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Trial registered on ANZCTR
Registration number
ACTRN12616000244404
Ethics application status
Approved
Date submitted
14/01/2016
Date registered
22/02/2016
Date last updated
22/05/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Onlay hernioplasty versus Rives–Stoppa repair for management of paraumbilical hernia associated with divarication of recti in diabetic patients in terms of recurrence and surgical site infection. A prospective randomized controlled trial.
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Scientific title
Onlay hernioplasty versus Rives–Stoppa repair for management of paraumbilical hernia associated with divarication of recti in diabetic patients in terms of recurrence and surgical site infection. A prospective randomized controlled trial.
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Secondary ID [1]
288318
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nil known
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Universal Trial Number (UTN)
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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:
Paraumbilical hernia
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Divarication of recti
297287
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Diabetes Mellitus
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Surgical Site Infection
297570
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Condition category
Condition code
Surgery
297481
297481
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0
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Surgical techniques
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Metabolic and Endocrine
297765
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Onlay hernioplasty procedure: After skin incision and identification of the sac, opening of the sac followed by reduction of the contents. The defect is closed and the mesh is applied on the anterior rectus sheet. Approximate duration of the procedure is 60 minutes.
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Intervention code [1]
293616
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Treatment: Surgery
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Comparator / control treatment
Rives–Stoppa repair, a longitudinal incision in the medial part of the anterior rectus sheet will be performed to reach the retro-rectal space. Then the defect is closed and the mesh is designed in an H shape and applied over the posterior rectus sheet beneath the recti muscles with the transverse part of the H lying between the xiphoid process and the umbilicus. This will be followed by closure of anterior rectus sheet. Approximate duration of the procedure is 60 - 90 minutes.
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Control group
Active
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Outcomes
Primary outcome [1]
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Recurrence of the paraumbilical hernia
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Assessment method [1]
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Timepoint [1]
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at 1, 3, 6 and 12 months by examination by the surgeon during follow-up visits in outpatient clinic
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Primary outcome [2]
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Surgical Site infection
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Assessment method [2]
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Timepoint [2]
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at 1, 3, 6 and 12 months by examination by the surgeon during follow-up visits in outpatient clinic
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Secondary outcome [1]
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Operative time (minutes) measured from first skin incision till final repair of the incision
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Assessment method [1]
319912
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Timepoint [1]
319912
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measured by operative nurse at the time of operation.
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Secondary outcome [2]
319913
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Time to regain domestic and work activities (days)
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Assessment method [2]
319913
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Timepoint [2]
319913
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noticed by the patient and recorded by the surgeon during the first visit of the patient to outpatient clinic at 14th day.
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Secondary outcome [3]
319914
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Postoperative chronic postoperative pain
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Assessment method [3]
319914
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Timepoint [3]
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measured by Modified Visual Analog Scale after 3, 6 and12 month at rest and with movement by the surgeon during follow-up visits in outpatient clinic
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Eligibility
Key inclusion criteria
diabetic patients suffering from paraumbilical hernia associated with divarication of recti.
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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 with previous hernioplasty or who are planning to be pregnant within less than 2 years will be excluded from the research
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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)
Closed envelop technique
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A total number of 60 envelops (30 onlay repair and 30 Rives–Stoppa) was prepared. OR nurse with no involvement in the research chose an envelope and informed the surgeons just before the operation.
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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 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
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
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Actual
1/10/2015
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Date of last participant enrolment
Anticipated
1/04/2016
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Actual
19/04/2016
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Date of last data collection
Anticipated
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Actual
7/05/2017
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Sample size
Target
60
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Accrual to date
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Final
60
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Recruitment outside Australia
Country [1]
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Egypt
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State/province [1]
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Alexandria
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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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Alexandria Main University Hospital
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Address [1]
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1 Kolleyet al teb st.
Azareeta
Alexandria
21526
Egypt
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Country [1]
292689
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Egypt
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Primary sponsor type
Hospital
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Name
Alexandria Main University Hospital
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Address
1 Kolleyet al teb st.
Azareeta
Alexandria
21526
Egypt
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Country
Egypt
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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]
291411
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None
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Country [1]
291411
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
294162
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Ethical committee of Alexandria college of Medicine
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Ethics committee address [1]
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1 Kolleyet al teb st. Azareeta Alexandria 21526 Egypt
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Ethics committee country [1]
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Egypt
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Date submitted for ethics approval [1]
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18/08/2015
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Approval date [1]
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01/10/2015
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Ethics approval number [1]
294162
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Summary
Brief summary
Para-umbilical hernia is one of the common types of hernia. It has a female to male ratio of 5:1. Not uncommonly, para-umbilical is associated with divarication of recti which is separation of the two muscles, usually as a result of the linea alba thinning and stretching. There are many surgical procedures for repair of hernia; however,the recurrence rate remains the main expected consequence. Many studies proved the effect of diabetes on increasing surgical site infection which may affect the result of hernia repair especially when using prostheses. Repairs of the abdominal wall that use permanent prostheses differ based on where the prosthesis is placed anatomically. Onlay repair is one of the commonest repairs used to repair abdominal wall in which mesh is applied superficial to anterior rectus sheeths. Being an easy technique may be the cause of its wide practice. However, Onlay techniques have reported recurrence rates as high as 23% in cases with complex weak abdomen. In addition, locating the mesh in the subcutaneous space carries the risk of surgical site infection with subsequent fistulas or even recurrence. Rives–Stoppa repair, is technically difficult repair and involves retro muscular prefascial placement of a large mesh anterior to the posterior rectus sheath and primary closure of the anterior fascia. It has a theoretical advantage of keeping the mesh away from the wound and subsequently less liability of surgical site infection. The aim of this study is to compare between Onlay hernioplasty and Rives–Stoppa repair for management of paraumbilical hernia associated with divarication of recti in diabetic patients in terms of recurrence and surgical site infection.
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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]
706
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/AnzctrAttachments/369922-Ethical approval.docx
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Contacts
Principal investigator
Name
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A/Prof Walid Abd El Maksoud PhD, MD, MRCS
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Address
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Associate Professor, General Surgery Department, Faculty of Medicine, Alexandria University. Chamblion street, el azareeta, Alexandria Governorate, Egypt. 21526
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Country
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Egypt
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Phone
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+20 1211433351
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Walid Abd El Maksoud PhD, MD, MRCS
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Address
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Associate Professor, General Surgery Department, Faculty of Medicine, Alexandria University. Chamblion street, el azareeta, Alexandria Governorate, Egypt. 21526
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Country
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Egypt
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Phone
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+20 1211433351
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Fax
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Email
62747
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[email protected]
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Contact person for scientific queries
Name
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Walid Abd El Maksoud PhD, MD, MRCS
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Address
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Associate Professor, General Surgery Department, Faculty of Medicine, Alexandria University. Chamblion street, el azareeta, Alexandria Governorate, Egypt. 21526
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Country
62748
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Egypt
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Phone
62748
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+20 1211433351
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Fax
62748
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Email
62748
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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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