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Trial registered on ANZCTR
Registration number
ACTRN12616000359437
Ethics application status
Approved
Date submitted
17/12/2015
Date registered
21/03/2016
Date last updated
23/08/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Comparison of post-operative mobility recovery in participants undergoing keyhole colorectal surgery treated with intraperitoneal ropivacaine/placebo for post-op pain management.
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Scientific title
A double-blinded randomised placebo-controlled clinical trial assessing postoperative recovery using intraperitoneal local anaesthetic in laparoscopic colorectal surgery.
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Secondary ID [1]
288108
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JHGIS08
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Universal Trial Number (UTN)
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Trial acronym
LAPLAP study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
post-operative pain
296971
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Condition category
Condition code
Surgery
297228
297228
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0
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Other surgery
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Anaesthesiology
298176
298176
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0
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Pain management
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Ropivacaine hydrochloride 0.2% continuous infusion of up to 4mls per hour (depending on patient weight, as prescribed by the treating Anaesthetist) via intraperitoneal catheter administered post-operatively up to 5 days as determined by the treating surgical team or pain team.
Other anaesthetic agents for the operative procedure will be at the discretion of the treating Anaesthetist.
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Intervention code [1]
293415
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Treatment: Drugs
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Comparator / control treatment
0.9% sodium chloride infusion of up to 4mls per hour (depending on patient weight) via intraperitoneal catheter.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Difference in pre-operative De Morton Mobility Index (DEMMI) score and post-operative score.
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Assessment method [1]
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Timepoint [1]
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Day 7 and 30 post-operatively
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Secondary outcome [1]
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Postoperative analgesic consumption (MilliEquivalents of morphine) from medical record pain management prescription charts.
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Assessment method [1]
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Timepoint [1]
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Post-operatively daily for 3 days.
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Secondary outcome [2]
319433
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Postoperative pain scores (Visual Analogue Scales 0-10)
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Assessment method [2]
319433
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Timepoint [2]
319433
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Daily for 3 days
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Secondary outcome [3]
319434
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Postoperative forced expiratory volume in first second (FEV1),
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Assessment method [3]
319434
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Timepoint [3]
319434
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Daily for 3 days and day 30
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Secondary outcome [4]
319435
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Time to first flatus as per medical record documentation.
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Assessment method [4]
319435
0
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Timepoint [4]
319435
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Post-operatively in hours to when first passage of flatus occurs.
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Secondary outcome [5]
319436
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Time to first bowel motion as per medical record documentation.
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Assessment method [5]
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Timepoint [5]
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Post-operatively in hours to when first bowel motion occurs.
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Secondary outcome [6]
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Ileus rates in groups (lack of any evidence of gut function >48 hours) as per medical record documentation of flatus and bowel motion activity.
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Assessment method [6]
319437
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Timepoint [6]
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Post-operatively until discharge.
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Secondary outcome [7]
319438
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Post-operative nausea and vomiting graded by the Simplified PONV impact scale
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Assessment method [7]
319438
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Timepoint [7]
319438
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Daily for 3 days.
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Secondary outcome [8]
319439
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Length of hospital stay (days) as per medical record.
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Assessment method [8]
319439
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Timepoint [8]
319439
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To time of hospital discharge
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Secondary outcome [9]
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Post-operative surgical complications graded by the Clavien-Dindo Classification of Surgical Complications.
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Assessment method [9]
319440
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Timepoint [9]
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Up to day 30 post-operatively
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Secondary outcome [10]
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Patient satisfaction with analgesia after discharge (Likert scale and percent satisfaction)
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Assessment method [10]
319441
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Timepoint [10]
319441
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After discharge up to day 7.
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Secondary outcome [11]
319442
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Surgical Recovery Score
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Assessment method [11]
319442
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Timepoint [11]
319442
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Daily for 3 days then at day 7 and day 30.
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Secondary outcome [12]
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Postoperative forced vital capacity (FVC)
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Assessment method [12]
322030
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Timepoint [12]
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Daily for 3 days and day 30
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Secondary outcome [13]
322033
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Postoperative peak expiratory flow (PEF)
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Assessment method [13]
322033
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Timepoint [13]
322033
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Post-operatively daily for 3 days and day 30
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Eligibility
Key inclusion criteria
All patients undergoing elective or semi-urgent booked laparoscopic colorectal resection
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Minimum age
18
Years
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Maximum age
No limit
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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
Patients from the above group will be excluded if they:
-are under 18 years of age, or
-Refuse or are unable to give written informed consent to participate in the study, or
-have severe renal impairment or
-receive an epidural, spinal or other neuroaxial anaesthetic, or
-receive an operation that involved extra incisions outside the abdominal wall (such as abdomino-perineal resections) or
-have a known allergy or adverse drug reaction to local anaesthetic agents or morphine or fentanyl, or
-have a history of arrhythmia or long QT syndrome associated with the drugs used in this trial, or
-remain intubated post procedure
-Pregnant or lactating females
-Are taking regular opiate narcotics pre-operatively
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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
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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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
18/04/2016
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Actual
8/07/2016
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Date of last participant enrolment
Anticipated
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Actual
5/12/2017
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Date of last data collection
Anticipated
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Actual
28/02/2018
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Sample size
Target
96
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Accrual to date
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Final
96
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
4871
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John Hunter Hospital Royal Newcastle Centre - New Lambton
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Recruitment hospital [2]
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Newcastle Private Hospital - New Lambton Heights
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Recruitment postcode(s) [1]
12379
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2305 - New Lambton Heights
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Recruitment postcode(s) [2]
12380
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2305 - New Lambton
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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unfunded
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Address [1]
292526
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unfunded
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Country [1]
292526
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Primary sponsor type
Government body
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Name
Hunter New England Local Health District
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Address
Lookout Road
New Lambton Heights NSW 2305
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
291236
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Address [1]
291236
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Country [1]
291236
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
294001
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Hunter New England Human Research Ethics Committee
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Ethics committee address [1]
294001
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Locked Bag 1 New Lambton NSW 2305
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Ethics committee country [1]
294001
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Australia
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Date submitted for ethics approval [1]
294001
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26/11/2015
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Approval date [1]
294001
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02/03/2016
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Ethics approval number [1]
294001
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15/12/16/3.01
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Summary
Brief summary
Most colorectal surgery is now performed laparoscopically. Therefore most pain is deep inside the abdomen rather than the small incisions on the abdominal wall. This study would like to use a pain management technique that uses local anaesthetic infused via plastic catheters into the intraperitoneal space in the abdomen, close to the internal incisions. It is hoped that by doing this patients will need to use less opioid drugs and thereby avoid the side effects of these drugs and possibly recover more quickly from the surgical procedure with less pain. Currently there are many different pain management techniques used after surgery and include: -Intravenous pain medication with opioid drugs such as Morphine or Fentanyl. -Epidural (small plastic tube inserted near spinal cord where medication can be given) with a combination of local anaesthetic drugs +/- morphine-like drugs. -Local anaesthetic blocks via small plastic tubes placed between the abdominal muscles at the time of operation and allow for local anaesthetic to be given between these muscles. -Oral pain medication such as paracetamol and oxycodone. -A combination of any of the above techniques. These techniques can have side effects especially with the Morphine-like drugs that can be a problem in patients having surgery on the bowel and include: -Nausea and vomiting -Reduced bowel function (constipation or bowel temporarily stops working - ileus) -Drowsiness or sleepiness -Slowed respiratory rate and reduced cough -Reduced mobility leading to prolonged bedrest -Increased risk of blood clots due to immobility Because of these side effects the study is designed to see if the local anaesthetic infused intraperitoneally will result in improved pain relief, mobility, earlier return of gut function and less complications,
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
805
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/AnzctrAttachments/369753-1512163.01 Approval Multi-site LeadHREC (2).pdf
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Contacts
Principal investigator
Name
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Dr Stephen Smith
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Address
62070
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Surgical Services
John Hunter Hospital
Locked Bag 1
Hunter Region Mail Centre NSW 2310
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Country
62070
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Australia
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Phone
62070
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+61 2 49855153
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Fax
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Email
62070
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[email protected]
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Contact person for public queries
Name
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Rosemary Carroll
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Address
62071
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Surgical Services
John Hunter Hospital
Locked Bag 1
Hunter Region Mail Centre NSW 2310
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Country
62071
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Australia
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Phone
62071
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+61 2 49855153
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Fax
62071
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Email
62071
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[email protected]
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Contact person for scientific queries
Name
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Stephen Smith
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Address
62072
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Surgical Services
John Hunter Hospital
Locked Bag 1
Hunter Region Mail Centre NSW 2310
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Country
62072
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Australia
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Phone
62072
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+61 2 49855153
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Fax
62072
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Email
62072
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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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