RECRUITING

Effectiveness of Methods for Pyloric Drainage in esophagecTomY: Botox vs. Pyloromyotomy

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

The goal of this pragmatic, registry-based, randomized clinical trial is to find out if using botulinum toxin (Botox) to help drain the stomach during an esophagectomy works as well as a pyloromyotomy in patients undergoing elective esophagectomy for benign or malignant esophageal disease. Both methods are intended to prevent problems with food emptying too slowly from the stomach (delayed gastric emptying), which can cause discomfort after surgery. The main question it aims to answer is: Is intrapyloric Botox injection as a drainage procedure during esophagectomy non-inferior in preventing symptoms of delayed gastric emptying at 6 months postoperatively compared to pyloromyotomy? Researchers will compare intrapyloric Botox injection to pyloromyotomy to see if Botox is non-inferior to pyloromyotomy in easing symptoms of delayed gastric emptying. Participants will: Be randomized to one of two treatment groups-either intrapyloric Botox injection or pyloromyotomy-during their esophagectomy. Complete surveys assessing digestive symptoms at standard postoperative follow-up intervals (3 months, 6 months, 1 year, and 2 years postoperatively). Undergo a standard gastric emptying study at 6 months after surgery.

Official Title

Comparative Effectiveness of Intrapyloric Botulinum Toxin Injection Versus Pyloromyotomy for Pyloric Drainage During Esophagectomy: A Registry-Based, Pragmatic Randomized Noninferiority Trial

Quick Facts

Study Start:2024-12-03
Study Completion:2028-05-31
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT06721520

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. * 18 years of age or older
  2. * Undergoing elective esophagectomy (thoracoabdominal, Ivor-Lewis, McKeown)
  3. * Receiving a gastric conduit for alimentary reconstruction
  4. * Technically able to receive either intrapyloric Botox injection or pyloromyotomy as ultimately determined intraoperatively
  5. * Willing and able to provide informed consent
  6. * Willing and able to participate in long-term follow up including study visits and surveys
  1. * Undergoing emergent esophagectomy (e.g., for esophageal perforation)
  2. * Patients with underlying neuromuscular disease as Botox would be contraindicated (amyotrophic lateral sclerosis, myasthenia gravis, muscular dystrophies, Lambert-Eaton syndrome)
  3. * Patients undergoing left thoracoabdominal without left cervical neck incision (i.e., Sweet esophagectomy) - excluded due to the extent of gastric resection
  4. * Pregnancy
  5. * Allergy or hypersensitivity to botulinum toxin
  6. * Cannot feasibly receive both pyloric interventions as determined intraoperatively (e.g., patients with central obesity undergoing thoracoabdominal esophagectomy makes for a technically difficult pyloromyotomy)

Contacts and Locations

Study Contact

Andrew Conner, MD
CONTACT
216-316-6644
connera5@ccf.org

Principal Investigator

Siva Raja, MD
PRINCIPAL_INVESTIGATOR
The Cleveland Clinic

Study Locations (Sites)

Cleveland Clinic
Cleveland, Ohio, 44195
United States

Collaborators and Investigators

Sponsor: The Cleveland Clinic

  • Siva Raja, MD, PRINCIPAL_INVESTIGATOR, The Cleveland Clinic

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2024-12-03
Study Completion Date2028-05-31

Study Record Updates

Study Start Date2024-12-03
Study Completion Date2028-05-31

Terms related to this study

Keywords Provided by Researchers

  • Esophagectomy
  • Delayed gastric emptying
  • Delayed conduit emptying
  • Botox
  • botulinum toxin
  • Pyloromyotomy
  • Pyloric drainage

Additional Relevant MeSH Terms

  • Esophageal Cancer Surgery
  • Esophagectomy
  • Delayed Gastric Emptying Following Procedure
  • Esophageal Diseases
  • Esophageal Achalasia
  • Pylorus Dysfunction
  • Esophageal Dysmotility