- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning 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.
Studieöversikt
Status
Betingelser
Intervention / Behandling
Detaljerad beskrivning
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.
Studietyp
Inskrivning (Förväntat)
Fas
- Fas 3
Kontakter och platser
Studiekontakt
- Namn: Camilla Tajzler, BA, CCRA
- Telefonnummer: 35876 905-522-1155
- E-post: tajzlec@mcmaster.ca
Studera Kontakt Backup
- Namn: Anil Kapoor, MD, FRCSC
- Telefonnummer: 33218 905-522-1155
- E-post: akapoor@mcmaster.ca
Studieorter
-
-
Ontario
-
Hamilton, Ontario, Kanada, L8N4A6
- St. Joseph's Healthcare Hamilton - McMaster Institute of Urology
-
-
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
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
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Enda
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
---|---|
Aktiv komparator: Laparoscopic Assisted Partial Nephrectomy
Current standard for partial nephrectomies.
|
Robotic (Davinci)
|
Aktiv komparator: Robotic Assisted Partial Nephrectomy
Possible new standard for partial nephrectomies.
|
Regular Laparoscopic Technique.
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
---|---|---|
Warm ischemia time
Tidsram: 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)
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
---|---|---|
eGFR
Tidsram: 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
Tidsram: 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
Tidsram: 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.
Tidsram: 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
Tidsram: Minutes to hours after nephrectomy up to 3 months post-operatively.
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Minutes to hours after nephrectomy up to 3 months post-operatively.
|
|
Length of hospital stay
Tidsram: 3-7 Days
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Calculated from day of admission to day of discharge from hospital.
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3-7 Days
|
Positive surgical margin rate
Tidsram: 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
Tidsram: 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
|
Samarbetspartners och utredare
Sponsor
Studieavstämningsdatum
Studera stora datum
Studiestart (Förväntat)
Primärt slutförande (Förväntat)
Avslutad studie (Förväntat)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Uppskatta)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Andra studie-ID-nummer
- RALPLPNNX
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