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Trial registered on ANZCTR
Registration number
ACTRN12616000242426
Ethics application status
Approved
Date submitted
6/12/2015
Date registered
22/02/2016
Date last updated
22/02/2016
Type of registration
Retrospectively registered
Titles & IDs
Public title
Mesh fixation with glue in the inguinal hernia repair. Does it provide benefits to suture fixation?
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Scientific title
Effect of N-Butyl-2 cyanoacrylate for mesh fixation in Lichtenstein hernioplasty on pain, surgical time, recurrence and complications.
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Secondary ID [1]
288081
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None
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Universal Trial Number (UTN)
u1111-1177-3121
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Trial acronym
FELIU
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Inguinal hernia
297534
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Condition category
Condition code
Surgery
297190
297190
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0
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Surgical techniques
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Musculoskeletal
297818
297818
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants are randomised to one of two procedures for hernia repair: 1) Lichtenstein tension-free hernioplasty using N-Butyl-2-cyanoacrylate for mesh fixing or 2) Lichtenstein tension-free hernioplasty using nonabsorbable sutures for mesh fixing.
The use of this adhesive is only in the fixation of the mesh. The mesh is fixed using a drop of the N-Butyl-2-cyanoacrylate adhesive in each location where normally a stitch would be placed.
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Intervention code [1]
293391
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Treatment: Surgery
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Comparator / control treatment
The Lichtenstein tension-free mesh repair, which is an example of hernioplasty and is currently one of the most popular open inguinal hernia repair techniques.
Opening of the deep fascia of the thigh and exposure of the femoral canal to check for a femoral hernia. Division of the external oblique aponeurosis from the external ring laterally for up to 5 cm, safeguarding the ilioinguinal nerve.
Mobilization of the superior (safeguarding the iliohypogastric nerve) and inferior flaps of the external oblique aponeurosis to expose the underlying structures. Mobilization of the spermatic cord, along with the cremaster, including the ilioinguinal nerve, the genitofemoral nerve, and the spermatic vessels, opening of the coverings of the spermatic cord and identification and isolation of the hernia sac.
Inversion, division, resection, or ligation of the sac, as indicated; depending on the type of hernia and hernia sac. Placement and fixation of mesh. we set the prosthesis to the inguinal ligament with nonabsorbable suture, also place it around the spermatic cord creating a reinforcement to the internal inguinal ring.
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Control group
Active
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Outcomes
Primary outcome [1]
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Evaluation of acute pain. Using the visual analog scale for each patient assessment.
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Assessment method [1]
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Timepoint [1]
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30 days, 3 months and 6 months after surgery
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Secondary outcome [1]
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Incidence of chronic pain. Using the visual analog scale for each patient assessment.
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Assessment method [1]
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Timepoint [1]
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Assessment 12 months, one year and two years after surgery.
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Secondary outcome [2]
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Recurrence rate. We assess the recurrence of the hernia by physical examination at each visit , if we have doubts during the assessement, we ask an ultrasound.
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Assessment method [2]
320506
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Timepoint [2]
320506
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Assessment 12 months, one year and two years after surgery
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Eligibility
Key inclusion criteria
Patients with unilateral inguinal hernia more than 18 years, electively operated using the technique of Lichtenstein. Patients who accept their inclusion in the study
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Minimum age
18
Years
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Maximum age
80
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patient under 18 or over 80 years, bilateral hernia, emergency surgery other than the Lichtenstein technique. Patients who do not accept their inclusion in the study.
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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)
Random. Single-blind. The nurse assistant takes a paper of sealed opaque envelope, indicating the group the patient belongs, just before placing the mesh.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Through a computer program
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
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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
Safety/efficacy
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Statistical methods / analysis
Analysis using SPSS 7.5-Windows (SPSS, Chicago, IL). Chi-2 and Fisher exact test was used for qualitative variables expressed as frequencies and Student t test for quantitative variables expressed as mean and standard deviation, after checking the normal distribution. Statistical significance was set at p <0.05.
We estimate the sample size on the basis of observations made previously by other researchers, who found differences between 1-3 points on the VAS scale in acute pain, and using a categorical variable (yes/no) chronic pain (pain 6 months after surgery) found a rate of 10% in suture group and 0 % adhesive group.
Accepting an alpha risk of 0.05 and a beta risk of 0.2 in a bilateral contrast, 70 subjects in the first group and 70 are set out in the second to detect a difference equal to or greater than 1 unit on the VAS pain scale. It is assumed that the common standard deviation of 2 units. It has been estimated rate of loss to follow up of 10%.
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
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Actual
26/11/2013
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Date of last participant enrolment
Anticipated
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Actual
15/04/2015
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
140
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Accrual to date
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Final
140
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Recruitment outside Australia
Country [1]
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Spain
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State/province [1]
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Barcelona
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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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Consorci Sanitari de l'Anoia
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Address [1]
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Av Catalunya 7. Igualada Postcode 08700. Barcelona. Spain.
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Country [1]
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Spain
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Primary sponsor type
Hospital
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Name
Consorci Sanitari de l'Anoia
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Address
Av Catalunya 11. Igualada. Postcode 08700. Barcelona. Spain
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Country
Spain
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Secondary sponsor category [1]
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None
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Name [1]
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None
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Address [1]
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None
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Country [1]
291218
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Comite Etico de Investigacion Clinica del Hospital Universitario de Bellvitge.
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Ethics committee address [1]
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Feixa Llarga s/n L'Hospitalet de Llobregat
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Ethics committee country [1]
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Spain
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Date submitted for ethics approval [1]
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09/12/2014
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Approval date [1]
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05/11/2015
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Ethics approval number [1]
293984
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AC178/14
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Summary
Brief summary
Randomized Clinical Trial, in which they have included patients with unilateral inguinal hernia, elective surgery, over 18 years and agreed to be included. Patients were randomized to one of two treatment groups: Mesh fixation with nonabsorbable sutures or fixation with n- butyl-2 - cyanoacrylate. They have been collected from the patient 's own variables and associated with the intervention. The main objective is to assess the impact on acute pain, secondary objectives are to assess chronic pain and the incidence of hernia recurrence. Pain was assessed using the visual analog scale at each patient visit. Recurrent hernia has been evaluated by physical examination in consultation, in case of doubt has been requested inguinal ultrasound. We observed lower incidence of acute pain in the group of mesh fixation with cyanoacrylate (p<0.05). There were no differences in the development of chronic pain or the incidence of hernia 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
61998
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Mr LUIS ALFONSO VEGA ROJAS
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Address
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Mariano Cuiner Street 4. 1. 1. Igualada, Barcelona. Postcode 08700. Spain
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Country
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Spain
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Phone
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+34652727153
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Fax
61998
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Email
61998
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[email protected]
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Contact person for public queries
Name
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LUIS ALFONSO VEGA ROJAS
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Address
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Mariano Cuiner Street 4. 1. 1. Igualada, Barcelona. Postcode 08700. Spain
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Country
61999
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Spain
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Phone
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+34652727153
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Fax
61999
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Email
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[email protected]
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Contact person for scientific queries
Name
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Josep Camps
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Address
62000
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Av Catalunya 7. Igualada Postcode 08700, Barcelona. Spain
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Country
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Spain
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Phone
62000
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+34630140400
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Fax
62000
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Email
62000
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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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