NCT03755219

Brief Summary

The study attempts to quantify the relative risks for recurrence depending on complex combinations of plausible risk factors, in particular mesh, mesh fixation, hernia size and hernia type. For this purpose the investigators will analyze data from the Swedish Hernia Registry (SHR).

Trial Health

100
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
38,450

participants targeted

Target at P75+ for all trials

Timeline
Completed

Started Jan 2005

Longer than P75 for all trials

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

January 1, 2005

Completed
13 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2017

Completed
11 months until next milestone

First Submitted

Initial submission to the registry

November 21, 2018

Completed
6 days until next milestone

First Posted

Study publicly available on registry

November 27, 2018

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2018

Completed
Last Updated

December 1, 2022

Status Verified

November 1, 2022

Enrollment Period

13 years

First QC Date

November 21, 2018

Last Update Submit

November 30, 2022

Conditions

Keywords

Totally extraperitonealTransabdominal preperitonealFibrin glueFibrin sealantMesh fixationFixation devices

Outcome Measures

Primary Outcomes (2)

  • Reoperation for recurrence

    The date of the recurrent surgery

    Assessment at Dec 31, 2018

  • Death

    The date of death

    Assessment at Dec 31, 2018

Study Arms (8)

StdPPM

Standard pure polypropylene mesh. "Standard" is defined in SHR by weight ≥ 50 g/square meter.

Procedure: TEPProcedure: TAPP

LWM

Lightweight mesh: Either a pure polypropylene mesh, or a polypropylene-based composite mesh. The study uses SHR's classification of "light-weight" = \<50 g/square meter.

Procedure: TEPProcedure: TAPP

Tacks, metal

Metal staples or tacks. Material specification of staples/tacks was introduced in SHR 2012.

Procedure: TEPProcedure: TAPP

Tacks, absorbable

Absorbable synthetic staples or tacks. Material specification of staples/tacks was introduced in SHR 2012.

Procedure: TEPProcedure: TAPP

Tacks, uncategorized

Staples or tacks were in SHR 2005-2011 not further categorized. This category also includes staples/tacks registered from 2012 and forth, not being specified as either metal or absorbable.

Procedure: TEPProcedure: TAPP

Fibrin glue

Biologic glue/sealant produced from human donor blood

Procedure: TEPProcedure: TAPP

Non-fixation

Mesh is deployed without fixation

Procedure: TEPProcedure: TAPP

3D Mesh

Mesh categorized by anatomical shaped, rather than material or weight. Therefore, this category will be excluded in the original study. Depending on the volume of casess found, the 3D mesh category may eventually be analyzed separately in another study..

Procedure: TEPProcedure: TAPP

Interventions

TEPPROCEDURE

By laparoscopic (keyhole) approach, the hernia is repaired with a plastic mesh which the surgeon may or may not anchor with some sort of fixation device

Also known as: Laparoscopic totally extraperitoneal mesh repair
3D MeshFibrin glueLWMNon-fixationStdPPMTacks, absorbableTacks, metalTacks, uncategorized
TAPPPROCEDURE

By laparoscopic (keyhole) approach, the hernia is repaired with a plastic mesh which the surgeon may or may not anchor with some sort of fixation device

Also known as: Laparoscopic transabdominal preperitoneal mesh repair
3D MeshFibrin glueLWMNon-fixationStdPPMTacks, absorbableTacks, metalTacks, uncategorized

Eligibility Criteria

Age15 Years+
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

The study population consists of all laparoscopic TEP and TAPP repairs that have been registered in the SHR from September 1, 2005 until December 31, 2017. The database is the SHR, which was launched in 1992 and prospectively records groin (lateral, medial and femoral) hernia repairs, including both public and private hospitals. The source population are all residents in Sweden from the age of 15 years, having a state-assigned personal identity number.

You may qualify if:

  • All laparoscopic (mainly TEP and TAPP) repairs that have been registered in the SHR from January 1, 2005 until December 31, 2018.

You may not qualify if:

  • Open repairs.
  • Hernioplasties that were converted from laparoscopic to open surgery.
  • Age \< 15 years.
  • Patients not having a 10-digit state-assigned Patient Identification Number.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (4)

  • Novik B, Nordin P, Skullman S, Dalenback J, Enochsson L. More recurrences after hernia mesh fixation with short-term absorbable sutures: A registry study of 82 015 Lichtenstein repairs. Arch Surg. 2011 Jan;146(1):12-7. doi: 10.1001/archsurg.2010.302.

    PMID: 21242440BACKGROUND
  • Novik B, Hagedorn S, Mork UB, Dahlin K, Skullman S, Dalenback J. Fibrin glue for securing the mesh in laparoscopic totally extraperitoneal inguinal hernia repair: a study with a 40-month prospective follow-up period. Surg Endosc. 2006 Mar;20(3):462-7. doi: 10.1007/s00464-005-0391-3. Epub 2006 Jan 19.

    PMID: 16424986BACKGROUND
  • Novik B, et al. Mesh and mesh fixation in laparoscopic groin hernia repairs. A study of 25,189 TEP and TAPP in the Swedish Hernia Registry [congress abstract]. Hernia 2019; 23 (Suppl 2):S251-S252. https://doi.org/10.1007/s10029-019-02013-8

    RESULT
  • Novik B, Sandblom G, Ansorge C, Thorell A. Association of Mesh and Fixation Options with Reoperation Risk after Laparoscopic Groin Hernia Surgery: A Swedish Hernia Registry Study of 25,190 Totally Extraperitoneal and Transabdominal Preperitoneal Repairs. J Am Coll Surg. 2022 Mar 1;234(3):311-325. doi: 10.1097/XCS.0000000000000060.

MeSH Terms

Conditions

Hernia, InguinalHerniaHernia, FemoralRecurrence

Interventions

tetraethylpyrazinetetra-4-amidinophenoxypropane

Condition Hierarchy (Ancestors)

Hernia, AbdominalPathological Conditions, AnatomicalPathological Conditions, Signs and SymptomsDisease AttributesPathologic Processes

Study Officials

  • Bengt Novik

    Dept of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Target Duration
14 Years
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

November 21, 2018

First Posted

November 27, 2018

Study Start

January 1, 2005

Primary Completion

December 31, 2017

Study Completion

December 31, 2018

Last Updated

December 1, 2022

Record last verified: 2022-11

Data Sharing

IPD Sharing
Will not share