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Trial registered on ANZCTR
Registration number
ACTRN12623000751673
Ethics application status
Approved
Date submitted
9/05/2023
Date registered
11/07/2023
Date last updated
12/07/2023
Date data sharing statement initially provided
11/07/2023
Type of registration
Retrospectively registered
Titles & IDs
Public title
Assessing the effect of drug treatment with a needle from the coccyx in patients with chronic anal fissure
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Scientific title
The Effect of Caudal Epidural Injection on Healing in the Treatment of Chronic Anal Fissure
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Secondary ID [1]
309631
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none
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Universal Trial Number (UTN)
U1111-1292-3567
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic anal fissure
329960
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Condition category
Condition code
Anaesthesiology
326866
326866
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0
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Pain management
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Oral and Gastrointestinal
327096
327096
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A Hundred twenty consecutive patients with the diagnosis of chronic anal fissure were enrolled this randomized, controlled study. Caudal epidural injection group (Group K, n=60) was treated with 5cc bupivacain + 5cc isotonic from a caudal epidural for a total of 3 sessions at the beginning, 1 week and 2 weeks later; The patients who were taken to the surgery room were monitored using electrocardiography, arterial pressure(noninvasive) and pulse oximetry, and baseline values were recorded. 10 ml for each patient. 0.25% Bupivacaine (Marcain, OSEL) was prepared using a syringe. A pillow was placed in the pelvic region of patients in the prone position. After the area was cleaned and covered, the sacral hiatus was determined by palpation by the anesthesiologist and a 22 G 9 cm needle was pushed forward until bone was touched at a 45° angle to the skin. Then, the angle of the needle, which was withdrawn to the skin, was decreased from 20° to 5°, and it was pushed forward 5-6 cm into the epidural distance by passing through the sacrococcygeal ligament. After observing that the blood and cerebrospinal fluid did not result in negative aspiration, the prepared bupivacaine was injected.The approximate duration of each caudal epidural injection session was 15 minutes.
The diagnosis of chronic anal fissure and the evaluation of the anal fissure during the caudal epidural injection(CEI) procedure were performed by an expert colorectal surgeon.
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Intervention code [1]
326061
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Prevention
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Comparator / control treatment
In the second group, the control group (Group C, n=60) was given topical drug therapy in the form of a cream rectal containing 5% tribinoside and 2% lidocaine hydrochloride as the active ingredient.
All patients will apply the cream by the rectal route 3 times a day for 2 weeks.
All patients will be called by phone and their treatment applications will be checked.
At the end of 2 weeks, the patients were admitted to the outpatient clinic.
The diagnosis of chronic anal fissure and the evaluation of the anal fissure during the caudal epidural injection(CEI) procedure were performed by an expert colorectal surgeon.
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Control group
Active
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Outcomes
Primary outcome [1]
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Visual analog scale(VAS) for pain were used to assess the severity of symptoms of chronic anal fissure.
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Assessment method [1]
334714
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Timepoint [1]
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Baseline (pre-injection), 1 week post-baseline (pre-injection) and 2 weeks post-baseline (pre-injection)
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Primary outcome [2]
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The Wexner constipation score(WCS) for constipation were used. to assess the severity of symptoms of chronic anal fissure.
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Assessment method [2]
334715
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Timepoint [2]
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Baseline (pre-injection), 1 week post-baseline (pre-injection) and 2 weeks post-baseline (pre-injection)
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Secondary outcome [1]
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The Short Form (SF)-36 was used to determine the quality of life of the patient before and after Caudal Epidural Injection applications.
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Assessment method [1]
421837
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Timepoint [1]
421837
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At the Baseline (pre-injection) and 2 weeks post-baseline (pre-injection)
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Eligibility
Key inclusion criteria
Patients were included in the study if they were older than 18 years or older with chronic anal fissure for at least 6 months.
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Minimum age
18
Years
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Maximum age
70
Years
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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 were pregnancy, diabetes mellitus, neurological diseases, spinal cord lesions, and use of cardiac pacemaker or an implantable cardiac defibrillator.
Age <18 or >70 years patients
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Study design
Purpose of the study
Treatment
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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)
Allocation involved contacting the holder of the allocation schedule who was "off-site" or at central administration site.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software (i.e. computerised sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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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
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Actual
3/07/2023
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
120
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Accrual to date
30
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Final
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Recruitment outside Australia
Country [1]
25492
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Turkey
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State/province [1]
25492
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DIYARBAKIR
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Health Sciences University Diyarbakir Gazi Yasargil Research and Education Hospital, Diyarbakir, Turkey
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Address [1]
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Talaytepe, Üçkuyular Mahallesi Elazig Yolu, Üzeri 10.Km, 21010 Kayapinar/Diyarbakir
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Country [1]
313815
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Turkey
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Primary sponsor type
Individual
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Name
ERHAN GÖKÇEK
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Address
Talaytepe, Üçkuyular Mahallesi Elazig Yolu, Üzeri 10.Km, 21010 Kayapinar/Diyarbakir
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Country
Turkey
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Secondary sponsor category [1]
315652
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None
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Name [1]
315652
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Address [1]
315652
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Country [1]
315652
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
312975
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Health Sciences University Diyarbakir Gazi Yasargil Research and Education Hospital, Diyarbakir, Turkey
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Ethics committee address [1]
312975
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Talaytepe, Üçkuyular Mahallesi Elazig Yolu, Üzeri 10.Km, 21010 Kayapinar/Diyarbakir
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Ethics committee country [1]
312975
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Turkey
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Date submitted for ethics approval [1]
312975
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Approval date [1]
312975
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21/04/2022
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Ethics approval number [1]
312975
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Summary
Brief summary
The primary aim of this study was to test the hypothesis that caudal epidural injection provides a more effective improvement to medical treatment in patients with chronic anal fissure. In addition, the secondary aim of our study was to show that caudal epidural injection provides a significant improvement in the quality of life of patients with chronic anal fissures because they have less constipation.
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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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A/Prof Erhan Gökçek
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Address
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Diyarbakir Gazi Yasargil Training and Education Hospital
Talaytepe, Üçkuyular Mahallesi Elazig Yolu, Üzeri 10.Km, 21010 Kayapinar/Diyarbakir
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Country
126550
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Turkey
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Phone
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+904122580060
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Fax
126550
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Email
126550
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[email protected]
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Contact person for public queries
Name
126551
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Erhan Gökçek
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Address
126551
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Diyarbakir Gazi Yasargil Training and Education Hospital
Talaytepe, Üçkuyular Mahallesi Elazig Yolu, Üzeri 10.Km, 21010 Kayapinar/Diyarbakir
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Country
126551
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Turkey
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Phone
126551
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+904122580060
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Fax
126551
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Email
126551
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[email protected]
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Contact person for scientific queries
Name
126552
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Erhan Gökçek
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Address
126552
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Diyarbakir Gazi Yasargil Training and Education Hospital
Talaytepe, Üçkuyular Mahallesi Elazig Yolu, Üzeri 10.Km, 21010 Kayapinar/Diyarbakir
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Country
126552
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Turkey
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Phone
126552
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+904122580060
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Fax
126552
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Email
126552
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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)?
Yes
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What data in particular will be shared?
after de-identification; individual participant data underlying published results only.
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When will data be available (start and end dates)?
available for 5 years after publication
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Available to whom?
case-by-case basis at the discretion of Primary Sponsor
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Available for what types of analyses?
only to achieve the aims in the approved proposal
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How or where can data be obtained?
[email protected]
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What supporting documents are/will be available?
No Supporting Document Provided
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.
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