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A Prospective, Randomized, Phase III Study to Evaluate the Efficacy and Safety of Fibrin Sealant Grifols as an Adjunct to Hemostasis as Compared to Cellulose Sheets in Hepatic Surgery Resections.

Authors :
Bjelović, Miloš
Ayguasanosa, Jaume
Kim, Robin D.
Stojanović, Miroslav
Vereczkei, András
Nikolić, Srdjan
Winslow, Emily
Emre, Sukru
Xiao, Gary
Navarro-Puerto, Jordi
Courtney, Kecia
Barrera, Gladis
on behalf of the investigators of the Fibrin Sealant Grifols in Hepatic Resection Clinical Investigation Study Group
investigators of the Fibrin Sealant Grifols in Hepatic Resection Clinical Investigation Study Group
Source :
Journal of Gastrointestinal Surgery; Nov2018, Vol. 22 Issue 11, p1939-1949, 11p
Publication Year :
2018

Abstract

<bold>Background: </bold>Local hemostatic agents have a role in limiting bleeding complications associated with liver resection.<bold>Methods: </bold>In this randomized, phase III study, we compared the efficacy and safety of Fibrin Sealant Grifols (FS Grifols) with oxidized cellulose sheets (Surgicel®) as adjuncts to hemostasis during hepatic resections. The primary efficacy endpoint was the proportion of patients achieving hemostasis at target bleeding sites (TBS) within 4 min (T4) of treatment application. Secondary efficacy variables were time to hemostasis (TTH) at a later time point if re-bleeding occurs and cumulative proportion of patients achieving hemostasis by time points T2, T3, T5, T7, and T10.<bold>Results: </bold>The rate of hemostasis by T4 was 92.8% in the FS Grifols group (n = 163) and 80.5% in the Surgicel® group (n = 162) (p = 0.01). The mean TTH was significantly shorter (p < 0.001) in the FS Grifols group (2.8 ± 0.14 vs. 3.8 ± 0.24 min). The rate of hemostasis by T2, T5, and T7 was higher and statistically superior in the FS Grifols group compared to Surgicel®. No substantial differences in adverse events (AE) were noted between treatment groups. The most common AEs were procedural pain (36.2 vs. 37.7%), nausea (20.9 vs. 23.5%), and hypotension (14.1 vs 6.2%).<bold>Conclusions: </bold>FS Grifols was safe and well tolerated as a local hemostatic agent during liver resection surgeries. Overall, data demonstrate that the hemostatic efficacy of FS Grifols is superior to Surgicel® and support the use of FS Grifols as an effective local hemostatic agent in these surgical procedures. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
1091255X
Volume :
22
Issue :
11
Database :
Complementary Index
Journal :
Journal of Gastrointestinal Surgery
Publication Type :
Academic Journal
Accession number :
132880576
Full Text :
https://doi.org/10.1007/s11605-018-3852-4