Dusting vs Basketing in RIRS: a Single-center Prospective Randomised Trial

Status Recruiting

Clinical Trial Summary

The investigator aims to perform a prospective and randomized controlled trial comparing the safety and efficacy of active basket extraction of fragments and stone dusting during the RIRS.

Clinical Trial Description

RIRS has been widely adopted and used by urologists worldwide in the management of renal stones due to less invasiveness and efficacy, especially in small to moderate-sized renal stones. RIRS has several advantages over SWL for stones less than 2 cm diameter. Most importantly, removing the stone in one session without the need for other treatment modalities.

Furthermore, the application of RIRS has expanded to larger stones reaching up to 35 mm in some cases,in spite of not being the first line therapy for the larger stones. RIRS has advantages over the PCNL especially concerning complications. Namely lower or no bleeding events and the less invasiveness of RIRS.

Options for the treatment of intrarenal stones include fragmenting the stone then extracting large fragments using a basket or dusting the stone into very small fragments then leaving the (dust) to pass spontaneously.

The idea of dusting in RIRS emerges as a counterpart of the originally taught fragmentation and basketing of the stones. Aiming to reduce multiple entries and exits for the renal system and ultimately not requiring UAS or baskets during the surgery. Thus theoretically decreasing operative time and costs with the same SFRs, In addition to minimizing the risk of ureteral injury .

So there is a debate amongst surgeons whether to laser the stone to dust or fragment and retrieve intra-renal fragments. EAU guidelines on the surgical management of urolithiasis stated that dusting strategies should be limited to the treatment of large renal stones. Without clearly differentiating between dusting or fragmentation and basketing. Cho et al; favored fragmentation technique especially for large renal stones because the dust in dusting technique may affect visualization and obscure small stone fragments. But this was an opinion and not built on a direct comparative study.

Until now, there is no consensus on how to achieve optimal stone clearance once the primary stone is fragmented with lithotripsy. And to date, no prospective randomized study has addressed the practice of active extraction vs. spontaneous passage ;

Study Design

Related Conditions & MeSH terms

Urolithiasis

Clinical Trial Details

NCT number	NCT03207659
Study type	Interventional
Source	The First Affiliated Hospital of Guangzhou Medical University
Contact	Guohua Zeng, Ph.D and M.D.
Phone	+86 13802916676
Email	gzgyzgh@vip.sina.com
Status	Recruiting
Phase	N/A
Start date	August 1, 2017
Completion date	December 2018

View Details

See also
Status	Clinical Trial	Phase
Enrolling by invitation	`NCT04746378` - PRedictive Accuracy of Initial Stone Burden Evaluation.
Recruiting	`NCT05100017` - Methocarbamol vs Oxybutynin for Management of Pain and Discomfort S/P Ureteroscopy Procedure	N/A
Recruiting	`NCT04021381` - Citrate Salts for Stone-free Result After Flexible Ureterorenoscopy for Inferior Calyx Calculi	Phase 3
Completed	`NCT02266381` - A Prospective Comparison of Fluoroscopic, Sonographic or Combined Approach for Renal Access in Percutaneous Nephrolithotomy	N/A
Terminated	`NCT01431378` - Pilot Study of Model Based Iterative Reconstruction Using 64-Slice	N/A
Completed	`NCT01451931` - Study of Tomography of Nephrolithiasis Evaluation	Phase 4
Completed	`NCT01295879` - Vitamin D Repletion in Stone Formers With Hypercalciuria	Phase 4
Completed	`NCT02895711` - Radiation Dose of Pediatric Patients During Ureteroscopy
Completed	`NCT05340075` - Staged Bilateral Percutaneous Nephrolithotomy
Recruiting	`NCT03919227` - Measurement of Resistance During UAS Insertion Procedure in RIRS	N/A
Recruiting	`NCT03717285` - Under Direct Vision vs Under Non Direct Vision of Insertion of UAS in RIRS	N/A
Completed	`NCT05340088` - Optimal Passive Dilation Time in Retrograde Intrarenal Surgery
Completed	`NCT05032287` - Medical Expulsive Therapy Post-SWL For Renal Stones	N/A
Recruiting	`NCT05701098` - SOUND Pivotal Trial - (Sonomotion stOne comminUtion resoNance ultrasounD)	N/A
Not yet recruiting	`NCT04080973` - Metabolic Workup in Patients Suffering From Kidney Stone Disease and Osteopenia	N/A
Terminated	`NCT01736358` - The Use of Intranasal Ketoralac for Pain Management (Sprix)	Phase 4
Completed	`NCT01792765` - Management of Ureteral Calculi Using Ultrasound Guidance: A Radiation Free Approach	N/A
Completed	`NCT06211842` - Genetic Variations That Increase the Risk for Calcium Kidney Stones: a Family-based Study
Not yet recruiting	`NCT02214836` - Ultrasound Imaging of Kidney Stones and Lithotripsy	N/A
Not yet recruiting	`NCT04606758` - Fluoroscopic Guided vs US-guided Percutaneous Nephrolithotripsy for the Treatment of Stone Disease	N/A

Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.