NCT06438497

Brief Summary

Retrograde flexible ureteroscopy (RIRS) is currently the first-line treatment for renal stones \< 2cm. Lower pole renal stones(LPS) are a difficult problem for urologists. The flexible negative pressure suction ureteral sheath(f-UAS) can facilitate RIRS to flush out the fragments and dust in time, and provide a clear vision and reduce the renal pelvis pressure(RPP) during operation.Standard lithotomy position is the most commonly used position for RIRS. Besides, T-tilt position is also available for RIRS in special cases. Investigators were inspired by this and proposed the lateral position, which is available in cases of LPS.In long-term practice, investigators have found that the change of position and the use of f-UAS can improve stone-free rate(SFR). Investigators aimed to conduct a prospective randomized controlled trial to compare the SFR of different positions and different ureteral sheaths.

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
120

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started May 2024

Shorter than P25 for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

May 23, 2024

Completed
1 day until next milestone

First Submitted

Initial submission to the registry

May 24, 2024

Completed
10 days until next milestone

First Posted

Study publicly available on registry

June 3, 2024

Completed
5 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 1, 2024

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

November 1, 2024

Completed
Last Updated

September 24, 2024

Status Verified

September 1, 2024

Enrollment Period

5 months

First QC Date

May 24, 2024

Last Update Submit

September 21, 2024

Conditions

Keywords

RIRSlower pole renal stonesstone-free rateureteral access sheathflexible negative-pressurelateral position

Outcome Measures

Primary Outcomes (2)

  • Stone-free rate

    A low-dose and ultrathin 2-mm spiral CT was performed at 1 day postoperatively for evaluation of fnal SFR. Stone-free status was defined as no fragments observed or clinically insignifcant residual fragments (CIRF)\<2 mm.

    1 day

  • Stone-free rate

    A low-dose and ultrathin 2-mm spiral CT was performed at 1 month postoperatively for evaluation of fnal SFR. Stone-free status was defined as no fragments observed or clinically insignifcant residual fragments (CIRF)\<2 mm.

    1 month

Secondary Outcomes (4)

  • Operative time

    During surgery

  • Hemoglobin drop

    1 day after surgery

  • Hospital stay

    1 week

  • Complication rate

    1 month after sugery

Study Arms (4)

RIRS with f-UAS, lateral position

EXPERIMENTAL

In group 1, patients were placed on operating table in lateral position. A flexible negative-pressure suction ureteric access sheath (f-UAS) is placed under the pelvi-ureteral junction (PUJ) in RIRS.

Procedure: RIRS with f-UAS, lateral position

RIRS with f-UAS, lithotomy position

EXPERIMENTAL

In group 2, patients were placed on operating table in lithotomy position. A flexible negative-pressure suction ureteral access sheath (f-UAS) is placed under the pelvi-ureteric junction (PUJ) in RIRS.

Procedure: RIRS with f-UAS, lithotomy position

RIRS with traditional UAS, lateral position

EXPERIMENTAL

In group 3, patients were placed on operating table in lateral position. A traditional ureteric access sheath (UAS) is placed under the pelvi-ureteral junction (PUJ) in RIRS.

Procedure: RIRS with traditional UAS, lateral position

RIRS with traditional UAS, lithotomy position

ACTIVE COMPARATOR

In group 4, patients were placed on operating table in lithotomy position. A traditional ureteral access sheath (UAS) is placed under the pelvi-ureteric junction (PUJ) in RIRS.

Procedure: RIRS with traditional UAS, lithotomy position

Interventions

In this intervention, patients were placed on operating table in lateral position. The coronal plane of the patient body was perpendicular to the operating table. The upper limbs were extended and fxed with brackets. A f-UAS is placed under the pelvi-ureteric junction (PUJ) in RIRS. The tip of the UAS has good flexibility and deformability. It can passively bend with the bending of the flexible ureteroscope (f-URS).

RIRS with f-UAS, lateral position

In this intervention, patients were placed on operating table in lithotomy position. This position is common and standard. A f-UAS is placed under the pelvi-ureteric junction (PUJ) in RIRS. The tip of the UAS has good flexibility and deformability. It can passively bend with the bending of the flexible ureteroscope (f-URS).

RIRS with f-UAS, lithotomy position

In this intervention, patients were placed on operating table in lateral position. The coronal plane of the patient body was perpendicular to the operating table. The upper limbs were extended and fxed with brackets. A traditional UAS is placed under the pelvi-ureteric junction (PUJ) in RIRS.

RIRS with traditional UAS, lateral position

In this intervention, patients were placed on operating table in lithotomy position. This position is common and standard. A traditional UAS is placed under the pelvi-ureteric junction (PUJ) in RIRS.

RIRS with traditional UAS, lithotomy position

Eligibility Criteria

Age18 Years - 70 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • LPS with a diameter of 10-20 mm
  • American Society of Anesthesiologists(ASA) score Ⅰ,Ⅱ and Ⅲ
  • Adult patients

You may not qualify if:

  • Ureteric stricture
  • Urethral deformity
  • Renal malformation, including horseshoe kidney, ectopic kidney and transplanted kidney
  • Pregnancy
  • Multiple stones in diferent calyces, including upper pole and middle pole

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University

Guangzhou, Guangdong, 510230, China

RECRUITING

MeSH Terms

Conditions

Urolithiasis

Condition Hierarchy (Ancestors)

Urologic DiseasesFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesMale Urogenital Diseases

Central Study Contacts

Guohua Zeng, Ph.D and M.D

CONTACT

Wen Zhong, Ph.D and M.D

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Vice president

Study Record Dates

First Submitted

May 24, 2024

First Posted

June 3, 2024

Study Start

May 23, 2024

Primary Completion

November 1, 2024

Study Completion

November 1, 2024

Last Updated

September 24, 2024

Record last verified: 2024-09

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