The ENTREPPMENT trial: comparing treatments for inguinal hernia

ISRCTN ISRCTN18591339
DOI https://doi.org/10.1186/ISRCTN18591339
Secondary identifying numbers N/A
Submission date
09/01/2012
Registration date
08/02/2012
Last edited
04/08/2021
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Digestive System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Hernia (a lump that results from a part of the bowel slipping through a weakness in the abdominal wall) of the groin is a common disease; every year 30,000 hernia repairs are performed in the Netherlands. The main serious adverse event is postoperative chronic pain, not recurrence. A recently completed study showed less postoperative chronic pain after transinguinal hernia repair (TIPP) when compared to Lichtenstein, the reference technique used in the Netherlands.
A new technique transrectus sheath preperitoneal (TREPP) has been developed that is expected to reduce postoperative chronic pain even more. This study will compare both techniques.

Who can participate?
Adults with an American Society of Anesthesiologists (ASA) classification < 4 (not too much comorbidity), with an unilateral hernia of the groin that has never been repaired before.

What does the study involve?
TIPP and TREPP will be compared. When a patient is eligible they will be randomly assigned to receive either a repair by TIPP or by TREPP. They are both open repair techniques.

What are the possible benefits and risks of participating?
There are no benefits.
There are no risks, other than the risk of having surgery.

Where is the study run from?
The study will be performed in five medical centers in the Netherlands (Radboud University Nijmegen Medical Center; Gelderse Vellei Hospital Ede; St Jansdal Hospital Harderwijk; St. Elisabeth Hospital and TweeSteden Hospital Tilburg/Waalwijk).
The lead center is Radboud University Nijmegen Medical Center.

When is the study starting and how long is it expected to run for?
The trial will start mid of 2012, expected time for inclusion is 1-1.5 years. Total follow up is 1 year.

Who is funding the study?
Radboud University Nijmegen Medical Center

Who is the main contact?
Willem Bökkerink
Willem.Bokkerink@radboudumc.nl

Study website

Contact information

Dr Willem Bökkerink
Scientific

Radboud University Nijmegen Medical Center
Geert Grooteplein Zuid 10
Nijmegen
6525 GA
Netherlands

Study information

Study designInterventional multi-center randomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleThe ENTREPPMENT trial: the TransREctus sheath Preperitoneal mesh repair Procedure (TREPP) compared to the TransInguinal Preperitoneal Procedure (TIPP): a randomised clinical trial
Study objectivesTREPP will reduce postoperative chronic pain after inguinal hernia repair with 50%, compared to TIPP.

On 21/02/2014 the following changes were made to the trial record:
1. The anticipated start date was changed from 01/06/2012 to 20/02/2014
2. The anticipated end date was changed from 01/06/2014 to 20/08/2016
Ethics approval(s)Approval obtained from CMO region Arnhem-Nijmegen on 24/07/2012, ref 2012/060, local ref NL38842.091.12.
Health condition(s) or problem(s) studiedInguinal hernia
Intervention800 patients will be randomised into the two operation techniques compared:
1. TREPP (transrectus sheath preperitoneal mesh repair) (400 participants)
2. TIPP (transinguinal preperitoneal repair) (400 participants)

Both hernia repairs are performed in day treatment, or with a total stay of 1 night in hospital. Both groups will visit the outpatient department at 6 weeks, 6 months and 12 months.

A physical exam will be done for evaluation of numbness of the operation area; questionnnaires are filled in (SF-36, EuroQol 3D, pain disability index). Total follow up is 1 year.
Intervention typeOther
Primary outcome measureSevere adverse events, e.g. postoperative chronic pain, mortality, recurrence, bleeding
Secondary outcome measures1. Hospital stay
2. Operation time
3. Return to daily activities (e.g. work)
4. Health status
5. Economic evaluation (cost effectiveness)
Overall study start date20/02/2014
Completion date31/03/2018

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
Upper age limit80 Years
SexBoth
Target number of participants800
Key inclusion criteria1. Primary, unilateral groin hernia
2. Aged 18-80 years
3. American Society of Anaesthesiologists (ASA) Classification 1-3
4. Signed informed consent
Key exclusion criteria1. Recurrent hernia
2. Scrotal/femoral hernia
3. Acute incarcerated inguinal hernia
4. Psychiatric disease or other reasons making follow-up or questionnaires unreliable
5. Previous preperitoneal surgery (e.g. radical prostatectomy)
Date of first enrolment20/02/2014
Date of final enrolment20/08/2016

Locations

Countries of recruitment

  • Netherlands

Study participating centre

Radboud University Nijmegen Medical Center
Nijmegen
6525 GA
Netherlands

Sponsor information

Radboud University Nijmegen Medical Center (Netherlands)
Hospital/treatment centre

Geert Grooteplein-Zuid 10
Nijmegen
6525 GA
Netherlands

Website http://www.umcn.nl/
ROR logo "ROR" https://ror.org/05wg1m734

Funders

Funder type

Hospital/treatment centre

Radboud University Nijmegen Medical Center (Netherlands)

No information available

Results and Publications

Intention to publish date31/03/2019
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryData sharing statement to be made available at a later date
Publication and dissemination planPlanned publication in a high-impact peer reviewed journal.
IPD sharing planThe data sharing plans for the current study are unknown and will be made available at a later date

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 03/03/2013 Yes No
Abstract results Abstract provisionally accepted for ESA congress May 2021 Cologne 02/08/2021 04/08/2021 No No

Editorial Notes

04/08/2021: Publication reference added.
09/08/2017: Overall trial end date has been updated from 20/08/2016 to 31/03/2018. Publication and dissemination plan has been added. Participant level data sharing plan has been added. Intention to publish date has been added.