- ICH GCP
- Registre américain des essais cliniques
- Essai clinique 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.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
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.
Type d'étude
Inscription (Anticipé)
Phase
- Phase 3
Contacts et emplacements
Coordonnées de l'étude
- Nom: Camilla Tajzler, BA, CCRA
- Numéro de téléphone: 35876 905-522-1155
- E-mail: tajzlec@mcmaster.ca
Sauvegarde des contacts de l'étude
- Nom: Anil Kapoor, MD, FRCSC
- Numéro de téléphone: 33218 905-522-1155
- E-mail: akapoor@mcmaster.ca
Lieux d'étude
-
-
Ontario
-
Hamilton, Ontario, Canada, L8N4A6
- St. Joseph's Healthcare Hamilton - McMaster Institute of Urology
-
-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La 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
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
---|---|
Comparateur actif: Laparoscopic Assisted Partial Nephrectomy
Current standard for partial nephrectomies.
|
Robotic (Davinci)
|
Comparateur actif: Robotic Assisted Partial Nephrectomy
Possible new standard for partial nephrectomies.
|
Regular Laparoscopic Technique.
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Warm ischemia time
Délai: 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)
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
eGFR
Délai: 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
Délai: 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
Délai: 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.
Délai: 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
Délai: 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
Délai: 3-7 Days
|
Calculated from day of admission to day of discharge from hospital.
|
3-7 Days
|
Positive surgical margin rate
Délai: 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
Délai: 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
|
Collaborateurs et enquêteurs
Parrainer
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Anticipé)
Achèvement primaire (Anticipé)
Achèvement de l'étude (Anticipé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Autres numéros d'identification d'étude
- RALPLPNNX
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Étudie un produit d'appareil réglementé par la FDA américaine
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