- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02291406
Importance of Surgical Approach for Gynecological Surgery on Metabolic Effects and Subsequent Recovery
Importance of Surgical Approach for Hysterectomies on Metabolic Effects Regarding Development of Insulin Resistance and Subsequent Recovery. A Randomized Controlled Study.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This is a prospective randomized controlled single center study. Primary screening will take place in the gynecological ward of Orebro University hospital according to the inclusion and exclusion criteria. 20 patients will be enrolled. All participants are randomized between robotic assisted total laparoscopic hysterectomy and total abdominal hysterectomy.
The main purpose of this study are to determine if robotic assisted laparoscopic hysterectomy induces less insulin resistance compare to abdominal hysterectomy. Both patients with benign and malignant disease are included. In addition inflammatory factors such as IL-6 and CRP are measured and clinical recovery is measured.
Each patient will be studied twice using the hyperinsulinemic normoglycemic clamp, a method that now is the gold standard for determining insulin sensitivity. During the clamp insulin is infused intravenously to attain an elevation at levels seen after an abnormal meal. At the same time glucose is infused to balance the effect of insulin and to maintain normal blood glucose level. The amount of the glucose infusion needed is the level of insulin sensitivity. The clamp procedure is performed before surgery as a control measure and the morning after surgery to yield the relative change in insulin sensitivity caused by the operation (postoperative insulin resistance). Before the onset of the infusion, and after 60 minutes of steady state during insulin stimulation, blood is collected for the analysis of immune function. This is also collected 3 hours after surgery.
A 6 minutes walk test is performed before surgery and the day after surgery, in order to determine a more clinical measure on recovery.
In addition demographic and clinical data are systematically collected during the hospital stay and 30 days after.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Lena Wijk, MD
- Phone Number: +46196022040
- Email: lena.wijk@oru.se
Study Contact Backup
- Name: Kerstin Nilsson, MD, PhD
- Phone Number: +46196022389
- Email: kerstin.nilsson@orebroll.se
Study Locations
-
-
-
Örebro, Sweden
- Recruiting
- Örebro Univeristy Hospital
-
Contact:
- Lena Wijk, MD
- Phone Number: +46196022040
- Email: lena.wijk@oru.se
-
Contact:
- Kerstin Nilsson, MD, PhD
- Phone Number: +46196022389
- Email: kerstin.nilsson@orebroll.se
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Over 18 years of age
- Scheduled to total hysterectomy and/or bilateral salpingo-oophorectomy (BSOE).
- Both malignant or benign indications
- The operation should be technically possible to perform with laparoscopy or by abdominal incision, including approval from an anesthesiologist
- Acceptance to participate in the study and signed written informed consent document
- Proficiency in Swedish language
Exclusion Criteria:
- The operation is anticipated to comprise more than the hysterectomy + BSOE
- Diabetes mellitus
- Severe chronic pain or massive pain medication
- Severe inflammatory disease like active severe endometriosis or inflammatory bowel disease
- Known severe adhesions in the abdomen
- Contraindications on non steroidal analgesia
- Medication with drugs or disease affecting insulin resistance for example cortisone
- Mentally disabled women who cannot fill in the questionnaires or understand the consequences of participating in a trial
- Severe psychiatric disease or on medication for psychiatric disease so that the physician consider participation in the trial inappropriate
Study Plan
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 |
---|---|
Active Comparator: Robot assisted laparoscopic hysterectomy
Robot assisted laparoscopic total hysterectomy
|
Robotic assisted total laparoscopic hysterectomy.
|
Active Comparator: Abdominal hysterectomy
Standard extrafascial abdominal total hysterectomy through a low transverse abdominal wall incision.
|
Standard extrafascial abdominal total hysterectomy through a low transverse abdominal wall incision.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Insulin resistance
Time Frame: 3 weeks
|
Insulin resistance is measured by the hyperinsulinemic normoglycemic clamp, a method that now is the golden standard for determining insulin sensitivity.
The clamp is measured 1-2 weeks before surgery and on the morning after surgery.
|
3 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes in biomarkers of inflammation and the immune system.
Time Frame: 3 weeks
|
Biomarkers for example IL6 and CRP are measured.
Biomarkers are measured two times during the hyperinsulinemic normoglycemic clamp before surgery, 3 hours after surgery and two times during the clamp after surgery.
|
3 weeks
|
6 minutes walk test
Time Frame: 3 weeks
|
Measured before surgery and on the day after surgery 25-26 hours after surgery.
|
3 weeks
|
postoperative outcomes
Time Frame: 4 weeks
|
Postoperative outcome is registered systematically according to the ERAS Society register.
|
4 weeks
|
complications
Time Frame: 4 weeks
|
Adverse events are registered systematically from start of anesthesia to 30 days after surgery
|
4 weeks
|
Collaborators and Investigators
Sponsor
Investigators
- Study Chair: Kerstin Nilsson, MD, PhD, Department of Obstetrics and Gynecology, Örebro University Hospital, School of medicine, Örebro University, Sweden
- Principal Investigator: Lena Wijk, MD, Department of Obstetrics and Gynecology, Örebro University Hospital, School of Health and Medical Sciences, Örebro University, Sweden
- Study Chair: Olle Ljungqvist, MD, Prof, Department of Surgery, Örebro University Hospital, School of Health and Medical Sciences Örebro University, Sweden.
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- OLL-431061
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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