This international, prospective and multicenter registry was designed to collect clinical evidence for the endoscopic vacuum treatment using Eso-SPONGE® for anastomotic leakage after esophageal resection or iatrogenic or spontaneous esophageal perforation.

Description:

Anastomotic Leakages or other defects in the upper gastrointestinal tract can have serious consequences for the affected patients. Different parameters, like the size, location, time to diagnosis of the lesion, but also the general condition of the patient, have a significant influence on the clinical outcome of the patient. Often this situation is accompanied by symptoms of sepsis and a significant morbidity rate with corresponding substantial mortality rate. For this reason the treatment of this clinical situation is often a challenge for the clinician.

Besides surgical examination and the endoscopic stent system, good experiences have been obtained with the Endo-SPONGE® therapy for the lower gastrointestinal tract. In the future the endoluminal vacuum therapy for the upper gastrointestinal is available, too, with Eso-SPONGE®.

Eso-SPONGE® represent an innovative therapy concept for the treatment of this problem in the upper gastrointestinal tract, which can contribute significantly to the reduction of morbidity and mortality of the patients.

The overall success rate of endoscopic esophageal vacuum therapy in the literature ranges from 80-100%. Currently only cohort studies including a small number of patients have been performed and published. Therefore an international, prospective and multicenter registry was designed to collect clinical evidence for Eso-SPONGE treatment concept in a large population under daily clinical routine.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 200
• Est. completion date: December 2025
• Est. primary completion date: December 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Endoscopic vacuum therapy (EVT) of anastomotic leakage after esophageal resection or spontaneous or iatrogenic perforations

• age > 18 years

• written informed consent

Exclusion Criteria:

• none

Related Conditions & MeSH terms

• Esophageal Perforation
• Leakage After Esophagectomy
• Leakage After Gastrectomy
• Perforation of the Esophagus

Intervention

Device:
• Eso-SPONGE® vacuum treatment

Locations

Country	Name	City	State
Germany	Zentralklinik Bad Berka	Bad Berka
Germany	Augusta-Kliniken GmbH	Bochum	Nordrhein-Westfalen
Germany	St. Johannes-Hospital Dortmund	Dortmund	Nordrhein-Westfalen
Germany	Sankt Katharinen Krankenhaus	Frankfurt	Hessen
Germany	Universitätsklinikum Freiburg	Freiburg
Germany	Wald-Klinikum Gera	Gera	Thüringen
Germany	Universitätsmedizin Greifswald	Greifswald
Germany	Städtisches Krankenhaus Heinsberg	Heinsberg
Germany	Klinikum Herford	Herford	Hessen
Germany	EVK Herne	Herne	Nordrhein-Westfalen
Germany	Universitätsklinikum Kiel	Kiel	Schleswig-Holstein
Germany	Krankenhaus der Augustinerinnen	Köln
Germany	Asklepios Klinik	Lich	Hessen
Germany	Klinikum Lüneburg, Klinik für Allgemein-, Viszeral- & Thoraxchirurgie	Lüneburg	Niedersachsen
Germany	Siloah St. Trudpert Klinikum	Pforzheim	Baden-Württemberg
Germany	Universitätsklinikum Tübingen	Tübingen
Germany	Klinikum Wilhelmshaven	Wilhelmshaven	Niedersachsen

Sponsors (2)

Lead Sponsor	Collaborator
Aesculap AG	Universitätsklinikum Kiel

Country where clinical trial is conducted

Germany, 

References & Publications (36)

Ahrens M, Schulte T, Egberts J, Schafmayer C, Hampe J, Fritscher-Ravens A, Broering DC, Schniewind B. Drainage of esophageal leakage using endoscopic vacuum therapy: a prospective pilot study. Endoscopy. 2010 Sep;42(9):693-8. doi: 10.1055/s-0030-1255688. Epub 2010 Aug 30. — View Citation

Bludau M, Holscher AH, Herbold T, Leers JM, Gutschow C, Fuchs H, Schroder W. Management of upper intestinal leaks using an endoscopic vacuum-assisted closure system (E-VAC). Surg Endosc. 2014 Mar;28(3):896-901. doi: 10.1007/s00464-013-3244-5. Epub 2013 Oct 23. — View Citation

Brangewitz M, Voigtlander T, Helfritz FA, Lankisch TO, Winkler M, Klempnauer J, Manns MP, Schneider AS, Wedemeyer J. Endoscopic closure of esophageal intrathoracic leaks: stent versus endoscopic vacuum-assisted closure, a retrospective analysis. Endoscopy. 2013 Jun;45(6):433-8. doi: 10.1055/s-0032-1326435. Epub 2013 Jun 3. — View Citation

Gubler C, Schneider PM, Bauerfeind P. Complex anastomotic leaks following esophageal resections: the new stent over sponge (SOS) approach. Dis Esophagus. 2013 Aug;26(6):598-602. doi: 10.1111/dote.12005. Epub 2012 Nov 30. — View Citation

Heits N, Stapel L, Reichert B, Schafmayer C, Schniewind B, Becker T, Hampe J, Egberts JH. Endoscopic endoluminal vacuum therapy in esophageal perforation. Ann Thorac Surg. 2014 Mar;97(3):1029-35. doi: 10.1016/j.athoracsur.2013.11.014. Epub 2014 Jan 18. — View Citation

Kuehn F, Schiffmann L, Rau BM, Klar E. Surgical endoscopic vacuum therapy for anastomotic leakage and perforation of the upper gastrointestinal tract. J Gastrointest Surg. 2012 Nov;16(11):2145-50. doi: 10.1007/s11605-012-2014-3. Epub 2012 Sep 5. — View Citation

Lenzen H, Negm AA, Erichsen TJ, Manns MP, Wedemeyer J, Lankisch TO. Successful treatment of cervical esophageal leakage by endoscopic-vacuum assisted closure therapy. World J Gastrointest Endosc. 2013 Jul 16;5(7):340-5. doi: 10.4253/wjge.v5.i7.340. — View Citation

Loske G, Muller C. [Vacuum therapy of an esophageal anastomotic leakage--a case report]. Zentralbl Chir. 2009 Jun;134(3):267-70. doi: 10.1055/s-0028-1098764. Epub 2009 Apr 22. German. — View Citation

Loske G, Muller C. Endoscopic vacuum-assisted closure of upper intestinal anastomotic leaks. Gastrointest Endosc. 2009 Mar;69(3 Pt 1):601-2; author reply 602. doi: 10.1016/j.gie.2008.06.058. No abstract available. — View Citation

Loske G, Schorsch T, Mueller CT. Endoscopic intraluminal vacuum therapy of duodenal perforation. Endoscopy. 2010;42 Suppl 2:E109. doi: 10.1055/s-0029-1243947. Epub 2010 Mar 19. No abstract available. — View Citation

Loske G, Schorsch T, Muller C. Endoscopic intracavitary vacuum sponge therapy of anastomotic leakage in the proximal colon after right-sided colectomy. Endoscopy. 2010;42 Suppl 2:E171-2. doi: 10.1055/s-0029-1244177. Epub 2010 Jun 16. No abstract available. — View Citation

Loske G, Schorsch T, Muller C. Endoscopic intracavitary vacuum therapy of Boerhaave's syndrome: a case report. Endoscopy. 2010;42 Suppl 2:E144-5. doi: 10.1055/s-0029-1244092. Epub 2010 Apr 19. No abstract available. — View Citation

Loske G, Schorsch T, Muller C. Endoscopic vacuum sponge therapy for esophageal defects. Surg Endosc. 2010 Oct;24(10):2531-5. doi: 10.1007/s00464-010-0998-x. Epub 2010 Mar 24. — View Citation

Loske G, Schorsch T, Müller C. Erste Erfahrungen mit der intraluminalen endoskopischen Vakuumschwammtherapie zur Behandlung von Duodenaldefekten. Z Gastroenterol. 2010; 48: 55

Loske G, Schorsch T, Muller C. Intraluminal and intracavitary vacuum therapy for esophageal leakage: a new endoscopic minimally invasive approach. Endoscopy. 2011 Jun;43(6):540-4. doi: 10.1055/s-0030-1256345. Epub 2011 Mar 29. — View Citation

Loske G, Schorsch T, Müller C. Intraluminale und intracavitäre Vakuumtherapie bei Ösophagusdefekten. Z Gastroenterol. 2010; 48: 19.

Loske G, Schorsch T. [Endoscopic intraluminal vacuum therapy of complete esophageal-jejunal anastomotic rupture: a case report.] Viszeralmedizin. 2011; 27: 166-168.

Loske G, Schorsch T. [Intraluminale Vakuumtherapie - ein innovativer endoskopischer Ansatz zur Therapie von duodenalen Leckagen.] Endoscopy. 2010; 23 (4). 267-269.

Murphy T, Jobe BA. Endoluminal management of anastomotic dehiscence after esophagectomy: an increasing quiver of options reflects the difficulty in realizing a definitive therapy. Gastrointest Endosc. 2010 Feb;71(2):387-9. doi: 10.1016/j.gie.2009.09.033. No abstract available. — View Citation

Richter F, Hendricks A, Schniewind B, Hampe J, Heits N, von Schonfels W, Reichert B, Eberle K, Ellrichmann M, Baumann P, Egberts JH, Becker T, Schafmayer C. Eso-Sponge(R) for anastomotic leakage after oesophageal resection or perforation: outcomes from a — View Citation

Saadi A, Perentes JY, Gonzalez M, Tempia AC, Wang Y, Demartines N, Ris HB, Krueger T. Vacuum-assisted closure device: a useful tool in the management of severe intrathoracic infections. Ann Thorac Surg. 2011 May;91(5):1582-9. doi: 10.1016/j.athoracsur.2011.01.018. Epub 2011 Feb 26. — View Citation

Schniewind B, Schafmayer C, Both M, Arlt A, Fritscher-Ravens A, Hampe J. Ingrowth and device disintegration in an intralobar abscess cavity during endosponge therapy for esophageal anastomotic leakage. Endoscopy. 2011;43 Suppl 2 UCTN:E64-5. doi: 10.1055/s-0030-1255799. Epub 2011 Feb 21. No abstract available. — View Citation

Schniewind B, Schafmayer C, Voehrs G, Egberts J, von Schoenfels W, Rose T, Kurdow R, Arlt A, Ellrichmann M, Jurgensen C, Schreiber S, Becker T, Hampe J. Endoscopic endoluminal vacuum therapy is superior to other regimens in managing anastomotic leakage after esophagectomy: a comparative retrospective study. Surg Endosc. 2013 Oct;27(10):3883-90. doi: 10.1007/s00464-013-2998-0. Epub 2013 May 25. — View Citation

Schorsch T, Muller C, Loske G. Endoscopic vacuum therapy of anastomotic leakage and iatrogenic perforation in the esophagus. Surg Endosc. 2013 Jun;27(6):2040-5. doi: 10.1007/s00464-012-2707-4. Epub 2012 Dec 18. — View Citation

Schorsch T, Muller C, Loske G. Pancreatico-gastric anastomotic insufficiency successfully treated with endoscopic vacuum therapy. Endoscopy. 2013;45 Suppl 2 UCTN:E141-2. doi: 10.1055/s-0032-1326260. Epub 2013 May 28. No abstract available. — View Citation

Wallstabe I, Plato R, Weimann A. Endoluminal vacuum therapy for anastomotic insufficiency after gastrectomy. Endoscopy. 2010;42 Suppl 2:E165-6. doi: 10.1055/s-0029-1244150. Epub 2010 Jun 16. No abstract available. — View Citation

Wallstabe I, Tiedemann A, Schiefke I. Endoscopic vacuum-assisted therapy of an infected pancreatic pseudocyst. Endoscopy. 2011;43 Suppl 2 UCTN:E312-3. doi: 10.1055/s-0030-1256643. Epub 2011 Sep 13. No abstract available. — View Citation

Wallstabe I, Tiedemann A, Schiefke I. Endoscopic vacuum-assisted therapy of infected pancreatic pseudocyst using a coated sponge. Endoscopy. 2012;44 Suppl 2 UCTN:E49-50. doi: 10.1055/s-0031-1291525. Epub 2012 Mar 6. No abstract available. — View Citation

Wallstabe I, Weimann A. Eine neue endoskopische Technik im Management der Anastomoseinsuffizienz nach Ösophaguschirurgie. Z Gastroenterol 2007; 45

Wedemeyer J, Brangewitz M, Kubicka S, Jackobs S, Winkler M, Neipp M, Klempnauer J, Manns MP, Schneider AS. Management of major postsurgical gastroesophageal intrathoracic leaks with an endoscopic vacuum-assisted closure system. Gastrointest Endosc. 2010 Feb;71(2):382-6. doi: 10.1016/j.gie.2009.07.011. Epub 2009 Oct 30. — View Citation

Wedemeyer J, Helfritz FA, Brangewitz M, Winkler M, Manns MP, Schneider A. Endoskopische Vakuum-Schwamm-Therapie bei Leckagen im Verdauungstrakt . Gastrointest Endosc 2009; 23 (1): 41-45.

Wedemeyer J, Lankisch T. [Endoscopic vacuum-assisted closure]. Internist (Berl). 2013 Mar;54(3):309-14. doi: 10.1007/s00108-012-3182-7. German. — View Citation

Wedemeyer J, Schneider A, Manns MP, Jackobs S. Endoscopic vacuum-assisted closure of upper intestinal anastomotic leaks. Gastrointest Endosc. 2008 Apr;67(4):708-11. doi: 10.1016/j.gie.2007.10.064. — View Citation

Wedemeyer J, Schneider AS, Winkler M, Manns MP. Endoskopische Vakuumtherapie bei Perforationen und Anastomoseninsuffizienzen. Gastroenterologe. 2011; 6 (2): 120-123.

Weidenhagen R, Hartl WH, Gruetzner KU, Eichhorn ME, Spelsberg F, Jauch KW. Anastomotic leakage after esophageal resection: new treatment options by endoluminal vacuum therapy. Ann Thorac Surg. 2010 Nov;90(5):1674-81. doi: 10.1016/j.athoracsur.2010.07.007. — View Citation

Wettstein M, Frieling T, Luthen R, Heintges T, Niederau C, Oette M, Vogt C, Vom Dahl S. [Endoscopic therapy for leaks in the gastrointestinal tract, the bile ducts and the pancreas]. Z Gastroenterol. 2011 Jun;49(6):740-8. doi: 10.1055/s-0031-1273422. Epub 2011 Jun 1. German. — View Citation

* Note: There are 36 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Healing rate of the esophageal anastomosis leakage or esophageal perforation	Reduction of the cavity, endoscopic vacuum therapy no longer necessary	until day of discharge (approximately 2 weeks)
Secondary	Number of Eso-SPONGE® changes		until day of discharge (approximately 2 weeks)
Secondary	Total number of sponges used	Total number of Eso-SPONGE® units used until day of discharge	until day of discharge (approximately 2 weeks)
Secondary	Average replacement intervals	Period of time between exchange of ESO-Sponge®	until day of discharge (approximately 2 weeks)
Secondary	Duration of endoscopic vacuum therapy	Number of days during which Eso-SPONGE® was applied	until day of discharge (approximately 2 weeks)
Secondary	Complication Rate	Number of Complications during endoscopic vacuum treatment (e.g. death, re-operations, stenosis, pneumonia, peritonitis, mediastinitis)	until day of discharge (approximately 2 weeks)