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Trial registered on ANZCTR
Registration number
ACTRN12613001050741
Ethics application status
Approved
Date submitted
17/09/2013
Date registered
20/09/2013
Date last updated
20/09/2013
Type of registration
Retrospectively registered
Titles & IDs
Public title
Laparoscopic Transabdominal Preperitoneal For Recurrent Inguinal Hernia: A Randomized Trial
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Scientific title
Identifying the recurrence rate, time off from work, postoperative pain, scrotal swelling and wound infections in laparoscopic transabdominal preperitoneal , open preperitoneal versus anterior approach for recurrent inguinal hernia: a prospective randomized trial
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Secondary ID [1]
283241
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none
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Universal Trial Number (UTN)
U1111-1148-1455
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Recurrent inguinal hernia
290109
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Inguinoscrotal swellings
290123
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Condition category
Condition code
Surgery
290489
290489
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0
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Surgical techniques
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
1-The laparoscopic transabdominal preperitoneal repair (TAPP):
The hernia defect was inspected. The properitoneal space was dissected from lateral to medial at the level of the retroinguinal (Bogros') space, with parietalization of the spermatic cord posteriorly and outwards. The dissection was continued medially towards the retropubic space, extending behind the symphysis pubis and iliopubic tract, exposing the pectineal ligament. The peritoneum forming the hernia sac was pulled in, separating it from the cord structures. A 15 x 10 cm sheet of polypropylene mesh was placed so as to cover the Hesselbach's triangle, the indirect space, and the femoral ring areas. The mesh was fixed using an endoscopic multifire hernia stapler. The mean operative time was 122.5 minutes (80-170).
2- The open preperitoneal approach to the inguinal region was performed under general or regional anesthesia, as originally described by Nyhus . Through a lower abdominal transverse incision, the anterior rectus sheath was incised and the rectus muscle reflected medially. The preperitoneal space was cleaved with blunt dissection, exposing the myopectineal orifice. The cord was explored and the hernias were reduced. A 15x15 cm polypropylene mesh with a slit was inserted in the preperitoneal space and fixed with nonabsorbable sutures to pubic tubercle and Cooper's ligament. The mesh was passed behind the cord and manipulated to lay flat against the posterior inguinal floor overlapping the entire myopectineal orifice. The mean operative time was 71.6 minutes (40–120).
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Intervention code [1]
287966
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Treatment: Surgery
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Comparator / control treatment
Intervention: Laparoscopic Transabdominal Preperitoneal and Open preperitoneal approach Comparator/Control: anterior inguinal approach.
The anterior tension-free repair, as defined by Lichtenstein was performed using 6 x 11 cm polypropylene mesh. The mean operative time was 94.7 minutes (60-150).
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Control group
Active
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Outcomes
Primary outcome [1]
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The primary end point of the study was recurrence of the hernia, defined as a clinically detectable characteristic swelling in the groin and diagnosed by the authors.
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Assessment method [1]
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Timepoint [1]
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The follow up period was 41 +/- 26.87 months
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Secondary outcome [1]
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The secondary end points were time off from work, defined as the number of days between the day of surgery and the first day a patient returned to work .
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Assessment method [1]
304680
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Timepoint [1]
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from the day of surgery until the first day a patient returned to work
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Secondary outcome [2]
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Postoperative pain was assessed using Visual Analog Scale pain score (1–10): Mild (1–4) , moderate (5–7), severe (8–10).
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Assessment method [2]
304681
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Timepoint [2]
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Postoperative pain was assessed after one month post-operatively.
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Secondary outcome [3]
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Scrotal swelling was assessed clinically by the treating surgeons.
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Assessment method [3]
304682
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Timepoint [3]
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2 weeks
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Secondary outcome [4]
304683
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Wound infection was assessed clinically by the treating surgeons.
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Assessment method [4]
304683
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Timepoint [4]
304683
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2 weeks
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Eligibility
Key inclusion criteria
all patients are of male sex and had unilateral recurrent inguinal scrotal and irreducible hernias.
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Minimum age
42
Years
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Maximum age
65
Years
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Sex
Males
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients with primary inguinal hernias and patients with marked obesity (BMI > 35) and ASA grade 3 and beyond were excluded
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/01/2007
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Actual
6/01/2007
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Date of last participant enrolment
Anticipated
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Actual
23/04/2011
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
60
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
5417
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Egypt
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State/province [1]
5417
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Port-Fouad general hospital
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Address [1]
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Al-obour zone, postal code: 11664,Port-Fouad general hospital, Port-Fouad, Port-Said, Egypt
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Country [1]
287981
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Egypt
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Funding source category [2]
287982
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Hospital
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Name [2]
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Suez Canal University hospital
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Address [2]
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Faculty of medicine, Suez Canal University. Sheikh Zaid zone, postal code: 22366, Ismailia, Egypt
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Country [2]
287982
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Egypt
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Primary sponsor type
Individual
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Name
Aly Saber
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Address
19 Al-guish street, postal code:11433 Port-Fouad ,Port-Said , Egypt
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Country
Egypt
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Secondary sponsor category [1]
286702
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None
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Name [1]
286702
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Address [1]
286702
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Country [1]
286702
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
289911
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Ethical committee of Port- Fouad general hospital
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Ethics committee address [1]
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Al-obour zone, postal code :11644 , Port- Fouad general hospital, Port-Fouad, Port-Said, Egypt.
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Ethics committee country [1]
289911
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Egypt
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Date submitted for ethics approval [1]
289911
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Approval date [1]
289911
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Ethics approval number [1]
289911
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Summary
Brief summary
The present work aimed at comparing three approaches in repair of recurrent inguinal hernia: anterior inguinal approach, open properitoneal repair and transabdominal pro-peritoneal repair and as regards regarding complications and early recurrence.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Aly Saber
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Address
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Al-obour zone, postal code: 11664,Port-Fouad general hospital, Port-Fouad, Port-Said, Egypt
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Country
43034
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Egypt
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Phone
43034
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+201223752032
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Fax
43034
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Email
43034
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[email protected]
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Contact person for public queries
Name
43035
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Aly Saber
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Address
43035
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Al-obour zone, postal code: 11664,Port-Fouad general hospital, Port-Fouad, Port-Said, Egypt
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Country
43035
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Egypt
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Phone
43035
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+201223752032
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Fax
43035
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Email
43035
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[email protected]
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Contact person for scientific queries
Name
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Aly Saber
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Address
43036
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Al-obour zone, postal code: 11664,Port-Fouad general hospital, Port-Fouad, Port-Said, Egypt
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Country
43036
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Egypt
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Phone
43036
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+201223752032
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Fax
43036
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Email
43036
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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