NephrectomyNCT05498246
Bipolar Coagulation Versus Suture Renorrhaphy in Laparoscopic Partial Nephrectomy
A study testing laparoscopic partial nephrectomy in people with Nephrectomy, run by Benha University at 1 site in Egypt.
Trial summary
To compare between bipolar coagulation of tumor bed in laparoscopic partial nephrectomy versus suture renorrhaphy Read more about this study
- Who is it for?
- Ages 18 to 75 years
- Conditions the study is for
- Nephrectomy
- What is being tested?
- laparoscopic partial nephrectomy
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 siteEgypt
- Study dates
- 5 Dec 2020to 25 Dec 2021
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Radiological diagnosis of renal mass less than 7cm
- Renal mass in patients with chronic kidney disease
Who cannot join
- Patients with Central or hilar renal masses
- Renal masses close to pelvi-calyceal system
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Bipolar Coagulation Versus Suture Renorrhaphy for Hemostasis of Tumour Bed in Laparoscopic Partial Nephrectomy: Prospective Randomized Comparative Study
To compare between bipolar coagulation of tumor bed in laparoscopic partial nephrectomy versus suture renorrhaphy
Read the detailed description
Partial nephrectomy is the standard of care for T1 renal masses (local tumour) it preserves as much normal renal tissue as possible to avoid post-operative acute renal failure, chronic kidney disease and associated metabolic and cardiovascular morbidities . The main challenges that affect partial nephrectomy outcome is the need for renal ischemia to achieve good hemostasis, and the long-term oncological consequences associated with positive surgical margin. Laparoscopic partial nephrectomy has been widely used lately as it is associated with less blood loss, short hospital stay and early recovery in comparison to open partial nephrectomy . Hemostasis of the tumor bed after laparoscopic partial nephrectomy can be achieved by various techniques including Suture renorrhaphy which can be used whatever the bleeding area, the size of bleeding vessel, or the amount of bleeding. However, it consumes more ischemia time, involves functional parenchyma, and requires high laparoscopic skills . There for in our study we tried to find a way to improve the functional and oncological outcome of laparoscopic partial nephrectomy by comparing the bipolar coagulation versus conventional suture renorrhaphy in performing stable hemostasis of tumor bed
- Conditions
- Nephrectomy
- Being tested
- laparoscopic partial nephrectomy
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
laparoscopic partial nephrectomyProcedure or surgery
Operations were done under general anesthesia. Patients were positioned in modified lateral kidney position for trans-peritoneal procedures. Pneumoperitoneum using the Veress needle technique and trocar placement . Dissection to the renal hilum for good and sufficient exposure of the renal vessels. Good exposure of the tumor and marking the excision site with electro cautery. Clamping of renal vessels using laparoscopic Bulldog appliers. Excision of the renal mass using visual assessment to determine the suitable depth of normal parenchyma to be excised in order to achieve a negative surgical margin. Unclamping was done and re-assessment of the hemostasis to secure residual bleeding points. Approximation of the edges of renal parenchyma using suturing in both groups. The specimen was placed in an EndoCatch bag and removed through pfannenstiel incisionsurgical drain was placed in the paracolic gutter
| Study group | Role | What they receive |
|---|---|---|
| group (A) included 30 cases in which we used bipolar coagulation for hemostasis | Active comparator | group (A) included 30 cases in which we used bipolar coagulation for hemostasis Receives: Procedure: laparoscopic partial nephrectomy |
| group (B) included 30 cases in which we used suture renorrhaphy | Active comparator | group (B) included 30 cases in which we used suture renorrhaphy Receives: Procedure: laparoscopic partial nephrectomy |
What is being measured
The primary outcome is the main question the study is designed to answer.
To compare between bipolar coagulation of tumor bed in laparoscopic partial nephrectomy versus suture renorrhaphy
patients were assessed preoperative by weight in kg and height in meters weight and height will be combined to report body mass index in kg/m^2 ,base line creatinine in mil gm ,baseline hemoglobin in gm,leterality ,CT to examine size in cm and RENAL score and asses patients intra operative by operative time in minutes ,ischemic time in minutes ,estimated blood loss in gm and hospital stay in days
Measured: baseline frame
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Aug 2022
- Study start5 Dec 2020
- Primary completion10 Dec 2021
- Study completion25 Dec 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (17)Papers the sponsor has linked to this study.
- Other trials for NephrectomyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Patients were divided into two groups by close envelope method in this prospective study. group (A) included 30 cases in which we used bipolar coagulation for hemostasis ,group (B) included 30 cases in which we used suture renorrhaphy.
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 60 participants (actual)
Sponsor and investigators
- Lead sponsor
- Benha University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Mohamed Kadry Mostafa, Benha University
- Investigators
- mostafa khalil, MD, Principal investigator, Data analysisAli Abdelkarim, MD, Principal investigator, data collections
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05498246
- Sponsor's protocol ID
- Lap in partial nephrectomy
- Status last verified
- Aug 2022
- First submitted
- 3 Aug 2022
- Last updated
- 12 Aug 2022
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Msezane LP, Katz MH, Gofrit ON, Shalhav AL, Zorn KC. Hemostatic agents and instruments in laparoscopic renal surgery. J Endourol. 2008 Mar;22(3):403-8. doi: 10.1089/end.2007.9844.
PubMed 18355135Aron M, Gill IS. Minimally invasive nephron-sparing surgery (MINSS) for renal tumours part I: laparoscopic partial nephrectomy. Eur Urol. 2007 Feb;51(2):337-46; discussion 46-7. doi: 10.1016/j.eururo.2006.10.018. Epub 2006 Oct 20.
PubMed 17095144Zhang C, Xu Y, Zhang Z, Qiao B, Yang K, Liu R, Ma B. Laparoscopic simple enucleation and coagulation on tumor bed using argon beam coagulator for treating small renal cell carcinomas: an animal study followed by clinical application. Med Sci Monit. 2012 May;18(5):BR193-7. doi: 10.12659/msm.882729.
PubMed 22534702Harbin, A. C, Giusto, L, Lee, V. S., Nadhan, K., Mooney, J., & Eun, D. D. The Use of Argon Beam Coagulation During Robotic Partial Nephrectomy in an Animal Model. Videourology. (2015).
Garcia-Segui A, Bercowsky E, Gascon-Mir M. [Simplified renorrhaphy using self-retaining barbed suture during laparoscopic partial nephrectomy]. Actas Urol Esp. 2012 Sep;36(8):497-502. doi: 10.1016/j.acuro.2012.04.001. Epub 2012 Jul 20. Spanish.
PubMed 22819349Campbell SC, Novick AC, Belldegrun A, Blute ML, Chow GK, Derweesh IH, Faraday MM, Kaouk JH, Leveillee RJ, Matin SF, Russo P, Uzzo RG; Practice Guidelines Committee of the American Urological Association. Guideline for management of the clinical T1 renal mass. J Urol. 2009 Oct;182(4):1271-9. doi: 10.1016/j.juro.2009.07.004. Epub 2009 Aug 14. No abstract available.
PubMed 19683266Kutikov A, Uzzo RG. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009 Sep;182(3):844-53. doi: 10.1016/j.juro.2009.05.035. Epub 2009 Jul 17.
PubMed 19616235Moinzadeh A, Gill IS, Rubenstein M, Ukimura O, Aron M, Spaliviero M, Nahen K, Finelli A, Magi-Galluzzi C, Desai M, Kaouk J, Ulchaker JC. Potassium-titanyl-phosphate laser laparoscopic partial nephrectomy without hilar clamping in the survival calf model. J Urol. 2005 Sep;174(3):1110-4. doi: 10.1097/01.ju.0000168620.36893.6c.
PubMed 16094075Harmon WJ, Kavoussi LR, Bishoff JT. Laparoscopic nephron-sparing surgery for solid renal masses using the ultrasonic shears. Urology. 2000 Nov 1;56(5):754-9. doi: 10.1016/s0090-4295(00)00766-4.
PubMed 11068293Desai MM, Gill IS, Ramani AP, Spaliviero M, Rybicki L, Kaouk JH. The impact of warm ischaemia on renal function after laparoscopic partial nephrectomy. BJU Int. 2005 Feb;95(3):377-83. doi: 10.1111/j.1464-410X.2005.05304.x.
PubMed 15679798Zhao PT, Richstone L, Kavoussi LR. Laparoscopic partial nephrectomy. Int J Surg. 2016 Dec;36(Pt C):548-553. doi: 10.1016/j.ijsu.2016.04.028. Epub 2016 Apr 21.
PubMed 27109204Ota T, Komori H, Rii J, Ochi A, Suzuki K, Shiga N, Nishiyama H. Soft coagulation in partial nephrectomy without renorrhaphy: feasibility of a new technique and early outcomes. Int J Urol. 2014 Mar;21(3):244-7. doi: 10.1111/iju.12276. Epub 2013 Sep 18.
PubMed 24102735Kim DK, Kim LH, Raheem AA, Shin TY, Alabdulaali I, Yoon YE, Han WK, Rha KH. Comparison of Trifecta and Pentafecta Outcomes between T1a and T1b Renal Masses following Robot-Assisted Partial Nephrectomy (RAPN) with Minimum One Year Follow Up: Can RAPN for T1b Renal Masses Be Feasible? PLoS One. 2016 Mar 17;11(3):e0151738. doi: 10.1371/journal.pone.0151738. eCollection 2016.
PubMed 26987069Ramani AP, Desai MM, Steinberg AP, Ng CS, Abreu SC, Kaouk JH, Finelli A, Novick AC, Gill IS. Complications of laparoscopic partial nephrectomy in 200 cases. J Urol. 2005 Jan;173(1):42-7. doi: 10.1097/01.ju.0000147177.20458.73.
PubMed 15592022Takagi T, Kondo T, Omae K, Iizuka J, Kobayashi H, Yoshida K, Hashimoto Y, Tanabe K. Assessment of Surgical Outcomes of the Non-renorrhaphy Technique in Open Partial Nephrectomy for >/=T1b Renal Tumors. Urology. 2015 Sep;86(3):529-33. doi: 10.1016/j.urology.2015.05.018. Epub 2015 Jul 14.
PubMed 26187014
Study at a glance
From the registry record, last updated by the sponsor on 12 Aug 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Bipolar Coagulation Versus Suture Renorrhaphy for Hemostasis of Tumour Bed in Laparoscopic Partial Nephrectomy: Prospective Randomized Comparative Study
- ClinicalTrials.gov ID
- NCT05498246
- Acronym / sponsor ID
- Lap in partial nephrectomy
- Conditions
- Nephrectomy
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 60 participants (actual)
- Lead sponsor
- Benha UniversityUniversity, hospital or other
- Study start
- 5 Dec 2020 (actual)
- Primary completion
- 10 Dec 2021 (actual)
- Study completion
- 25 Dec 2021 (actual)
- First posted
- 12 Aug 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
To compare between bipolar coagulation of tumor bed in laparoscopic partial nephrectomy versus suture renorrhaphy
Detailed description
Partial nephrectomy is the standard of care for T1 renal masses (local tumour) it preserves as much normal renal tissue as possible to avoid post-operative acute renal failure, chronic kidney disease and associated metabolic and cardiovascular morbidities . The main challenges that affect partial nephrectomy outcome is the need for renal ischemia to achieve good hemostasis, and the long-term oncological consequences associated with positive surgical margin. Laparoscopic partial nephrectomy has been widely used lately as it is associated with less blood loss, short hospital stay and early recovery in comparison to open partial nephrectomy . Hemostasis of the tumor bed after laparoscopic partial nephrectomy can be achieved by various techniques including Suture renorrhaphy which can be used whatever the bleeding area, the size of bleeding vessel, or the amount of bleeding. However, it consumes more ischemia time, involves functional parenchyma, and requires high laparoscopic skills . There for in our study we tried to find a way to improve the functional and oncological outcome of laparoscopic partial nephrectomy by comparing the bipolar coagulation versus conventional suture renorrhaphy in performing stable hemostasis of tumor bed
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
- Model description
- Patients were divided into two groups by close envelope method in this prospective study. group (A) included 30 cases in which we used bipolar coagulation for hemostasis ,group (B) included 30 cases in which we used suture renorrhaphy.
| Arm | Type | Receives |
|---|---|---|
| group (A) included 30 cases in which we used bipolar coagulation for hemostasis | Active comparator | Procedure: laparoscopic partial nephrectomygroup (A) included 30 cases in which we used bipolar coagulation for hemostasis |
| group (B) included 30 cases in which we used suture renorrhaphy | Active comparator | Procedure: laparoscopic partial nephrectomygroup (B) included 30 cases in which we used suture renorrhaphy |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- Radiological diagnosis of renal mass less than 7cm
- Renal mass in patients with chronic kidney disease
Key exclusion criteria (2 listed)
- Patients with Central or hilar renal masses
- Renal masses close to pelvi-calyceal system
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| laparoscopic partial nephrectomyOperations were done under general anesthesia. Patients were positioned in modified lateral kidney position for trans-peritoneal procedures. Pneumoperitoneum using the Veress needle technique and trocar placement . Dissection to the renal hilum for good and sufficient exposure of the renal vessels. Good exposure of the tumor and marking the excision site with electro cautery. Clamping of renal vessels using laparoscopic Bulldog appliers. Excision of the renal mass using visual assessment to determine the suitable depth of normal parenchyma to be excised in order to achieve a negative surgical margin. Unclamping was done and re-assessment of the hemostasis to secure residual bleeding points. Approximation of the edges of renal parenchyma using suturing in both groups. The specimen was placed in an EndoCatch bag and removed through pfannenstiel incisionsurgical drain was placed in the paracolic gutter | Procedure or surgery | group (A) included 30 cases in which we used bipolar coagulation for hemostasis, group (B) included 30 cases in which we used suture renorrhaphy |
Primary outcome
To compare between bipolar coagulation of tumor bed in laparoscopic partial nephrectomy versus suture renorrhaphy
Time frame: baseline frame
patients were assessed preoperative by weight in kg and height in meters weight and height will be combined to report body mass index in kg/m^2 ,base line creatinine in mil gm ,baseline hemoglobin in gm,leterality ,CT to examine size in cm and RENAL score and asses patients intra operative by operative time in minutes ,ischemic time in minutes ,estimated blood loss in gm and hospital stay in days
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 12 Aug 2022.
- Results publication: PubMed 18355135Msezane LP, Katz MH, Gofrit ON, Shalhav AL, Zorn KC. Hemostatic agents and instruments in laparoscopic renal surgery. J Endourol. 2008 Mar;22(3):403-8. doi: 10.1089/end.2007.9844.
- Results publication: PubMed 17095144Aron M, Gill IS. Minimally invasive nephron-sparing surgery (MINSS) for renal tumours part I: laparoscopic partial nephrectomy. Eur Urol. 2007 Feb;51(2):337-46; discussion 46-7. doi: 10.1016/j.eururo.2006.10.018. Epub 2006 Oct 20.
- Results publication: PubMed 22534702Zhang C, Xu Y, Zhang Z, Qiao B, Yang K, Liu R, Ma B. Laparoscopic simple enucleation and coagulation on tumor bed using argon beam coagulator for treating small renal cell carcinomas: an animal study followed by clinical application. Med Sci Monit. 2012 May;18(5):BR193-7. doi: 10.12659/msm.882729.
- Results publicationHarbin, A. C, Giusto, L, Lee, V. S., Nadhan, K., Mooney, J., & Eun, D. D. The Use of Argon Beam Coagulation During Robotic Partial Nephrectomy in an Animal Model. Videourology. (2015).
- Results publication: PubMed 22819349Garcia-Segui A, Bercowsky E, Gascon-Mir M. [Simplified renorrhaphy using self-retaining barbed suture during laparoscopic partial nephrectomy]. Actas Urol Esp. 2012 Sep;36(8):497-502. doi: 10.1016/j.acuro.2012.04.001. Epub 2012 Jul 20. Spanish.
- Results publication: PubMed 19683266Campbell SC, Novick AC, Belldegrun A, Blute ML, Chow GK, Derweesh IH, Faraday MM, Kaouk JH, Leveillee RJ, Matin SF, Russo P, Uzzo RG; Practice Guidelines Committee of the American Urological Association. Guideline for management of the clinical T1 renal mass. J Urol. 2009 Oct;182(4):1271-9. doi: 10.1016/j.juro.2009.07.004. Epub 2009 Aug 14. No abstract available.
- Results publication: PubMed 19616235Kutikov A, Uzzo RG. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009 Sep;182(3):844-53. doi: 10.1016/j.juro.2009.05.035. Epub 2009 Jul 17.
- Results publication: PubMed 16094075Moinzadeh A, Gill IS, Rubenstein M, Ukimura O, Aron M, Spaliviero M, Nahen K, Finelli A, Magi-Galluzzi C, Desai M, Kaouk J, Ulchaker JC. Potassium-titanyl-phosphate laser laparoscopic partial nephrectomy without hilar clamping in the survival calf model. J Urol. 2005 Sep;174(3):1110-4. doi: 10.1097/01.ju.0000168620.36893.6c.
- Results publication: PubMed 11068293Harmon WJ, Kavoussi LR, Bishoff JT. Laparoscopic nephron-sparing surgery for solid renal masses using the ultrasonic shears. Urology. 2000 Nov 1;56(5):754-9. doi: 10.1016/s0090-4295(00)00766-4.
- Results publication: PubMed 15679798Desai MM, Gill IS, Ramani AP, Spaliviero M, Rybicki L, Kaouk JH. The impact of warm ischaemia on renal function after laparoscopic partial nephrectomy. BJU Int. 2005 Feb;95(3):377-83. doi: 10.1111/j.1464-410X.2005.05304.x.
- Results publication: PubMed 27109204Zhao PT, Richstone L, Kavoussi LR. Laparoscopic partial nephrectomy. Int J Surg. 2016 Dec;36(Pt C):548-553. doi: 10.1016/j.ijsu.2016.04.028. Epub 2016 Apr 21.
- Results publication: PubMed 24102735Ota T, Komori H, Rii J, Ochi A, Suzuki K, Shiga N, Nishiyama H. Soft coagulation in partial nephrectomy without renorrhaphy: feasibility of a new technique and early outcomes. Int J Urol. 2014 Mar;21(3):244-7. doi: 10.1111/iju.12276. Epub 2013 Sep 18.
Related trials for Nephrectomy
Recruiting
Implementation of a Pain Management Plan in Major Open Abdominal Surgeries.
Abdomen Cancer, Pancreas Adenocarcinoma (MSI-H)
Not yet recruitingObservational study
Hugo™ RAS Urology Post-Market Clinical Study
Prostatectomy, Cystectomy
Active, not recruitingPhase 2
Upfront Immune Checkpoint Inhibitors With Deferred Cytoreductive Nephrectomy for Metastatic Renal Cell Carcinoma
Immune Checkpoint Inhibitors, Cytoreductive Nephrectomy
Active, not recruitingPhase 2
NSAID Use After Robotic Partial Nephrectomy
Kidney Cancer, Renal Cancer
Recruiting
Effect of Non-Clamping and Sutureless Technique on Postoperative Renal Function in Robot-Assisted Partial Nephrectomy
Renal Neoplasms, Localized Kidney Tumors
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
mostafa khalil, MD principal investigator
Data analysis
Ali Abdelkarim, MD principal investigator
data collections
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing laparoscopic partial nephrectomy in people with Nephrectomy, run by Benha University at 1 site in Egypt.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 12 Aug 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
To compare between bipolar coagulation of tumor bed in laparoscopic partial nephrectomy versus suture renorrhaphy (time frame: baseline frame). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05498246, which also lists 17 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Aug 2022.