Random Evaluation of Patients Who Have Had Laparoscopic Partial Nephrectomy

Kidney Cancer Clinical Trial

Official title:

Randomized, Prospective Evaluation of Hemostatic Agents in Robotic-Assisted Laparoscopic Partial Nephrectomy

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT04120805
• Other study ID #: IRB15-0519
• Status: Recruiting
• Phase: N/A
• Start date: January 1, 2016
• Est. completion date: March 1, 2026

Study information

• Verified date: November 2023
• Source: University of Chicago
• Contact: Arieh Shalhav, MD
• Phone: 773-834-9889
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to evaluate the necessity of using hemostatic agents as a tool when performing robotic partial nephrectomy in the treatment of kidney cancer. This project asks whether patients who undergo robotic partial nephrectomy without the surgeon using hemostatic agents during the procedure will have the same, fewer, or more complications than when patients undergo this same surgery with the surgeon using hemostatic agents during the procedure.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 178
• Est. completion date: March 1, 2026
• Est. primary completion date: September 1, 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Male and female patients aged 18 years and older.

2. Patients must have a solid or cystic renal mass suspicious for malignancy by imaging with ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI).

3. Patients must be initially scheduled RALPN as opposed to radical nephrectomy or other techniques for partial nephrectomy such as open surgery or pure laparoscopy without robot assistance.

4. Patients with bilateral kidneys or a solitary kidney, so long as these are native kidneys as opposed to a transplanted kidney.

5. Patients can have the common single renal artery and single renal vein, or they can have common variants such as two renal arteries and/or two renal veins.

Exclusion Criteria:

1. Patients on hemodialysis.

2. Patients who have had a renal transplantation.

3. Patients on therapeutic anticoagulation prior to surgery (example anticoagulants include: aspirin 325 mg daily, clopidogrel, warfarin, fondaparinux, dabigatran, and rivaroxaban). However, patients who take aspirin 81 mg daily as their daily regimen will be included.

4. Patients with bleeding disorders (example: hemophilia) and other documented coagulopathy (example: chronic liver disease) with INR greater than 1.0 at baseline.

5. Patients who have had a prior surgical procedure, aside from percutaneous renal biopsy, on the kidney in the current operation.

6. Patients with over 100 mL of estimated blood loss (calculated by anesthesia team using the suction canisters) prior to clamping of the renal hilum will be excluded.

Related Conditions & MeSH terms

• Kidney Cancer
• Kidney Neoplasms

Intervention

Device:
• Hemostatic Agent
Patients undergoing robotic-assisted laparoscopic partial nephrectomy with the use of hemostatic agents by a surgeon

Other:
• No Hemostatic Agent
Patients undergoing robotic-assisted laparoscopic partial nephrectomy without the use of hemostatic agents by a surgeon

Locations

Country	Name	City	State
United States	The University of Chicago	Chicago	Illinois

Sponsors (1)

Lead Sponsor	Collaborator
University of Chicago

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	An absolute change in hemoglobin	The change in hemoglobin will be measured as the difference between the hemoglobin obtained postoperatively and the hemoglobin obtained preoperatively.	up to 6 months
Secondary	Total number of major bleeding complications	Major complications are blood loss requiring transfusion of packed red blood cells, reoperation and endovascular ablation	up to 6 months
Secondary	Safety monitoring parameters: Number of participants with treatment-related adverse events as assessed by CTCAE v4.0	Safety monitoring parameters including stroke, death, cardiac arrest, myocardial infarction and urine leak	up to 6 months
Secondary	Operating room parameters	Operating room parameters including number of sutures used during renorrhaphy and capsular closure, duration of renorrhaphy and patients in group 2 with no hemostatic agents who required HA at the surgeons discretion	up to 6 months
Secondary	Patients with a hospital stay over 30 days	Total length of all inpatient hospital stay over 30 days measured in days	up to 6 months