A Prospective, Multicenter, Randomized Trial Comparing Laparoscopy VS Conventional Mesh Repair of Incisional and Umbilical Hernia
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Incisional Hernia
- Sponsor
- Assistance Publique - Hôpitaux de Paris
- Enrollment
- 98
- Locations
- 1
- Primary Endpoint
- Parietal postoperative complications: 1- haematoma, 2- abscess, 3- seroma 4- cutaneous necrosis
- Status
- Terminated
- Last Updated
- 4 years ago
Overview
Brief Summary
The aim of this study is to compare immediate and long-term (24 months) results of laparoscopic and open mesh repair of incisional and umbilical hernia.
Detailed Description
The aim of this study is to compare immediate and long-term (24 months) results of laparoscopic and open mesh repair of incisional and umbilical hernia. Five hundred patients will be included in this randomized, multicentric trial. Hypotheses are that laparoscopic approach: 1- reduces immediate parietal complications without increasing intra abdominal septic complications 2- is less invasive and also reduces patients' hospital stay and recovery time; 3- has the same efficacy, than open approach.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Age \> 18
- •Incisional or umbilical hernia over 2 cm and less than 6 cm in diameter
Exclusion Criteria
- •Patients with a complicated incisional (pain, occlusion, cutaneous necrosis), irreductible painless incisional or umbilical hernia will not be considered as a complication
- •Patients with a recurrence of incisional hernia
- •Patients with an incisional or umbilical hernia whose lateral edges are located so that fixation of the mesh (which must extend beyond the 4 to 5 cm) is not possible
- •Pregnant women
- •Patients with HIV therapy
- •Patients with cirrhotic ascites or other signs of hepatic insufficiency (bilirubin\> 35 micromol / l; TP \< 55%) or significant thrombocytopenia (\< 60 000 platelets)
- •Patients with a contra indication for laparoscopy
- •Patients with a life expectancy \< one year, or whose mobility within two years of treatment will damage proper monitoring
- •Patients unable to understand information about the protocol
Outcomes
Primary Outcomes
Parietal postoperative complications: 1- haematoma, 2- abscess, 3- seroma 4- cutaneous necrosis
Time Frame: 2 months
Postoperative intra abdominal complications: peritonitis, occlusion, haemorrhage
Time Frame: 2 months
Secondary Outcomes
- Postoperative fever > 38°5(2 months)
- Recurrence of incisional or umbilical hernia(24 months)
- Postoperative phlebitis(2 months)
- Postoperative pain: measured by a- Visual Analogic Score (VAS 0-10): 1-number of days with VAS > 5; 2- maximal VAS, and b- duration (days) of morphine use(2 months)
- Duration of hospital stay(2 months)
- Mesh infection(24 months)
- Postoperative ileus(2 months)
- Duration of drainage(2 months)
- Occlusion due to intra peritoneal mesh(2 months)
- Trocar site hernia(24 months)
- Postoperative pulmonary embolism(2 months)
- Postoperative urinary infection(2 months)
- Peritonitis due to intraperitoneal mesh(24 months)