Open or Keyhole Surgery Through the Chest for Newborn Babies: Effect on Blood Gases

NCT ID: NCT01467245

Last Updated: 2022-03-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-08-31

Study Completion Date

2013-08-31

Brief Summary

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This is a pilot randomised controlled trial comparing open versus thoracoscopic surgery for repair of oesophageal atresia with tracheo-oesophageal fistula or congenital diaphragmatic hernia in neonates. Thoracoscopic surgery involves insufflation of carbon dioxide into the thoracic cavity and may therefore cause hypercapnia and acidosis.

Detailed Description

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Conditions

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Esophageal Atresia With Tracheo-esophageal Fistula Congenital Diaphragmatic Hernia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Hypercapnia during thoracoscopy

keyhole surgery through the chest for repair of oesophageal atresia with tracheo-oesophageal fistula or congenital diaphragmatic hernia in neonates

Group Type EXPERIMENTAL

Hypercapnia during thoracoscopy

Intervention Type PROCEDURE

keyhole surgery through the chest for repair of oesophageal atresia with tracheo-oesophageal fistula or congenital diaphragmatic hernia in neonates

Open surgery

open surgery for repair of oesophageal atresia with tracheo-oesophageal fistula or congenital diaphragmatic hernia in neonates

Group Type EXPERIMENTAL

Open surgery

Intervention Type PROCEDURE

open surgery for repair of oesophageal atresia with tracheo-oesophageal fistula or congenital diaphragmatic hernia in neonates

Interventions

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Hypercapnia during thoracoscopy

keyhole surgery through the chest for repair of oesophageal atresia with tracheo-oesophageal fistula or congenital diaphragmatic hernia in neonates

Intervention Type PROCEDURE

Open surgery

open surgery for repair of oesophageal atresia with tracheo-oesophageal fistula or congenital diaphragmatic hernia in neonates

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Neonates with diagnosis of oesophageal atresia with tracheo-oesophageal fistula or congenital diaphragmatic hernia

-\>1.6 Kg
* Conventional ventilation (no high frequency ventilation or iNO) for at least 24 hours.
* FiO2 \<0.4
* No requirement for inotropes for at least 24 hours

Exclusion Criteria

* Late diagnosis (after 1 month of age)
* Major congenital heart defects or pulmonary hypertension
* Bilateral grade IV intraventricular haemorrhage
* Previous ECMO
* FiO2 ≥ 0.4
Maximum Eligible Age

1 Month

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Great Ormond Street Hospital for Children NHS Foundation Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Agostino Pierro, Prof

Role: PRINCIPAL_INVESTIGATOR

Great Ormond Street Hospital for Children NHS Foundation Trust

Locations

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Great Ormond Street Hospital for Children NHS Trust

London, , United Kingdom

Site Status

Countries

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United Kingdom

References

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Yang EY, Allmendinger N, Johnson SM, Chen C, Wilson JM, Fishman SJ. Neonatal thoracoscopic repair of congenital diaphragmatic hernia: selection criteria for successful outcome. J Pediatr Surg. 2005 Sep;40(9):1369-75. doi: 10.1016/j.jpedsurg.2005.05.036.

Reference Type BACKGROUND
PMID: 16150335 (View on PubMed)

Holcomb GW 3rd, Rothenberg SS, Bax KM, Martinez-Ferro M, Albanese CT, Ostlie DJ, van Der Zee DC, Yeung CK. Thoracoscopic repair of esophageal atresia and tracheoesophageal fistula: a multi-institutional analysis. Ann Surg. 2005 Sep;242(3):422-8; discussion 428-30. doi: 10.1097/01.sla.0000179649.15576.db.

Reference Type BACKGROUND
PMID: 16135928 (View on PubMed)

Krosnar S, Baxter A. Thoracoscopic repair of esophageal atresia with tracheoesophageal fistula: anesthetic and intensive care management of a series of eight neonates. Paediatr Anaesth. 2005 Jul;15(7):541-6. doi: 10.1111/j.1460-9592.2005.01594.x.

Reference Type BACKGROUND
PMID: 15960636 (View on PubMed)

Bishay M, Giacomello L, Retrosi G, Thyoka M, Garriboli M, Brierley J, Harding L, Scuplak S, Cross KM, Curry JI, Kiely EM, De Coppi P, Eaton S, Pierro A. Hypercapnia and acidosis during open and thoracoscopic repair of congenital diaphragmatic hernia and esophageal atresia: results of a pilot randomized controlled trial. Ann Surg. 2013 Dec;258(6):895-900. doi: 10.1097/SLA.0b013e31828fab55.

Reference Type RESULT
PMID: 23604057 (View on PubMed)

Other Identifiers

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09SG04

Identifier Type: -

Identifier Source: org_study_id

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