SafeHeal Colovac Colorectal Anastomosis Protection Device evaluation (SAFE-2) pivotal study: an international randomized controlled study to evaluate the safety and effectiveness of the Colovac Colorectal Anastomosis Protection Device

Elisabeth Hain, Jérémie H. Lefèvre, Alison Ricardo, Sang Lee, Karen Zaghiyan, Elisabeth McLemore, Danny Sherwinter, Rebecca Rhee, Matthew Wilson, Joseph Martz, Justin Maykel, John Marks, Jorge Marcet, Philippe Rouanet, Leon Maggiori, Niels Komen, Nicolas De Hous, Zaher Lakkis, Jean Jacques Tuech, Fadi AttiyehEddy Cotte, Patricia Sylla

Research output: Contribution to journalArticlepeer-review

Abstract

Aim: Although proximal faecal diversion is standard of care to protect patients with high-risk colorectal anastomoses against septic complications of anastomotic leakage, it is associated with significant morbidity. The Colovac device (CD) is an intraluminal bypass device intended to avoid stoma creation in patients undergoing low anterior resection. A preliminary study (SAFE-1) completed in three European centres demonstrated 100% protection of colorectal anastomoses in 15 patients, as evidenced by the absence of faeces below the CD. This phase III trial (SAFE-2) aims to evaluate the safety and effectiveness of the CD in a larger cohort of patients undergoing curative rectal cancer resection. Methods: SAFE-2 is a pivotal, multicentre, prospective, open-label, randomized, controlled trial. Patients will be randomized in a 1:1 ratio to either the CD arm or the diverting loop ileostomy arm, with a recruitment target of 342 patients. The co-primary endpoints are the occurrence of major postoperative complications within 12 months of index surgery and the effectiveness of the CD in reducing stoma creation rates. Data regarding quality of life and patient's acceptance and tolerance of the device will be collected. Discussion: SAFE-2 is a multicentre randomized, control trial assessing the efficacy and the safety of the CD in protecting low colorectal anastomoses created during oncological resection relative to standard diverting loop ileostomy. Trial registration: NCT05010850.

Original languageEnglish
Pages (from-to)1271-1284
Number of pages14
JournalColorectal Disease
Volume26
Issue number6
DOIs
StatePublished - Jun 2024

Keywords

  • anastomotic leakage
  • bypass device
  • colorectal anastomosis
  • diverting stoma
  • loop ileostomy
  • low anterior resection

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