Ureteral Reimplantation for the Treatment of Extrinsic Malignant Ureteral Obstruction

NCT ID: NCT02160652

Last Updated: 2017-10-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

50 participants

Study Classification

OBSERVATIONAL

Study Start Date

2014-06-30

Study Completion Date

2018-06-30

Brief Summary

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A single center single arm prospective study, assessing the outcome of ureteral re-implantation for malignant ureteral obstruction.

Detailed Description

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The Research Question: Is laparoscopic ureteral re-implantation, for the treatment of malignant ureteral obstruction, associated with high patency rates, low complication rates, and a significant improvement in quality of life?

Study design: A single center single arm prospective study, assessing the outcome of ureteral re-implantation for malignant ureteral obstruction.

Study population: Patients with malignant ureteral obstruction, treated with laparoscopic ureteral re-implantation, who have a life expectancy of over 6 months and are willing and able to participate in the study.

Intervention: Laparoscopic ureteral re-implantation.

Study Time line: This will be a 1 year study. At initiation a baseline physical exam, blood test, and ultrasonography will be performed. Baseline quality of life questionnaires will be filled. After the operation, Follow-up visits will occur at 1, 3, 6 and 12 months after surgery. At each follow up visit a medical history and physical examination, blood tests and quality of life questionnaires will be performed. At 3, 6 and 12 months renal ultrasonography will be performed.

Primary Endpoint: Ureteral patency at 6 months following treatment - assessed by stable or improved hydronephrosis and estimated glomerular filtration rate (eGFR) according to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation.

Study impact: Current treatments for malignant ureteral obstruction with nephrostomy tubes negatively impact the patient's quality of life. The findings of the current study may support the use of laparoscopic ureteral re-implantation for the treatment of malignant ureteral obstruction, if patency is preserved, and quality of life is improved, following the procedure.

Conditions

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Ureteral Obstruction

Keywords

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Ureteral Obstruction HYDRONEPHROSIS nephrostomy tube

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Study Groups

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Patients

Patients with malignant ureteral obstruction, treated with laparoscopic ureteral re-implantation, who have a life expectancy of over 6 months and are willing and able to participate in the study.

Laparoscopic ureteral re-implantation.

Intervention Type PROCEDURE

Laparoscopic ureteral re-implantation for the treatment of malignant ureteral obstruction.

Interventions

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Laparoscopic ureteral re-implantation.

Laparoscopic ureteral re-implantation for the treatment of malignant ureteral obstruction.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Adult patient, older than 18 years of age.
2. Patient with malignant ureteral obstruction diagnosed by creatinine elevation with evidence of ureteral obstruction on imaging.
3. Patient is scheduled for ureteral reimplantation due to extrinsic malignant ureteral obstruction.
4. American Society of Anesthesiologist score ≤3, enabling the patient to undergo surgery.

Exclusion Criteria

6. WHO performance status 0-2
7. The patient is willing and able to read, understand and sign the study specific informed consent form


1. Patients who underwent urinary diversion other than percutaneous nephrostomy or retrograde ureteral stenting prior to the planned treatment.
2. Patients unable to sign an informed consent for or unwilling to undergo so.
3. Life expectancy of less than 6 months, as defined according to the criteria by Ishioka et al. and predicted in the presence of:

* Low serum albumin before percutaneous nephrostomy/ retrograde ureteral stenting (3 gm/dl or less).
* Low grade hydronephrosis prior to percutaneous nephrostomy/ retrograde ureteral stenting placement (grade 1 or 2) as graded by the grading system of the Society for Fetal Urology
* Malignant ascites or malignant pleural effusion.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Rabin Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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David Margel, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Rabin Medical Center

Other Identifiers

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0185-14-RMC

Identifier Type: -

Identifier Source: org_study_id