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Trial registered on ANZCTR
Registration number
ACTRN12613000468729
Ethics application status
Not yet submitted
Date submitted
18/04/2013
Date registered
24/04/2013
Date last updated
24/04/2013
Type of registration
Prospectively registered
Titles & IDs
Public title
In patients having key-hole surgery for appendicitis, does it matter if we use a thorough washout of the contaminated area or just suck out the contamination? This is a study to compare the rates of post-operative infection with the two methods.
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Scientific title
In patients undergoing laparoscopic appendicectomy, does the use of suction-only as compared to irrigation-and-suction lead to a decrease in intra-abdominal infections?
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Secondary ID [1]
282332
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Nil
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Universal Trial Number (UTN)
U1111-1141-9020
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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:
Appendicitis
288879
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Condition category
Condition code
Surgery
289221
289221
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0
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Surgical techniques
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Oral and Gastrointestinal
289319
289319
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
During laparoscopic appendicectomy, irrigator-suction catheters will be used which irrigate the surgical field with normal saline prior to suction.
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Intervention code [1]
286947
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Treatment: Surgery
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Comparator / control treatment
Suction-only catheters will be used which do not perform any irrigation to the surgical field.
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Control group
Active
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Outcomes
Primary outcome [1]
289335
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Intra-abdominal abscess. We will search medical records for re-presentations to Emergency or admissions to the surgical unit. Diagnosis of intra-abdominal abscess will be with radiological confirmation (CT or ultrasound) or intra-operative findings at re-operation. Furthermore, a 6-week post-operative phone call will capture any patients who present to their GP or another hospital.
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Assessment method [1]
289335
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Timepoint [1]
289335
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6-weeks post-operatively
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Secondary outcome [1]
302257
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Wound infection. We will search medical records for re-presentations to Emergency or admissions to the surgical unit. Furthermore, a 6-week post-operative phone call will capture any patients who present to their GP or another hospital.
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Assessment method [1]
302257
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Timepoint [1]
302257
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6-weeks post-operatively
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Secondary outcome [2]
302258
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Duration of surgery - start and end times entered into hospital surgery database.
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Assessment method [2]
302258
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Timepoint [2]
302258
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Time of operation
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Eligibility
Key inclusion criteria
Adult patients (over 16) in whom appendicectomy is completed laparoscopically and the suppuration is localised to the right iliac fossa, right paracolic gutter or pelvis
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Minimum age
16
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
Appendicectomy for normal appendix or non-purulent appendicitis. Interval appendicectomy. Appendicectomy following percutaneous drainage of abscess.
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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)
All patients fulfilling the inclusion criteria will be identified by the treating surgical team and enrolled, including informed consent to be enrolled in the trial. Prior to surgery, the surgical team will allocate the patient by drawing a sealed, numbered, opaque envelope.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Patients will be randomised to either suction-only or irrigation-and-suction by computer-generated random numbers.
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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
Safety
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Statistical methods / analysis
As there is already an RCT in children demonstrating no difference, we have designed an equivalence design for our randomised trial. A sample size calculation was based on a clinically meaningful difference of 15% (calculated from exisiting studies suggesting abscess rates of 3.5% and 18.5% for the different groups - 18.5-3.5% = 15%). This resulted in a sample size of 61 patients per group. Allowing for protocol violation and loss to follow up, we will include 70 patients per group.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
3/06/2013
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Actual
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Date of last participant enrolment
Anticipated
31/12/2013
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Actual
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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
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
892
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Western Hospital - Footscray
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Recruitment hospital [2]
893
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Sunshine Hospital - St Albans
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Recruitment postcode(s) [1]
6692
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3011 - Footscray
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Recruitment postcode(s) [2]
6693
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3021 - St Albans
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Funding & Sponsors
Funding source category [1]
287090
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Hospital
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Name [1]
287090
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Western Hospital
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Address [1]
287090
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Gordon St, Footscray, VIC, 3011
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Country [1]
287090
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Australia
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Primary sponsor type
Individual
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Name
Prof Steven Chan
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Address
Sunshine Hospital, Furlong Rd, St Albans, VIC, 3021
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Country
Australia
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Secondary sponsor category [1]
285866
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None
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Name [1]
285866
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Address [1]
285866
0
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Country [1]
285866
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
289106
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Western Health Ethics Committee
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Ethics committee address [1]
289106
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Western Health Office for Research Level 3 Sunshine Hospital Furlong Rd St Albans, VIC, 3021
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Ethics committee country [1]
289106
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Australia
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Date submitted for ethics approval [1]
289106
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05/05/2013
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Approval date [1]
289106
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Ethics approval number [1]
289106
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Pending
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Summary
Brief summary
Laparoscopic appendicectomy is one of the most commonly performed urgent abdominal operations. Current practices of Irrigation or Suction-only are largely determined by individual surgeon’s bias based on intra-operative findings. To date, there is only one randomized, controlled trial comparing irrigation with suction only in children and none in adults. There is some retrospective data in children and adults. All of the existing data suggests “no difference” between these operative methods; in fact, some retrospective data suggest higher intra-abdominal abscess rates in irrigation groups, however there has never been a randomized trial in adults. There remains clinical equipoise and current practice is widely varied. Our hypothesis is that there is no difference between the two surgical methods and we aim to demonstrate that it doesn't matter to the patient which method is used.
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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
39258
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Prof Steven Chan
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Address
39258
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Sunshine Hospital
Furlong Rd, St Albans, VIC, 3021
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Country
39258
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Australia
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Phone
39258
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(+61) 3 83456666
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Fax
39258
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Email
39258
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[email protected]
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Contact person for public queries
Name
39259
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Hayden Snow
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Address
39259
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Western Hospital
Gordon St
Footscray, VIC, 3011
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Country
39259
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Australia
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Phone
39259
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(+61) 3 83456666
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Fax
39259
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Email
39259
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[email protected]
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Contact person for scientific queries
Name
39260
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Steven Chan
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Address
39260
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Sunshine Hospital
Furlong Rd, St Albans, VIC, 3021
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Country
39260
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Australia
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Phone
39260
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(+61) 3 83456666
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Fax
39260
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Email
39260
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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
Source
Title
Year of Publication
DOI
Embase
Irrigation versus suction alone during laparoscopic appendectomy; A randomized controlled equivalence trial.
2016
https://dx.doi.org/10.1016/j.ijsu.2016.01.099
N.B. These documents automatically identified may not have been verified by the study sponsor.
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