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Published in: Trials 1/2019

Open Access 01-12-2019 | Computed Tomography | Study protocol

Chimney Trial: study protocol for a randomized controlled trial

Authors: Elisa Mäkäräinen-Uhlbäck, Heikki Wiik, Jyrki Kössi, Maziar Nikberg, Pasi Ohtonen, Tero Rautio

Published in: Trials | Issue 1/2019

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Abstract

Background

Parastomal hernias (PSHs) are common, troubling the lives of people with permanent colostomy. In previous studies, retromuscular keyhole mesh placement has been the most-used technique for PSH prevention but results have been controversial. Additionally, surgical treatment of PSHs is associated with a high rate of complications and recurrences. Therefore, it is crucial to find the most effective way to prevent PSHs in the first place without an increased risk of complications. Due to a lack of adequate research, there is no clear evidence or recommendations on which mesh or technique is best to prevent PSHs.

Methods/design

The Chimney Trial is a Nordic, prospective, randomized controlled, multicenter trial designed to compare the feasibility and the potential benefits of specifically designed, intra-abdominal onlay mesh (DynaMesh®-Parastomal, FEG Textiltechnik GmbH, Aachen, Germany) against controls with permanent colostomy without mesh.
The primary outcome of the Chimney Trial is the incidence of a PSH detected by a computerized tomography (CT) scan at 12-month follow-up. Secondary outcomes are the rate of clinically detected PSHs, surgical-site infection as defined by the Centers for Disease Control and Prevention (CDC), complications as defined by the Clavien-Dindo classification, the reoperation rate, operative time, length of stay, quality of life as measured by the RAND-36 survey and colostomy impact score, and both direct and indirect costs. For each group, 102 patients were enrolled at attending hospitals and randomized at a ratio of 1:1 by browser-based software to receive a preventive mesh or a conventional colostomy without a mesh. Patients will be followed for 1 month and at 1, 3, and 5 years after the operation for long-term results and complications.

Discussion

The Chimney Trial aims to provide level-I evidence on PSH prevention.

Trial registration

ClinicalTrials.gov, ID: NCT03799939. Registered on 10 January 2019
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Metadata
Title
Chimney Trial: study protocol for a randomized controlled trial
Authors
Elisa Mäkäräinen-Uhlbäck
Heikki Wiik
Jyrki Kössi
Maziar Nikberg
Pasi Ohtonen
Tero Rautio
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Trials / Issue 1/2019
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-019-3764-y

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