Bipolar Coagulation Versus Suture Renorrhaphy in Laparoscopic Partial Nephrectomy

NCT05498246 | Completed

• 1 other identifier: Lap in partial nephrectomy
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

To compare between bipolar coagulation of tumor bed in laparoscopic partial nephrectomy versus suture renorrhaphy

Conditions

Nephrectomy

Outcome Measures

Primary Outcomes (1)

• 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

  baseline frame

Study Arms (2)

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

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

Procedure: laparoscopic partial nephrectomy

Interventions

laparoscopic partial nephrectomy PROCEDURE

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

group (A) included 30 cases in which we used bipolar coagulation for hemostasis; group (B) included 30 cases in which we used suture renorrhaphy

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Radiological diagnosis of renal mass less than 7cm
• Renal mass in patients with chronic kidney disease

You may not qualify if:

• Patients with Central or hilar renal masses
• Renal masses close to pelvi-calyceal system

Sponsors & Collaborators

• Benha University: lead

Study Sites (1)

Mohamed Kadry Mostafa

Banhā, Qalyubia Governorate, 013, Egypt

Location

Related Publications (17)

• 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.

  PMID: 18355135 RESULT

• Aron 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.

  PMID: 17095144 RESULT

• Zhang 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.

  PMID: 22534702 RESULT

• Harbin, 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).

  RESULT

• 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.

  PMID: 22819349 RESULT

• Campbell 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.

  PMID: 19683266 RESULT

• Kutikov 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.

  PMID: 19616235 RESULT

• Moinzadeh 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.

  PMID: 16094075 RESULT

• Harmon 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.

  PMID: 11068293 RESULT

• Desai 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.

  PMID: 15679798 RESULT

• Zhao 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.

  PMID: 27109204 RESULT

• Ota 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.

  PMID: 24102735 RESULT

• Kim 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.

  PMID: 26987069 RESULT

• Ramani 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.

  PMID: 15592022 RESULT

• Takagi 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.

  PMID: 26187014 RESULT

• Marszalek M, Chromecki T, Al-Ali BM, Meixl H, Madersbacher S, Jeschke K, Pummer K, Zigeuner R. Laparoscopic partial nephrectomy: a matched-pair comparison of the transperitoneal versus the retroperitoneal approach. Urology. 2011 Jan;77(1):109-13. doi: 10.1016/j.urology.2010.02.057.

  PMID: 20970830 RESULT

• Williams SB, Kacker R, Alemozaffar M, Francisco IS, Mechaber J, Wagner AA. Robotic partial nephrectomy versus laparoscopic partial nephrectomy: a single laparoscopic trained surgeon's experience in the development of a robotic partial nephrectomy program. World J Urol. 2013 Aug;31(4):793-8. doi: 10.1007/s00345-011-0648-5. Epub 2011 Jan 29.

  PMID: 21274541 RESULT

Study Officials

• mostafa khalil, MD

  Data analysis

  PRINCIPAL INVESTIGATOR

• Ali Abdelkarim, MD

  data collections

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: 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.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Bipolar coagulation versus suture renorrhaphy for hemostasis of tumour bed in laparoscopic partial nephrectomy: prospective randomized comparative study

Model Details: 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.

Study Record Dates

• First Submitted: August 3, 2022
• First Posted: August 12, 2022
• Study Start: December 5, 2020
• Primary Completion: December 10, 2021
• Study Completion: December 25, 2021
• Last Updated: August 12, 2022

Record last verified: 2022-08

Locations

EG (1)