Laparoscopic Versus Open Surgery for the Management of Cystic Echinococcosis of the Liver

NCT ID: NCT01643018

Last Updated: 2012-07-17

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

350 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-11-30

Study Completion Date

2012-05-31

Brief Summary

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Echinococcosis in humans is a parasitic tapeworm infection, caused by a larval stage (the metacestode) of Echinococcus species. The infection can be asymptomatic or severe, causing extensive organ damage and even death of the patient.

Echinococcosis is one of the most neglected parasitic diseases and the lack of the prospective randomised studies supports this idea. Development of new drugs and other treatment modalities receives very little attention, if any. In most developed countries, Cystic Echinococcosis (CE) is an imported disease of very low incidence and prevalence and is found almost exclusively in migrants from endemic regions. In endemic regions, predominantly settings with limited resources, patient numbers are high.

The aim of the hydatid cyst treatment is the death of the parasite and consequently the cure of the disease. It has to be done with a minimal risk and maximum comfort for the patient, and always paying attention to avoid complications, secondary hydatidosis, and relapses.

There are several treatment modalities. Of them the most preferred surgical method is traditional cyst management through a laparotomy incision. Same can be done with laparoscopy. In the past 15 years significant advances in laparoscopic surgical skills and techniques combined with explosive advances in laparoscopic technology have encouraged the application of laparoscopy to the evaluation and treatment of solid organs including the liver. There are many studies about the laparoscopic treatment of liver hydatid cyst published in the literature and the feasibility of this procedure has been demonstrated by them. While the majority of them are case reports or case series, there are some relatively large series comparing open versus laparoscopic surgery published in the last decade, which all are not randomized trial.

Detailed Description

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This is a multicenter, balanced randomization, double blind, active-controlled, parallel-group, non-inferiority study conducted in Turkey (4 sites).

The objective of this trial is to show there is no difference in rate of recurrence 2 years after laparoscopic as compared to open management of cystic echinococcosis of the liver, by at least M (non-inferiority margin). If PLAP/POP: denotes the cure rate in the laparoscopy group (LAP) / open group (OP), then the following two-sided test problem is assessed:

H0: POP - PLAP \>= M (Open Surgery is superior to Laparoscopic surgery) H1: POP - PLAP \< M (Laparoscopic surgery is not inferior to open surgery)

Conditions

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Echinococcosis, Hepatic Hydatid Cyst

Keywords

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cystic echinococcosis liver cyst hydatique treatment surgery laparoscopy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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laparoscopic surgery

-Laparoscopic surgery group describes the patients treated with laparoscopic surgery

Group Type EXPERIMENTAL

laparoscopic surgery

Intervention Type PROCEDURE

In laparoscopy group three trocars is used. The first is 10 mm and inserted within the umbilicus for telescop, the second is 10 mm and inserted just below the xiphoid process, and third is 5 mm and inserted at the right upper quadrant of the abdomen.

Open Surgery

-open surgery group describes the patients treated with traditional open surgery

Group Type ACTIVE_COMPARATOR

open surgery

Intervention Type PROCEDURE

-open surgery group describes the patients treated with traditional open surgery. In open surgery group a right subcostal incision is used.

Interventions

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laparoscopic surgery

In laparoscopy group three trocars is used. The first is 10 mm and inserted within the umbilicus for telescop, the second is 10 mm and inserted just below the xiphoid process, and third is 5 mm and inserted at the right upper quadrant of the abdomen.

Intervention Type PROCEDURE

open surgery

-open surgery group describes the patients treated with traditional open surgery. In open surgery group a right subcostal incision is used.

Intervention Type PROCEDURE

Other Intervention Names

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Laparoscopy laparotomy open

Eligibility Criteria

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Inclusion Criteria

* patients eighteen year-old or older
* patients diagnosed as cystic echinococcosis of the liver
* cyst number less then 3
* cyst size greater than 3 cm

Exclusion Criteria

* previous liver surgery
* recurrent disease
* hydatid cyst with multi-organ involvement
* liver hydatid cyst complicated with infection
* contraindication for general anesthesia
* contraindication for laparoscopic surgery
* patient younger than 18
* allergy to albendazole
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical Park Gaziantep Hospital

OTHER

Sponsor Role lead

Responsible Party

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Mehmet Kaplan

MKaplan

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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MEHMET KAPLAN, MD

Role: PRINCIPAL_INVESTIGATOR

Medical Park Gaziantep Hospital, Gaziantep, Turkey

Locations

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Hatem Hospital

Gaziantep, , Turkey (Türkiye)

Site Status

Medical Park Gaziantep Hospital

Gaziantep, , Turkey (Türkiye)

Site Status

25 Aralık State Hospital

Gaziantep, , Turkey (Türkiye)

Site Status

Dr.Ersin Aslan State Hospital

Gaziantep, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

Other Identifiers

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MK-001-CH

Identifier Type: -

Identifier Source: org_study_id