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Trial registered on ANZCTR
Registration number
ACTRN12618000542291
Ethics application status
Approved
Date submitted
19/03/2018
Date registered
11/04/2018
Date last updated
21/03/2019
Date data sharing statement initially provided
21/03/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Stoma closure using bio-absorbable reinforcement (SCUBAR).
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Scientific title
Prevention of incisional hernia after stoma closure using a synthetic bio-absorbable tissue reinforcement.
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Secondary ID [1]
294380
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Nil known
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Universal Trial Number (UTN)
U1111-1211-1072
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Trial acronym
SCUBAR
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Linked study record
None
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Health condition
Health condition(s) or problem(s) studied:
Incisional hernia after stoma reversal or resiting
307108
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Condition category
Condition code
Surgery
306219
306219
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0
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Surgical techniques
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intervention: At the time of stoma reversal or resiting, the intervention group will have Gore BioA synthetic absorbable tissue reinforcement placed by the operating surgeon in either the pre-peritoneal (retro-rectus) space or deep to the anterior fascia of the abdominal wall at the site of the stoma reversal. The recto-rectus position is preferred. If Gore BioA is to be placed in the retro-rectus position, after developing the pre-peritoneal space, the peritoneum will be closed with 2-0 or 3-0 PGA sutures at the discretion of the surgeon. Ideally the space created should be adequate to place the Gore™ BioA™ FS0808 (8 x 8cm). The Gore BioA is to be secured with 4 x 3-0 polydioxanone sutures. Suture closure of the fascia will be performed with interrupted 0 polydioxanone sutures. The additional time required to place and secure the mesh is estimated to be 10 minutes.
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Intervention code [1]
300681
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Treatment: Devices
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Comparator / control treatment
Control: At the time of stoma reversal or resiting, the control group will have routine suture closure of the fascia performed with interrupted 0 polydioxanone sutures.
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Control group
Active
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Outcomes
Primary outcome [1]
305234
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Incisional hernia formation at the site of the stoma one year following stoma reversal or re-siting. An incisional hernia will be defined according to the European Hernia Society definition as “any abdominal wall gap with or without a bulge in the area of post-operative scar perceptible or palpable by clinical examination or imaging”. Classification of incisional hernias will be by size, location and reducibility of the contents. This will be assessed by clinical examination in the surgeon's rooms or the outpatients clinic and by abdominal ultrasound at one year following surgery.
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Assessment method [1]
305234
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Timepoint [1]
305234
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1 year
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Primary outcome [2]
305235
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Incisional hernia formation at the site of the stoma three years following stoma reversal or re-siting. There is an ongoing risk of incisional hernia formation after surgery with time. An incisional hernia will be defined according to the European Hernia Society definition as “any abdominal wall gap with or without a bulge in the area of post-operative scar perceptible or palpable by clinical examination or imaging”. Classification of incisional hernias will be by size, location and reducibility of the contents. This will be assessed by clinical examination in the surgeon's rooms or the outpatients clinic and by abdominal ultrasound at three years following surgery.
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Assessment method [2]
305235
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Timepoint [2]
305235
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3 years
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Secondary outcome [1]
344552
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Surgical site infection. SSI will be defined according to the Centre for Disease Control (CDC) definitions for surgical site infection surveillance. This will be assessed prior to discharge and at a post-operative follow-up visit at approximately 30 days (range 4 - 6 weeks)
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Assessment method [1]
344552
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Timepoint [1]
344552
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30 days
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Secondary outcome [2]
344553
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Superficial wound dehisence. Superficial wound dehiscence will be recorded if a previously closed wound opens spontaneously and may not necessarily be associated with the presence of a SSI. This will be assessed prior to discharge and at a post-operative follow-up visit at approximately 30 days (range 4 - 6 weeks).
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Assessment method [2]
344553
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Timepoint [2]
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30 days
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Secondary outcome [3]
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Deep wound dehiscence. Deep wound dehiscence will be recorded if there is clinical evidence of dehiscence of the abdominal wall fascia defined as visualisation of separation of the abdominal wall fascia either at clinical examination or at reoperation. The identification of abdominal viscera in the wound base also equates to deep wound dehiscence. This will be assessed prior to discharge and at a post-operative follow-up visit at approximately 30 days (range 4 - 6 weeks)
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Assessment method [3]
344554
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Timepoint [3]
344554
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30 days
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Secondary outcome [4]
344555
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Operating time. The start and finish times of the operation are recorded on the operating count sheet by the scrub nurse in charge of the procedure. This information will be collected by the research team.
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Assessment method [4]
344555
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Timepoint [4]
344555
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1 days
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Secondary outcome [5]
344556
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Re-operation. Will be defined as an operation to treat post-operative complications associated with the stoma reversal or resiting within 30 days. This outcome will be recorded by the researchers on patient discharge from hospital.
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Assessment method [5]
344556
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Timepoint [5]
344556
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30 days
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Secondary outcome [6]
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Re-admission. Any requirement for the patient to be re-admitted to a hospital to manage a complication of the stoma reversal or resiting operation will be recorded by the research team.
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Assessment method [6]
344557
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Timepoint [6]
344557
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30 days
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Secondary outcome [7]
344558
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Wound haematoma. A wound haematoma will be defined as a large collection of blood clot at the surgical wound site. Small volumes of blood on surgical dressings will not be included. This will be assessed prior to discharge and at a post-operative follow-up visit at approximately 30 days (range 4 - 6 weeks).
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Assessment method [7]
344558
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Timepoint [7]
344558
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30 days
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Eligibility
Key inclusion criteria
Patient population: Any adult patients presenting for elective ileostomy or colostomy closure or re-siting.
Inclusion criteria:
1. Age > 18 years
2. Patient with a temporary stoma that has met criteria for stoma reversal or a permanent or temporary stoma that requires resiting.
3. Patient capable of participating in informed consent for the study
4. Patient willing to complete follow-up over the study period (3 years).
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion criteria:
1. Pregnancy
2. Pre-existing placement of synthetic non-absorbable mesh in the region of the stoma site.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central computer randomisation
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple computerised sequence generation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/06/2018
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Actual
10/12/2018
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Date of last participant enrolment
Anticipated
31/05/2020
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Actual
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Date of last data collection
Anticipated
31/05/2023
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Actual
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Sample size
Target
288
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Accrual to date
10
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
10412
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Westmead Hospital - Westmead
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Recruitment hospital [2]
10413
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Westmead Private Hospital - Westmead
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Recruitment hospital [3]
10414
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Blacktown Hospital - Blacktown
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Recruitment hospital [4]
10415
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Mount Druitt Hospital - Mount Druitt
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Recruitment hospital [5]
10416
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Norwest Private Hospital - Bella Vista
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Recruitment postcode(s) [1]
22098
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2145 - Westmead
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Recruitment postcode(s) [2]
22099
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2148 - Blacktown
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Recruitment postcode(s) [3]
22100
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2770 - Mount Druitt
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Recruitment postcode(s) [4]
22101
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2153 - Bella Vista
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Funding & Sponsors
Funding source category [1]
299020
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Hospital
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Name [1]
299020
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Westmead Hospital
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Address [1]
299020
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Colorectal Department
Hawkesbury Road
Westmead NSW 2145
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Country [1]
299020
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Australia
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Primary sponsor type
Hospital
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Name
Westmead Hospital
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Address
Colorectal Department
Hawkesbury Road
Westmead NSW 2145
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Country
Australia
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Secondary sponsor category [1]
298243
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None
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Name [1]
298243
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Address [1]
298243
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Country [1]
298243
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
299955
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Western Sydney Local Health District; Western Sydney Local Health District Human Research Ethics Committee.
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Ethics committee address [1]
299955
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Westmead Hospital Hawkesbury Road Westmead Nsw 2145
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Ethics committee country [1]
299955
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Australia
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Date submitted for ethics approval [1]
299955
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19/03/2018
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Approval date [1]
299955
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05/12/2019
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Ethics approval number [1]
299955
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AU RED LNR/18/WMEAD/388
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Summary
Brief summary
The rate of incisional hernia formation following closure of a temporary intestinal stoma is approximately 30%. Hernias following abdominal surgery are a significant cause of morbidity and may adversely affect a patient's quality of life and may require emergent repair. Currently closure of the abdominal fascia is accomplished with sutures however, newer surgical materials are now available to reinforce fascial closure which have shown promise in their abilities to reduce IH formation and tolerate bacterial contamination that is present in these contaminated wounds. We propose a randomised clinical trial in patients undergoing reversal or resiting of an intestinal stoma to have placement of a new synthetic tissue reinforcement material or standard repair to determine if this material can reduce incisional hernia formation with low morbidity, specifically surgical site infection which has prohibited the use of existing materials.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Graham Ctercteko
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Address
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Head of Department, Colorectal Surgery
Westmead Hospital
Hawkesbury Road
WESTMEAD NSW 2145
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Country
82074
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Australia
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Phone
82074
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+612 8890 5555
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Fax
82074
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Email
82074
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[email protected]
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Contact person for public queries
Name
82075
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Graham Ctercteko
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Address
82075
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Head of Department, Colorectal Surgery
Westmead Hospital
Hawkesbury Road
WESTMEAD NSW 2145
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Country
82075
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Australia
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Phone
82075
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+612 8890 5555
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Fax
82075
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Email
82075
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[email protected]
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Contact person for scientific queries
Name
82076
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Graham Ctercteko
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Address
82076
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Head of Department, Colorectal Surgery
Westmead Hospital
Hawkesbury Road
WESTMEAD NSW 2145
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Country
82076
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Australia
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Phone
82076
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+612 8890 5555
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Fax
82076
0
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Email
82076
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
DATA SECURITY
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
1681
Study protocol
374754-(Uploaded-20-03-2019-21-44-07)-Study-related document.docx
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF