Trial Review

The ANZCTR website will be unavailable from 1pm until 3pm (AEDT) on Wednesday the 30th of October for website maintenance. Please be sure to log out of the system in order to avoid any loss of data.

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this information for consumers
Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/study/NCT00763737




Registration number
NCT00763737
Ethics application status
Date submitted
30/09/2008
Date registered
1/10/2008
Date last updated
3/12/2020

Titles & IDs
Public title
Fetal Surgery for Moderate Left Sided Congenital Diaphragmatic Hernia.
Scientific title
Randomized Trial of Fetoscopic Endoluminal Tracheal Occlusion (FETO) Versus Expectant Management During Pregnancy in Fetuses With Left Sided and Isolated Congenital Diaphragmatic Hernia and Moderate Pulmonary Hypoplasia.
Secondary ID [1] 0 0
2008-4634
Secondary ID [2] 0 0
B32220084540
Universal Trial Number (UTN)
Trial acronym
TOTAL moderate
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Congenital Diaphragmatic Hernia 0 0
Fetal Surgery 0 0
Pulmonary Hypoplasia 0 0
Condition category
Condition code
Oral and Gastrointestinal 0 0 0 0
Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Surgery - Fetoscopic Endoluminal Tracheal Occlusion

Experimental: FETO - prenatal FETO at 30-31+6 weeks and removal at 34-34+6 wks, followed by standardized postnatal care

No intervention: Expectant management - expectant management during pregnancy followed by standardized neonatal care


Treatment: Surgery: Fetoscopic Endoluminal Tracheal Occlusion
prenatal balloon placement at 30-31+6 weeks and removal at 34-34+6 wks
Intervention code [1] 0 0
Treatment: Surgery
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Survival at discharge
Timepoint [1] 0 0
at the time of discharge from NICU, approximately 2 months
Primary outcome [2] 0 0
Supplemental oxygen at 6 months of age
Timepoint [2] 0 0
at 6 months of age
Secondary outcome [1] 0 0
Grading of oxygen dependency
Timepoint [1] 0 0
between 28 and 56 days of life if born >32 weeks; at 36 weeks postmenstrual age if born <32 weeks
Secondary outcome [2] 0 0
Pulmonary hypertension
Timepoint [2] 0 0
during NICU admission
Secondary outcome [3] 0 0
Use of extracorporeal membrane oxygenation
Timepoint [3] 0 0
during NICU admission
Secondary outcome [4] 0 0
Change in O/E LHR after FETO
Timepoint [4] 0 0
prior to unplug
Secondary outcome [5] 0 0
NICU days
Timepoint [5] 0 0
during NICU admission
Secondary outcome [6] 0 0
days of ventilatory support
Timepoint [6] 0 0
during NICU admission
Secondary outcome [7] 0 0
Periventricular leucomalacia
Timepoint [7] 0 0
during NICU admission
Secondary outcome [8] 0 0
Neonatal sepsis
Timepoint [8] 0 0
during NICU admission
Secondary outcome [9] 0 0
Intraventricular hemorrhage
Timepoint [9] 0 0
during NICU admission
Secondary outcome [10] 0 0
Retinopathy of prematurity
Timepoint [10] 0 0
during NICU admission
Secondary outcome [11] 0 0
Days until full enteral feeding
Timepoint [11] 0 0
during NICU admission
Secondary outcome [12] 0 0
Gastroesophageal reflux
Timepoint [12] 0 0
during NICU admission
Secondary outcome [13] 0 0
Day of postnatal surgery
Timepoint [13] 0 0
during NICU admission
Secondary outcome [14] 0 0
Use of patch
Timepoint [14] 0 0
at the time of postnatal surgery
Secondary outcome [15] 0 0
Defect size
Timepoint [15] 0 0
at the time of postnatal surgery
Secondary outcome [16] 0 0
Number of days alive in case of postnatal death
Timepoint [16] 0 0
during NICU admission

Eligibility
Key inclusion criteria
* Patients aged 18 years or more, who are able to consent
* Singleton pregnancy
* Anatomically and chromosomally normal fetus
* Left sided diaphragmatic hernia
* Gestation at randomization prior to 31 wks plus 5 d (so that occlusion is done at the latest on 31 wks plus 6 d)
* Estimated to have moderate pulmonary hypoplasia, defined prenatally as:

* O/E LHR 25-34.9% (included; irrespective of the position of the liver)
* O/E LHR 35-44.9% (included) with intrathoracic liver herniation as determined by ultrasound or MRI
* Acceptance of randomization and the consequences for the further management during pregnancy and thereafter.
* The patients must undertake the responsibility for either remaining close to, or at the FETO center, or being able to travel swiftly and within acceptable time interval to the FETO center until the balloon is removed.
* Intended postnatal treatment center must subscribe to suggested guidelines for "standardized postnatal treatment".
* Provide written consent to participate in this RCT
Minimum age
18 Years
Maximum age
No limit
Sex
Females
Can healthy volunteers participate?
No
Key exclusion criteria
* Maternal contraindication to fetoscopic surgery or severe medical condition in pregnancy that make fetal intervention risk full
* Technical limitations precluding fetoscopic surgery, such as severe maternal obesity, uterine fibroids or potentially others, not anticipated at the time of writing this protocol.
* Preterm labour, cervix shortened (<15 mm at randomization) or uterine anomaly strongly predisposing to preterm labour, placenta previa
* Patient age less than 18 years
* Psychosocial ineligibility, precluding consent
* Diaphragmatic hernia: right-sided or bilateral, major anomalies, isolated left-sided outside the O/E LHR limits for the inclusion criteria
* Patient refusing randomization or to comply with return to FETO center during the time period the airways are occluded or for elective removal of the balloon

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Parallel
Other design features
Phase
NA
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Completed
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
1/08/2010
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
1/03/2020
Sample size
Target
Accrual to date
Final
196
Recruitment in Australia
Recruitment state(s)
QLD
Recruitment hospital [1] 0 0
Mater Mother's Hospital - Brisbane
Recruitment postcode(s) [1] 0 0
4101 - Brisbane
Recruitment outside Australia
Country [1] 0 0
United States of America
State/province [1] 0 0
Texas
Country [2] 0 0
Belgium
State/province [2] 0 0
Leuven
Country [3] 0 0
Canada
State/province [3] 0 0
Ontario
Country [4] 0 0
France
State/province [4] 0 0
Clamart
Country [5] 0 0
France
State/province [5] 0 0
Paris
Country [6] 0 0
Germany
State/province [6] 0 0
Bonn
Country [7] 0 0
Italy
State/province [7] 0 0
Milan
Country [8] 0 0
Italy
State/province [8] 0 0
Rome
Country [9] 0 0
Poland
State/province [9] 0 0
Warsaw
Country [10] 0 0
Spain
State/province [10] 0 0
Catalunya
Country [11] 0 0
United Kingdom
State/province [11] 0 0
London

Funding & Sponsors
Primary sponsor type
Other
Name
University Hospital, Gasthuisberg
Address
Country
Other collaborator category [1] 0 0
Other
Name [1] 0 0
King's College Hospital NHS Trust (UK)
Address [1] 0 0
Country [1] 0 0
Other collaborator category [2] 0 0
Other
Name [2] 0 0
Hospital Clinic of Barcelona
Address [2] 0 0
Country [2] 0 0
Other collaborator category [3] 0 0
Other
Name [3] 0 0
Hopital Antoine Beclere
Address [3] 0 0
Country [3] 0 0
Other collaborator category [4] 0 0
Other
Name [4] 0 0
Hôpital Necker-Enfants Malades
Address [4] 0 0
Country [4] 0 0
Other collaborator category [5] 0 0
Other
Name [5] 0 0
University Hospital, Bonn
Address [5] 0 0
Country [5] 0 0
Other collaborator category [6] 0 0
Other
Name [6] 0 0
Mater Mothers' Hospital
Address [6] 0 0
Country [6] 0 0
Other collaborator category [7] 0 0
Other
Name [7] 0 0
Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico
Address [7] 0 0
Country [7] 0 0
Other collaborator category [8] 0 0
Other
Name [8] 0 0
Ospedale Pediatrico Bambino Gesù, Rome (IT)
Address [8] 0 0
Country [8] 0 0
Other collaborator category [9] 0 0
Other
Name [9] 0 0
Mount Sinai Hospital, Canada
Address [9] 0 0
Country [9] 0 0
Other collaborator category [10] 0 0
Other
Name [10] 0 0
Baylor College of Medicine
Address [10] 0 0
Country [10] 0 0
Other collaborator category [11] 0 0
Other
Name [11] 0 0
The University of Texas Health Science Center, Houston
Address [11] 0 0
Country [11] 0 0
Other collaborator category [12] 0 0
Other
Name [12] 0 0
Medical University of Warsaw
Address [12] 0 0
Country [12] 0 0

Ethics approval
Ethics application status

Summary
Brief summary
Trial website
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Jan A Deprest, MD PhD
Address 0 0
Universitaire Ziekenhuizen KU Leuven
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries

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

No documents have been uploaded by study researchers.

Results not provided in https://clinicaltrials.gov/study/NCT00763737