Renal Calculi Clinical Trial
Official title:
External Physical Vibration Lithecbole(EPVL) Contrast With the Traditional Row of Stone Effect After Retrograde Intrarenal Surgery(RIRS): A Multi-center Prospective Randomized Controlled Trial
The treatment of renal calculus by retrograde intrarenal surgery(RIRS) isn't able to eliminate stone completely, hastening fragments clearance just only rely on traditional expulsive methods such as high fluid intake ,increasing physical activity, medical expulsive therapy and changing body position. Therefore, researchers purpose to evaluate the effectiveness of external physical vibration lithecbole(EPVL) in treatment of residual fragments after RIRS by prospective study of clinical trial, which will improve stone-free rate of residual fragments and benefit more patients.
To evaluate the efficacy and safety of external physical vibration lithecbole for the
treatment of residual stone after the operation of RIRS,thereby improving stone clearance
rate. Investigators will do a multi-centers randomized controlled trial(RCT),and
investigators plan to perform this study in 10 hospitals,which are the First Affiliated
Hospital of Guangzhou Medical University of China, Department of Urology, The Second
Affiliated Hospital of Zhengzhou University of China, Jiangsu Province Hospital, Hubei
Province Hospital, Zhongshan Hospital, Tongji Hospital,Hubei provincial people's
Hospital,Guilin 181 Hospital,the People' Hospital of Huzhou,The People' Hospital of
Shaoyang.
Investigators plan to beginning their study August 2015 and end July 2016. One hundred and
eighty patients with postoperative residual stone after RIRS will be enrolled in this study.
By simple random sampling technique, all the patients will be assigned to the segment of
natural stone row group or physical row of stone group, compared two groups of patients with
stone clearance rate and complications, Investigators hope that through this test, improve
stone clearance rate after RIRS.
The principle of extracorporeal physical vibration:
A Simple harmonic motion technology in multi-direction was applied. The Lateral acceleration
was provided by the physical vibration device in the base through the harmonic vibration
wave in the horizontal direction, which induces the urinary stone separate with the kidney
or ureter, and expands a moving space for the stone. Meanwhile, an axial effect was produced
to push the stone by the physical vibration device in the handle through the harmonic
vibration wave in the multi- direction. Finally, with the help of changing the position and
direction of the extracorporeally physical vibration machine, the urinary stone was
discharged from the urinary collecting system.
Number:
180cases(90 cases in control group, 90 cases in EPVL group)
Grouping methods:
In this trial, investigators use equilibrium randomization methods that generate random
numerical code table, according to the table, patients are randomly assigned to different
groups.
Evaluating indicator Stone-free rate in 5 weeks after RIRS. Incidence rate of complications
and adverse reactions after EPVL(fever, hematuria).
Trial method; Cases selection and grouping: in 1 week after RIRS, the imaging KUB(abdominal
plain film), patients with radiolucent calculus need to be examined by CT demonstrate the
presence of residual fragments, and the cases that meeting inclusion criterion are randomly
assigned to groups, and the ureteral stent should be removed in 2 weeks;
Laboratory testing: blood routine, urine routine, renal function , coagulation function;
Strat the treatment of EPVL before the removal of ureteral stent.
Methods of control group(group1):
RIRS without EPVL Patients should be reexamined respectively in 1 and 2 weeks after RIRS,
and the ureteral stent should be removed in 2 weeks;
Patients should follow the measures below:
1. the amount of fluid intake is more than 2000ml/d
2. increase physical activity
3. rest in position on uninjured side, patients with lower renal calyx calculus need to
invert body;
Follow up timing: respectively in 2 ,3 and 5 weeks after RIRS.
Methods of EPVL group(group2):
Preparation before EPVL: the amount of fluid intake is about 1000-2000ml, start the
treatment of EPVL when patient's bladder is filling;
Record: patients' information, outcome of treatment (examined by KUB right after EPVL);
Start the treatment of EPVL;
Patients should follow the measures below:
1. the amount of fluid intake is more than 2000ml/d
2. increase physical activity
3. rest in position on uninjured side, patients with lower renal calyx calculus need to
invert body;
Patients should be reexamined in one week, meanwhile removing ureteral stent or perhaps
undergoing the treatment of EPVL once again.
Follow up timing: respectively in 1,2 and 4 weeks after EPVL..
Follow up project Laboratory testing: routine urinalysis; Imaging examination: KUB or kidney
CT scan (radiolucent calculus) Complications and adverse reactions. Data gathering Fill in
follow up table data; Radiological images; IVP(intravenous pyelography) or kidney CT scan;
Reexamined by KUB (radiopaque calculus) or CT (radiolucent calculus) right after RIRS,
respectively in 2 ,3 and 5 weeks after RIRS. If stones have been eliminated completely in
patients with radiolucent calculus before or at the fourth week of follow-up, investigator
must provide kidney CT scan.
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