Uterine Myomas Clinical Trial
Official title:
GYNAECARE MORCELLEX Tissue Morcellator vs. ROTOCUT GI Tissue Morcellator: a Randomized Controlled Study
To date, laparoscopic approach may apply to several gynecologic diseases. Among the recent
advances in laparoscopy an important role was assumed by the methods of tissue extraction.
In particular electronic power morcellators have become instruments of large use in surgical
practice.
The tissue morcellator is an endoscopic instrument indicated for cutting, coring and
extracting tissue in operative laparoscopy, and it has a pivotal role during specific
gynaecologic procedures as well as myomectomy and hysterectomy. The main advantages offered
by electronic morcellator consist in reduction of operative time and of risk in hernia
formation, this last due to the absence of fascia's tearing or stretching.
Recently, a new generation of tissue morcellator has been commercialized. In particular,
GYNECARE MORCELLEX (Ethicon-Johnson & Johnson Gateway, US) and ROTOCUT G1 (Karl Storz,
Culver City, CA, US) are two tissue morcellators currently available. These instruments seem
to offer advantages over the previous models in terms of precision, speed and durability.
The most useful of this features seems to be the higher speed, in particular it has been
calculated that they morcellate tissues approximately four times faster than those of the
previous generation. The high speed that characterizes this new morcellator potentially
results in reduced operative time with consequent benefits in other surgical outcomes such
as postoperative pain and recovery time.
Even if both morcellator seems to be high-quality instruments, no study was designed until
now to compare these two tools in a prospective fashion.
Patients with symptomatic uterine leiomyomas will be assessed for eligibility and will be
enrolled in the present protocol-study.
At entry, in each woman age, parity, body mass index (BMI), menopausal, socioeconomic and
work status, symptoms related to the gynecologic disease, previous major surgical
laparotomies, and associated medical condition will be assessed.
All eligible patients will be randomized in single blocks using a central computer
generating randomization lists (University of Catanzaro). The subjects will be assigned to
one of four subgroups of surgical treatment, i.e. group A1 myomectomies performed using
GYNECARE MORCELLEX, group A2 supracervical hysterectomies performed using GYNECARE
MORCELLEX, group B1 myomectomies performed using ROTOCUT G1 and group B2 supracervical
hysterectomies performed using ROTOCUT G1.
Before surgery, for each patient gynaecological and rectal examination, Papanicolau smear
test, ultrasonographic and hysteroscopic assessment with endometrial biopsy will be
performed.
For each surgical intervention the following parameters will be recorded: duration of
surgical procedures, intra-operative blood loss, amount of blood transfusion,
intra-operative complications, number of laparotomic conversion, postoperative pain,
post-operative complications, hospital stay, and time to return to full activity and/or
work.
Data will be analyzed using the intention-to-treat principle and a P value of 0.05 or less
will be considered significant.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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