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.
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
研究の種類
研究の種類
入学 (推定)
入学
段階
段階
- 適用できない
連絡先と場所
研究連絡先
研究連絡先
- 名前:Haitham M Jowah, Lecturer
- 電話番号:+967774831058
- メール:h.jowah@su.edu.ye
研究連絡先のバックアップ
- 名前:Waleed M Al-Ata, M.B.B.Ch
- 電話番号:+967777775223
- メール:Walidalata@gmail.com
研究場所
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Sanaa、イエメン、13078
- Al-Kuwait University Hospital
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コンタクト:
- Dr. Waleed M Al-Ata, M.B.B.Ch
- 電話番号:+967777775223
- メール:Walidalata@gmail.com
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-
参加基準
適格基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
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.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
アーム数
武器と介入
参加者グループ / アーム参加者グループ / アーム |
介入・治療介入・治療 |
|---|---|
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アクティブコンパレータ: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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アクティブコンパレータ: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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この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Incidence and Severity of Early Postoperative Complications
時間枠: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.
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Up to 30 days post-surgery
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二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Total Operative Time
時間枠: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
時間枠: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
時間枠: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)
時間枠: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
時間枠: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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協力者と研究者
捜査官
捜査官
- 主任研究者:Waleed M Al-Ata, M.B.B.Ch、Al-Kuwait University Hospital
- スタディディレクター:Khaled M Al-Kohlany, Associate Professor、Faculty of Medicine and Health Sciences, Sana'a University
- スタディチェア:Abualgaith A Alkholany, MD、Al-Kuwait University Hospital
研究記録日
主要日程の研究
研究開始 (推定)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
キーワード
追加の関連 MeSH 用語
その他の研究ID番号
その他の研究ID番号
- PCNL-SANA-2026
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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