MedPath

Timing of Inguinal Hernia Repair in Premature Infants

Not Applicable
Completed
Conditions
Premature Birth of Newborn
Inguinal Hernia
Interventions
Procedure: IH repair at 55-60 weeks post-menstrual age
Procedure: IH repair before NICU discharge
Registration Number
NCT01678638
Lead Sponsor
Vanderbilt University Medical Center
Brief Summary

The purpose of this study is to determine whether early (before NICU discharge) or late (55-60 weeks post-menstrual age) inguinal hernia repair is safer for premature infants who have an inguinal hernia.

Detailed Description

This is a randomized clinical trial comparing early versus late repair in premature infants with an inguinal hernia (IH) to determine which approach may be safer. Safety in this trial is defined as the freedom from significant adverse events, a reduction in hospital days during the study period, and normal neurodevelopmental testing at 2 years. Costs of each treatment strategy are also important and are being evaluated.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
338
Inclusion Criteria
  • Infant with estimated gestational age at birth of < 37 weeks, 0 days
  • In a NICU at participating site
  • Diagnosed with an IH per the pediatric surgery team
  • Parents and providers willing to randomize the infant
Exclusion Criteria
  • Infant is undergoing another operative procedure and IH repair is planned as a secondary procedure (e.g. fundoplication or G tube is planned, and IH repair is considered a secondary procedure)
  • Known major congenital anomaly that impacts neurodevelopmental outcome or chromosomal abnormality
  • Family unable to return for follow up and later IH repair; or likely unable to monitor IH as outpatient

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Late inguinal hernia (IH) repairIH repair at 55-60 weeks post-menstrual ageIH repair as outpatient at approximately 55-60 weeks post-menstrual age
Early inguinal hernia (IH) repairIH repair before NICU dischargeIH repair before NICU discharge
Primary Outcome Measures
NameTimeMethod
Significant adverse event (SAE) rate9 months beyond NICU discharge

Specific significant adverse events that are either treatment related or hernia related have been defined a priori and will be assessed in both groups from randomization until 9 months after NICU discharge.

Number of hospital daysFrom randomization until 9 months post NICU discharge

Total number of hospital days

Secondary Outcome Measures
NameTimeMethod
Bayley Scales of Infant Development, 3rd Edition22-26 months corrected age

Mean BSID scores; primarily cognitive domain

Hospital costsEnrollment through 9 months after NICU discharge

Departmental level costs at each participating institution will be determined for care that occurs from randomization until 9 months post NICU discharge.

Trial Locations

Locations (40)

University of Texas, Southwestern Medical Center; Children's Medical Center

🇺🇸

Dallas, Texas, United States

University of Texas Health Science Center at Houston; Children's Memorial Hermann Hospital

🇺🇸

Houston, Texas, United States

University of Washington School of Medicine; Seattle Children's Hospital

🇺🇸

Seattle, Washington, United States

University of Arkansas for Medical Sciences; Arkansas Children's Hospital

🇺🇸

Little Rock, Arkansas, United States

Tufts Medical Center

🇺🇸

Boston, Massachusetts, United States

Connecticut Children's Medical Center

🇺🇸

Hartford, Connecticut, United States

Naval Medical Center San Diego

🇺🇸

San Diego, California, United States

University of Minnesota Medical School; Amplatz Children's Hospital

🇺🇸

Minneapolis, Minnesota, United States

Cincinnati Children's Hospital

🇺🇸

Cincinnati, Ohio, United States

OHSU Doernbecher Children's Hospital

🇺🇸

Portland, Oregon, United States

University of Alabama at Birmingham School of Medicine; Children's Hospital of Alabama

🇺🇸

Birmingham, Alabama, United States

University of California, Los Angeles David Geffen School of Medicine; Mattel Children's & LA Biomed

🇺🇸

Los Angeles, California, United States

Southern California Permanente Group

🇺🇸

Los Angeles, California, United States

Valley Children's Hospital

🇺🇸

Madera, California, United States

UCSD Rady Children's Hospital

🇺🇸

San Diego, California, United States

Johns Hopkins All Children's Hospital

🇺🇸

Saint Petersburg, Florida, United States

University of Iowa

🇺🇸

Iowa City, Iowa, United States

SSM Health Cardinal Glennon Children's Hospital

🇺🇸

Saint Louis, Missouri, United States

Washington University School of Medicine in St. Louis; St. Louis Children's Hospital

🇺🇸

Saint Louis, Missouri, United States

Dartmouth-Hitchcock Medical Center

🇺🇸

Lebanon, New Hampshire, United States

Cohen Children's Medical Center

🇺🇸

Queens, New York, United States

Columbia University Irving Medical Center

🇺🇸

New York, New York, United States

Oishei Children's Hospital of Buffalo

🇺🇸

Buffalo, New York, United States

Albany Medical Center

🇺🇸

Albany, New York, United States

Akron Children's Hospital

🇺🇸

Akron, Ohio, United States

Ohio State University College of Medicine; Nationwide Children's Hospital

🇺🇸

Columbus, Ohio, United States

Duke University Medical Center; Duke Children's Hospital and Health Center

🇺🇸

Durham, North Carolina, United States

Dayton Children's Hospital

🇺🇸

Dayton, Ohio, United States

Women & Infants Hospital of Rhode Island

🇺🇸

Providence, Rhode Island, United States

Children's Hospital at Erlanger UT Chattanooga

🇺🇸

Chattanooga, Tennessee, United States

Monroe Carell Jr. Children's Hospital at Vanderbilt

🇺🇸

Nashville, Tennessee, United States

University of Tennessee Health Science Center; Le Bonheur Children's Hospital

🇺🇸

Memphis, Tennessee, United States

Baylor College of Medicine; Texas Children's Hospital

🇺🇸

Houston, Texas, United States

Primary Children's Hospital University of Utah

🇺🇸

Salt Lake City, Utah, United States

UVA Children's Hospital

🇺🇸

Charlottesville, Virginia, United States

Children's Hospital & Medical Center of Omaha

🇺🇸

Omaha, Nebraska, United States

UF Health Shands Children's Hospital

🇺🇸

Gainesville, Florida, United States

Medical University of South Carolina

🇺🇸

Charleston, South Carolina, United States

Virginia Commonwealth University Medical Center; Children's Hospital of Richmond

🇺🇸

Richmond, Virginia, United States

Medical College of Wisconsin; Children's Hospital of Wisconsin

🇺🇸

Milwaukee, Wisconsin, United States

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