- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00677196
The StoneBreakerTM Trial
The Canadian StoneBreakerTM Trial: A Randomized, Multicentre Trial Comparing The LMA StoneBreakerTM and the Swiss LithoClastR During Percutaneous Nephrolithotripsy.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Objective:
The purpose of this study is to compare the LMA StoneBreakerTM to the current standard of pneumatic lithotripsy, the Swiss LithoClastR, during percutaneous nephrolithotripsy (PNL).
Rationale:
Percutaneous nephrolithotripsy (PNL) is the preferred treatment modality for renal stones greater than 2cm in diameter.
The pneumatic lithotriptor functions as a pneumatic jackhammer, providing either a single pulse or a train of pulses at 2Hz as determined by the operator. Its chief advantage is its ability to fragment even the hardest calculi. The pneumatic lithotriptor, while extremely effective, does not utilize thermal energy and therefore has no risk of thermal damage to the surrounding tissue. The pneumatic lithotriptor currently in use, the Swiss LithoClast is powered by compressed medical air. The primary disadvantage of this device is that the residual calculi must be individually removed with forceps following fragmentation.
The StoneBreaker, manufactured by the Laryngeal Mask Airway Company, is a novel hand-held pneumatic lithotriptor. This device is powered by a compressed carbon dioxide cartridge.
Hypothesis:
The LMA StoneBreaker, provides more efficient lithotripsy of renal calculi treated by PNL over the existing pneumatic intracorporeal lithotriptor the Swiss LithoClast.
Methods:
Patients would be recruited to the study from the clinical population who present for stone management at VGH. None of the physicians involved has a financial interest in either of the devices being evaluated. The purpose is to compare the pneumatic lithotripsy devices and is not an evaluation of PNL, a procedure whose safety and efficacy is well established.
Patients who consented to PNL for management of their renal stone would be approached about entry into the study by either of the primary surgeons, the research coordinator, or the research fellows. Patients would understand that PNL is not an experimental procedure and that the research project specifically is comparing the two lithotripsy devices with similar mechanism of action and safety profile. The goal in all cases would be to render the patient stone free. The patients care would not deviate from our standard PNL care protocol, summarized below, with the exception of the use of a different lithoclast.
Pre-operatively, the patients are assessed in the Preanaesthetic clinic as necessary. Blood tests including CBC and differential, blood type and antibody screen, creatinine and electrolytes are routinely obtained. Urine samples will be sent preoperatively for culture and sensitivity. If the urine culture is positive, organism specific antibiotics will be prescribed prior to treatment. If the urine culture is negative, prophylactic antibiotics will be ordered and administered, prior to the induction of anaesthesia, by the treating surgeon.
Our standard operative protocol for PNL as described next will be followed for all cases. After receiving a general anaesthetic, cystoscopy and placement of a ureteral catheter on the affected side may be performed. The will be used to perform retrograde pyelography in order to determine the optimal access site to the kidney. A Foley catheter will be placed to drain the bladder throughout the procedure. Next, under fluoroscopic guidance, access to the affected renal collecting system will be obtained with a needle down which a guide wire is passed by the interventional radiology department or the operating surgeon.
The tract will be dilated to accommodate the 30F working sheath. The stone will then be visualized and fragmented with either of the two devices, determined by randomization. Remaining fragments will be removed using grasping forceps and an ultrasound suction device until the patient is rendered stone free. A final visual inspection of the collecting system will ensure the patient is stone free. The choice of renal drainage method after the procedure will be left to the discretion of the treating surgeon.
Statistical Analysis: Student's t-test and ANOVA will be used to determine statistical significance. P-values < 0.05 will be considered significant.
Study Type
Enrollment (Anticipated)
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
British Columbia
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Vancouver, British Columbia, Canada, V5Z 1M9
- Vancouver General Hospital
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients over the age of 18 undergoing PNL
- Previously untreated renal stones
- Patients with 3 or less individual renal calculi, accessible with a rigid nephroscope
- Stones must be at least >225mm2 area on KUB
- Patient must have a CT scan prior to treatment
Exclusion Criteria:
- Patients with an active contraindication for PNL (pregnancy, uncorrected coagulopathy, active urinary infection, contrast allergy)
- Partial staghorn calculi
- Complete staghorn calculi
- Stones in calyceal diverticulum
- Cases requiring multiple tracts
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: 1
The LMA StoneBreakerTM
|
The interventional device name is the LMA Stonebreaker pneumatic handheld lithotriptor.
|
Active Comparator: 2
Pneumatic Lithotripsy
|
Pneumatic lithotripsy, the Swiss LithoClastR during percutaneous nephrolithotripsy (PNL)
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Time to complete fragmentation of renal calculi treated via PNL
Time Frame: During surgery
|
During surgery
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Time to removal of large fragments using graspers & time required with US to remove small fragments/dust
Time Frame: During surgery
|
During surgery
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Ben Chew, MD, FRCSC, University of British Columbia
- Study Director: R. Paterson, MD, University of British Columbia
- Study Director: J. Wright, MD, University of British Columbia
- Study Director: J. Teichman, MD, University of British Columbia
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- H07-01887
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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