Hernia, Ventral Clinical Trial
Official title:
Ventral Incisional Hernia Repair: Comparison Of Laparoscopic and Open Repair With Mesh
The purpose of this research is to compare open ventral incisional hernia repair to the laparoscopic repair with respect to complications, recurrence, pain, return to normal activities of daily living, and return to work.
The appearance of ventral incisional hernia (VIH) following an open abdominal operation is
an important postoperative problem. While advances in anesthesia techniques, better methods
to prevent surgical infections, and improved treatment of infection, and the use of new
suture materials have reduced the incidence of incisional hernias, incisional hernias still
occurs in 0.5-11% of all open abdominal surgical procedures performed.
Overview of study design: We are conducting a 4 center randomized clinical trial to compare
the outcomes of two methods of surgical management of ventral incisional hernia. Patients
presenting to a physician with a ventral incisional hernia will be considered for the trial.
The study is designed to compare the rate of complications, pain, time to return to normal
activities, Health related quality of life (HRQoL) and patient satisfaction between
laparoscopic and open mesh repair for ventral incisional hernia. The rate of recurrence of
the hernia at 1-2 years will be evaluated as a secondary outcome. Four VA medical centers
with the capability of enrolling 40-50 patients a year have been selected based on volume,
experience with open and laparoscopic ventral herniorrhaphy and experience in the conduct of
clinical trials. Patients are recruited by physicians at each site and referred to the site
coordinator who screens them for eligibility. The trial is randomized but not blinded. The
randomization scheme takes into consideration that random allocation of patients to each
study group is made within each center. In addition to the participating center, the other
baseline variables that serve as stratification factors are first time or recurrent ventral
incisional hernia and patient with a body mass index greater or less than 35arm.
Timeline: The trial consists of 3 phases: Implementation, Patient intake and follow-up,
closeout and final analysis. 1-Implementation (2 months): The implementation which will
include funding, recruitment of the nurse coordinators and review of the study protocol and
techniques of operation was 2 months in duration. 2-Patient intake and follow up (32
months): All study patients are recruited during that period of time. Follow-up will occur
simultaneously and will end at close out. The range of follow-up is expected to range from 8
weeks to 34 months. 4-Final analysis and closeout: The participating centers will be given 2
months of funding to close out the data collection. During this period, all final follow-up
visits and data collection will be completed. Final analysis will run concurrently with
closeout.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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