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Supine vs. Prone PCNL for Large Renal Stones: A Randomized Trial in Yemen.

3. juni 2026 opdateret af: Haitham Mohammed Jowah, Sana'a University

Comparative Evaluation of Early Postoperative Complications, Cost-Effectiveness, and Patient-Centered Outcomes Following Supine and Prone Standard Percutaneous Nephrolithotomy (PCNL): A Randomized Controlled Trial

The goal of this clinical trial is to compare the safety, cost-effectiveness, and patient recovery of two different surgical positions for percutaneous nephrolithotomy (PCNL) in adults aged 18 to 70 years who have kidney stones larger than 2 cm. The main questions it aims to answer are:

  • Does the supine (lying on the back) surgical position result in fewer early postoperative complications than the traditional prone (lying on the stomach) position?
  • Does the supine position reduce the total surgery time, direct hospital costs, and postoperative pain?

Researchers will compare patients assigned to undergo PCNL in the supine position to those assigned to the prone position to see if the supine approach offers a safer, more cost-effective, and more comfortable recovery.

Participants will:

  • Undergo standard PCNL surgery to remove their kidney stones in either the supine or prone position.
  • Have their pain levels, surgery time, and any early surgical complications monitored during their hospital stay.
  • Complete brief questionnaires regarding their overall surgical satisfaction and quality of life at 1 month and 3 months after the procedure.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

140

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

  • Navn: Haitham M Jowah, Lecturer
  • Telefonnummer: +967774831058
  • E-mail: h.jowah@su.edu.ye

Undersøgelse Kontakt Backup

Studiesteder

  • Yemen
      • Sanaa, Yemen, 13078
        • Al-Kuwait University Hospital
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Patients aged 18-70 years.
  • Diagnosis of solitary or multiple renal stones with a cumulative diameter greater than 2 cm, confirmed by imaging (CT KUB).
  • Patients eligible for standard PCNL (24-30 Fr).
  • American Society of Anesthesiologists (ASA) physical status I-III.
  • Willingness and ability to provide informed consent.

Exclusion Criteria:

  • Patients with active urinary tract infection (UTI) not responding to antibiotics.
  • Patients with bleeding diathesis or on anticoagulant therapy that cannot be safely discontinued.
  • Patients with anatomical abnormalities of the kidney or urinary tract that preclude standard PCNL.
  • Pregnant women.
  • Patients with severe cardiopulmonary disease where general anesthesia or prolonged surgical positioning is contraindicated.
  • Patients with a history of previous ipsilateral renal surgery.
  • Patients unwilling or unable to comply with follow-up protocols.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Supine PCNL
Patients will undergo standard percutaneous nephrolithotomy (24-30 Fr tract size) performed in the supine position.
Procedure: Supine Percutaneous Nephrolithotomy (PCNL)
Standard PCNL performed with the patient in the supine position using a standard 24-30 Fr tract.
Aktiv komparator: Prone PCNL
Patients will undergo standard percutaneous nephrolithotomy (24-30 Fr tract size) performed in the conventional prone position.
Procedure: Prone Percutaneous Nephrolithotomy (PCNL)
Standard PCNL performed with the patient in the traditional prone position using a standard 24-30 Fr tract.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Incidence and Severity of Early Postoperative Complications
Tidsramme: Up to 30 days post-surgery
Complications will be assessed and classified using the Modified Clavien-Dindo Classification system. The scale ranges from Grade I (minor deviation from normal postoperative course) to Grade V (death of the patient). Lower grades indicate a better outcome.
Up to 30 days post-surgery

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Total Operative Time
Tidsramme: Intraoperative (Day 0)
Total duration of the surgical procedure, measured continuously from the initial skin incision to the final skin closure, recorded in minutes.
Intraoperative (Day 0)
Direct Hospitalization Costs
Tidsramme: From hospital admission to hospital discharge (typically 1 to 7 days)
Total direct medical costs associated with the procedure, calculated as the sum of disposable medical supply costs and hospital stay duration costs. Measured in Yemeni Rials (YER).
From hospital admission to hospital discharge (typically 1 to 7 days)
Postoperative Pain Score
Tidsramme: At 6 hours, 12 hours, and 24 hours post-surgery
Postoperative pain will be evaluated using the Visual Analog Scale. The scale ranges from 0 (no pain) to 10 (worst imaginable pain). Lower scores indicate a better outcome (less postoperative pain).
At 6 hours, 12 hours, and 24 hours post-surgery
Health-Related Quality of Life (HRQoL)
Tidsramme: At 1 month and 3 months post-surgery
Measured using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire. The utility index score will be calculated using the Kingdom of Saudi Arabia value set, ranging from -0.683 (worst possible health state) to 1.000 (full health), where higher scores indicate a better outcome (better health-related quality of life).
At 1 month and 3 months post-surgery
Patient Satisfaction Score
Tidsramme: At 30 days post-surgery
Overall patient satisfaction with the surgical experience, anesthetic process, and early recovery will be measured using a 5-point Likert-type satisfaction scale. The scale ranges from 1 (highly dissatisfied) to 5 (highly satisfied), where higher scores indicate a better outcome (greater patient satisfaction).
At 30 days post-surgery

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Sana'a University

Efterforskere

  • Ledende efterforsker: Waleed M Al-Ata, M.B.B.Ch, Al-Kuwait University Hospital
  • Studieleder: Khaled M Al-Kohlany, Associate Professor, Faculty of Medicine and Health Sciences, Sana'a University
  • Studiestol: Abualgaith A Alkholany, MD, Al-Kuwait University Hospital

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. juni 2026

Primær færdiggørelse (Anslået)

1. juni 2027

Studieafslutning (Anslået)

30. juni 2027

Datoer for studieregistrering

Først indsendt

31. maj 2026

Først indsendt, der opfyldte QC-kriterier

31. maj 2026

Først opslået (Faktiske)

4. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

5. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

3. juni 2026

Sidst verificeret

1. juni 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • PCNL-SANA-2026

Plan for individuelle deltagerdata (IPD)

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