- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02933398
A Trial Comparing - Robotic Assisted Versus Laparoscopic Partial Nephrectomy For Small Renal Masses (RALPLPNNX)
A Prospective Randomized Controlled Trial Comparing Two Minimally Invasive Surgical Modalities - Robotic Assisted Vs. Pure Laparoscopic Partial Nephrectomy For Small Renal Masses.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Small renal masses (SRM) <4cm are increasingly being discovered incidentally on imaging. The standard of care for management of SRMs is partial nephrectomy whenever feasible. In the last 10 years, a minimally invasive laproscopic approach has largely supplanted open surgery for the treatment of SRMs. Robot-assisted laparoscopic partial nephrectomy (RALPN) has emerged as an alternative to laparoscopic partial nephrectomy (LPN) and has been able to bridge the technical difficulties of LPN. The big question about the role and cost of RALPN in comparison to LPN especially in Canadian healthcare for SRMs still remains unanswered.
The objective of this proposed study is to conduct a randomized controlled trial to determine whether RALPN is better than LPN for the management of patients with SRMs. The primary outcomes will be warm ischemia time and secondary outcomes will be estimated glomerular filtration rate (eGFR), estimated blood loss, complication rate, length of hospital stay, positive surgical margin rate and cost comparison of these two techniques.
Study Type
Enrollment (Anticipated)
Phase
- Phase 3
Contacts and Locations
Study Contact
- Name: Camilla Tajzler, BA, CCRA
- Phone Number: 35876 905-522-1155
- Email: tajzlec@mcmaster.ca
Study Contact Backup
- Name: Anil Kapoor, MD, FRCSC
- Phone Number: 33218 905-522-1155
- Email: akapoor@mcmaster.ca
Study Locations
-
-
Ontario
-
Hamilton, Ontario, Canada, L8N4A6
- St. Joseph's Healthcare Hamilton - McMaster Institute of Urology
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients at least 18 years of age and capable of giving informed consent
- Patients scheduled for treatment of a renal tumor suitable to undergo LPN /RALPN
- Patients with SRMs (tumor(s) ≤ 4 cm)
Exclusion Criteria:
- Large tumors > 4.0cm
- Unable to have a general anesthetic
- Unable to comply with post-operative follow-up protocol
- Uncorrectable bleeding diathesis
- Tumors unsuitable for LPN/RALPN technique
- Evidence of metastatic disease
- Prior surgery on the affected kidney
- Ectopic or malrotated kidney
- Mental health condition that precludes informed consent
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: Laparoscopic Assisted Partial Nephrectomy
Current standard for partial nephrectomies.
|
Robotic (Davinci)
|
Active Comparator: Robotic Assisted Partial Nephrectomy
Possible new standard for partial nephrectomies.
|
Regular Laparoscopic Technique.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Warm ischemia time
Time Frame: Duration of the Surgical Procedure (Nephrectomy)
|
It will be measured intraoperatively from the time of application of Satinsky clamp on the renal hilum to the release of clamp (in minutes).
|
Duration of the Surgical Procedure (Nephrectomy)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
eGFR
Time Frame: Up to 24 months post operatively.
|
It will be measured preoperatively, postoperatively and at each of the follow-up visit.
|
Up to 24 months post operatively.
|
Estimated blood loss
Time Frame: Duration of the Surgical Procedure (Nephrectomy)
|
Will be measured intraoperatively from the amount of blood (ml) in the suction container.
|
Duration of the Surgical Procedure (Nephrectomy)
|
Complication rates as per Clavien-Dindo classification
Time Frame: Up to 24 months post-operatively.
|
It will be recorded for the intra-operative, post-operative and follow-up period.
|
Up to 24 months post-operatively.
|
Conversion rate to radical nephrectomy or OPN due to technical difficulty.
Time Frame: Duration of the Surgical Procedure
|
From the start of the partial nephrectomy in minutes to the time it was decided to convert to a radical nephrectomy.
|
Duration of the Surgical Procedure
|
Postoperative pain
Time Frame: Minutes to hours after nephrectomy up to 3 months post-operatively.
|
Minutes to hours after nephrectomy up to 3 months post-operatively.
|
|
Length of hospital stay
Time Frame: 3-7 Days
|
Calculated from day of admission to day of discharge from hospital.
|
3-7 Days
|
Positive surgical margin rate
Time Frame: 14 days
|
Will be based on the final pathology results which are usually ready in 1-2 weeks post surgery.
Distance to surgical margin will be looked at (mm to cm).
|
14 days
|
Costs of treatment
Time Frame: Up to 1 year
|
Clinical data and resource use for both treatments will be collected and unit cost estimates will be based on the St.
Joseph Healthcare case-costing system.
The cost will be conducted from the perspective of Ontario Ministry of Health and Long-term Care.
The cost of hospital stay will be calculated along with any hospital stay/procedure associated with a post-op complication.
|
Up to 1 year
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Anticipated)
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 (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- RALPLPNNX
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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