- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT07627503
Supine vs. Prone PCNL for Large Renal Stones: A Randomized Trial in Yemen.
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.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Type d'étude
Inscription (Estimé)
Phase
- N'est pas applicable
Contacts et emplacements
Coordonnées de l'étude
- Nom: Haitham M Jowah, Lecturer
- Numéro de téléphone: +967774831058
- E-mail: h.jowah@su.edu.ye
Sauvegarde des contacts de l'étude
- Nom: Waleed M Al-Ata, M.B.B.Ch
- Numéro de téléphone: +967777775223
- E-mail: Walidalata@gmail.com
Lieux d'étude
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Sanaa, Yémen, 13078
- Al-Kuwait University Hospital
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Contact:
- Dr. Waleed M Al-Ata, M.B.B.Ch
- Numéro de téléphone: +967777775223
- E-mail: Walidalata@gmail.com
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
La description
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.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Comparateur actif: Supine PCNL
Patients will undergo standard percutaneous nephrolithotomy (24-30 Fr tract size) performed in the supine position.
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Standard PCNL performed with the patient in the supine position using a standard 24-30 Fr tract.
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Comparateur actif: Prone PCNL
Patients will undergo standard percutaneous nephrolithotomy (24-30 Fr tract size) performed in the conventional prone position.
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Standard PCNL performed with the patient in the traditional prone position using a standard 24-30 Fr tract.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Incidence and Severity of Early Postoperative Complications
Délai: Up to 30 days post-surgery
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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.
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Up to 30 days post-surgery
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Total Operative Time
Délai: Intraoperative (Day 0)
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Total duration of the surgical procedure, measured continuously from the initial skin incision to the final skin closure, recorded in minutes.
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Intraoperative (Day 0)
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Direct Hospitalization Costs
Délai: From hospital admission to hospital discharge (typically 1 to 7 days)
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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).
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From hospital admission to hospital discharge (typically 1 to 7 days)
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Postoperative Pain Score
Délai: At 6 hours, 12 hours, and 24 hours post-surgery
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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).
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At 6 hours, 12 hours, and 24 hours post-surgery
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Health-Related Quality of Life (HRQoL)
Délai: At 1 month and 3 months post-surgery
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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).
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At 1 month and 3 months post-surgery
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Patient Satisfaction Score
Délai: At 30 days post-surgery
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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).
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At 30 days post-surgery
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Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Waleed M Al-Ata, M.B.B.Ch, Al-Kuwait University Hospital
- Directeur d'études: Khaled M Al-Kohlany, Associate Professor, Faculty of Medicine and Health Sciences, Sana'a University
- Chaise d'étude: Abualgaith A Alkholany, MD, Al-Kuwait University Hospital
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Estimé)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
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
Termes MeSH pertinents supplémentaires
- Maladies urogénitales
- Maladies urogénitales masculines
- Calculs
- Conditions pathologiques, anatomiques
- Maladies rénales
- Maladies urologiques
- Maladies urogénitales féminines
- Maladies urogénitales féminines et complications de la grossesse
- Urolithiase
- Calculs urinaires
- Conditions pathologiques, signes et symptômes
- Calculs rénaux
- Néphrolithiase
Autres numéros d'identification d'étude
- PCNL-SANA-2026
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Informations sur les médicaments et les dispositifs, documents d'étude
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