Comparison of Hydro-dissection Versus Ultrasonic Aspirator in Division of Liver Parenchyma in Laparoscopic Resection (LLS)

September 2, 2020 updated by: Ivan Kazakov, Moscow Clinical Scientific Center

Background: until now, there is no agreement about the safest and feasible method for liver parenchyma transection during laparoscopic liver resection.

Study design: prospective, randomized, single-center The purpose of the study: comparison of short-term results of two methods of parenchyma liver transection during laparoscopic liver resection

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

68

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Entuziastov Shosse,86
      • Moscow, Entuziastov Shosse,86, Russian Federation, 111123
        • Moscow Clinical Scientific Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

14 years to 76 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patients with benign lesions (hemangioma, focal nodular hyperplasia [FNH], hepatocellular adenoma, biliary cystadenoma, hydatid echinococcosis [only with total pericystectomy]) and malignant tumors (colorectal cancer metastases in the liver [CRLM], hepatocellular carcinoma [HCC], intrahepatic cholangiocellular carcinoma, gallbladder cancer T1b-3NxMo without invasion into bile ducts and adjacent organs), which involves laparoscopic segmental or major resection of the liver.
  • Gender: both, male and female
  • Minimum age 18 years
  • Maximum age: 80 years
  • ASA physical status I-IV
  • BMI up to 40 kg/m2
  • No simultaneous extrahepatic intra-abdominal procedures (bile duct resection, colon resection, partial duodenum resection)
  • Total bilirubin up to 100mmol/l if jaundice presents in non-cirrhotic patients
  • If cirrhosis is present, class A and B according to CTP score

Exclusion Criteria:

  • • Difficulty index > 12 points (see below)

    • Tumor invasion of IVC or portal trunk (necessity of vascular reconstruction)
    • Repeated liver resection before laparoscopic resection (the single resection before is not a contraindication)
    • Simultaneous extra-hepatic intra-abdominal procedures (bile duct resection, colon resection etc.)
    • Age under 18 years
    • Age above 80 years
    • ASA physical status >IV
    • BMI > 40 kg/m2
    • Total bilirubin >100mmol/l if jaundice presents in non-cirrhotic patients
    • If cirrhosis is present, class C according to CTP score
    • Persons who are incapable of giving consent
    • Pregnant or breast-feeding women
    • Patients enlisted in other studies

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: ErbeJet
liver resection using a bipolar dissector (Erbe), ultracision harmonic scalpel (Ethicon) and water-jet dissector (ERBEJET 2).
liver transection during laparoscopic liver resection
Experimental: Misonix
liver resection using a bipolar dissector (Erbe), ultracision harmonic scalpel (Ethicon), and ultrasonic aspirator (Misonix/SonaStar Ultrasonic Surgical Aspiration System)
liver transection during laparoscopic liver resection

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Intraoperative Blood Loss
Time Frame: 1 day
Absolute blood loss (ml) will be calculated as the amount of blood (collected only during the parenchyma resection) in suction the container after the subtraction of all irrigating fluids and weighing operative sponges.
1 day

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Аbsolute Measurement of Blood Loss in Relation to Resection Size (ml/cm^2)
Time Frame: 1 day
Аbsolute measurement of blood loss in relation to resection size (ml/cm^2).
1 day
Duration of Liver Parenchyma Transaction
Time Frame: 1 day
Duration of liver parenchyma transaction (min)
1 day
Necessity to Apply the Pringle Maneuver.
Time Frame: 1 day
the number of participants who needed to apply the Pringle maneuver
1 day
The Total Duration of Pringle Maneuver.
Time Frame: 1 day
The total duration of Pringle maneuver (min)
1 day
Hospital Stay (Day)
Time Frame: up to 1 month
Hospital stay (day)
up to 1 month

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Morbidity
Time Frame: 30 days
Morbidity according to Clavien-Dindo classification (it is advisable to activate complications class II-V). The Clavien-Dindo classification (CDC) is a standardized system for the registration of surgical complications. It consists of 7 grades (I, II, IIIa, IIIb, IVa, IVb and V). The major characteristic of the CDC system is that the severity of a complication is graded based on the type of therapy required to treat the complication. The CDC system has been validated and accepted worldwide for use in many fields of surgery. The complications that change the treatment of grade II-V.
30 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Study Chair: Mikhail Efanov, MD, PhD, Moscow Clinical Scientific Center

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 20, 2017

Primary Completion (Actual)

May 20, 2020

Study Completion (Actual)

May 20, 2020

Study Registration Dates

First Submitted

June 26, 2017

First Submitted That Met QC Criteria

July 3, 2017

First Posted (Actual)

July 5, 2017

Study Record Updates

Last Update Posted (Actual)

September 24, 2020

Last Update Submitted That Met QC Criteria

September 2, 2020

Last Verified

September 1, 2020

More Information

Terms related to this study

Other Study ID Numbers

  • MCNC 01/2017

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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