A Clinical Study Comparing the Effectiveness and Safety of Two Surgical Pathways for Laparoscopic Total Hysterectomy
A Single Center, Randomized, Single Blind, Parallel Controlled Clinical Study Comparing the Effectiveness and Safety of Two Surgical Pathways for Laparoscopic Total Hysterectomy
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Jiangsu
-
Suzhou, Jiangsu, China, 215000
- The First Affiliated Hospital of Soochow University
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- age ≥ 18 years;
- an indication for total hysterectomy, including leiomyoma, adenomyosis, abnormal uterine bleeding, high-grade squamous intraepithelial lesion (HSIL) or endometrial intraepithelial neoplasm (EIN);
- and a thorough understanding of the risks and benefits of both TU-LESS and MPLS surgical approaches, willingness to undergo either procedure, and provision of written informed consent.
Exclusion Criteria:
- concomitant vulvar, vaginal, or appendiceal pathologies requiring concurrent surgical intervention;
- confirmed or suspected invasive malignancy.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Transumbilical Laparoendoscopic Single-Site Surgery (TU-LESS) Group
Patients undergoing total hysterectomy via transumbilical laparoendoscopic single-site surgery (TU-LESS) under standardized ERAS protocol.
Perioperative management follows the same ERAS pathway as the comparator group.
|
Total hysterectomy performed through a single incision made at the umbilicus, using specialized single-port access devices.
|
|
Active Comparator: Multi-Port Laparoscopic Surgery (MPLS) Group
Patients undergoing total hysterectomy via conventional multi-port laparoscopic surgery (MPLS) under standardized ERAS protocol.
This serves as the active control representing current standard surgical practice.
|
Total hysterectomy performed through 3 to 4 small incisions in the abdomen, using conventional laparoscopic instruments and ports.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Comprehensive ERAS Achievement Rate at 24 Hours Postoperatively
Time Frame: Within 24 hours postoperatively
|
The proportion of patients achieving all five predefined ERAS criteria simultaneously within 24 hours post-surgery: (1) oral liquid intake tolerated; (2) first flatus passed; (3) spontaneous urination after catheter removal; (4) ambulation; and (5) Visual Analogue Scale (VAS) pain score ≤ 3. Failure to meet any single criterion within 24 hours is defined as non-achievement.
This is a composite primary outcome measure.
|
Within 24 hours postoperatively
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Postoperative Hemoglobin Level
Time Frame: Postoperative Day 1
|
Hemoglobin concentration measured on the first postoperative morning (Day 1).
|
Postoperative Day 1
|
|
Hemoglobin Decrease
Time Frame: From baseline to Postoperative Day 1
|
Calculated as preoperative hemoglobin minus postoperative Day 1 hemoglobin.
|
From baseline to Postoperative Day 1
|
|
Estimated Blood Loss (EBL)
Time Frame: Intraoperative
|
Intraoperative blood loss volume estimated by the attending surgeon.
|
Intraoperative
|
|
Blood Transfusion Rate
Time Frame: Intraoperative to 7 days postoperatively
|
Proportion of patients receiving allogeneic or autologous blood transfusion during or after surgery.
|
Intraoperative to 7 days postoperatively
|
|
Time to First Flatus
Time Frame: From end of surgery to event (within 7 days)
|
Time interval from the end of surgery to the first passage of flatus.
|
From end of surgery to event (within 7 days)
|
|
Rate of successful voiding following urinary catheter removal
Time Frame: From catheter removal to event (within 7 days)
|
Rate of successful voiding following urinary catheter removal
|
From catheter removal to event (within 7 days)
|
|
24-Hour Postoperative VAS Pain Score
Time Frame: At 24 hours postoperatively
|
Pain intensity assessed using the Visual Analogue Scale (0-10 cm, 0 = no pain, 10 = worst possible pain) at 24 hours postoperatively.
|
At 24 hours postoperatively
|
|
Patient Scar Assessment Scale (PSAS)
Time Frame: At 3 months postoperatively
|
Patient-reported scar evaluation using the PSAS component of the POSAS, assessing six items: pain, itchiness, color, stiffness, thickness, and irregularity.
Each item scored 1-10.
Total score ranges 6-60 (higher = worse scar).
|
At 3 months postoperatively
|
|
Observer Scar Assessment Scale (OSAS)
Time Frame: At 3 months postoperatively
|
Clinician-rated scar evaluation using the OSAS component of the POSAS, assessing six items: vascularity, pigmentation, thickness, relief, pliability, and surface area.
Each item scored 1-10.
Total score ranges 6-60 (higher = worse scar).
|
At 3 months postoperatively
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2024105 (South-Eastern Norway Regional Health Authority)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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