Outcomes From a RCT Comparing Preventive Versus Delayed Ligation of DVC During Robot-assisted Radical Prostatectomy

NCT ID: NCT03351088

Last Updated: 2017-11-22

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

Clinical Phase

NA

Total Enrollment

226 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-08-31

Study Completion Date

2017-12-31

Brief Summary

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Since its introduction, robot-assisted radical prostatectomy (RARP) have become the standard surgical approach for the treatment of prostate cancer in the United States and then in Europe. Continuous refinements of surgical technique has been described in order to maximise outcomes while minimizing morbidities.

The management of DVC is a crucial steps during RARP. It could be done prior or after its transection thanks to haemostatic effects of the pneumoperitoneum. This topic has been already investigated by some authors. However, no high quality evidence is available to opt in favour of either of the two approaches. Findings about estimated blood loss, positive surgical margins and urinary recovery differ among these studies and only one is a randomized controlled trial in a laparoscopic setting with a limited number of patients.

Therefore, our objective was to evaluate in a prospective randomised setting whether a delayed ligation of the dorsal vascular complex impacted on perioperative, functional and oncological outcomes as compared to preventive ligation during robot-assisted radical prostatectomy.

Detailed Description

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Conditions

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Prostate Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Preventive ligation

Preventive ligation of DVC is done after the opening of endopelvic fascia and before bladder neck dissection. DVC is ligated at the level of the apex with a 8-fashion single stich (1-0 Monocryl® CT-1 stich) trying to preserve puboprostatic ligaments and the muscle fibres of the rabdosphincter. DVC is then dissected at the end of prostatectomy before the section of the urethra.

Group Type OTHER

DVC ligation

Intervention Type PROCEDURE

Ligation of the dorsal vascular complex during robot-assisted radical prostatectomy

Delayed ligation

Delayed ligation is done after the section of the urethra and once the prostatectomy is completed with a single stich (3-0 Monocryl® UR-6).

Group Type OTHER

DVC ligation

Intervention Type PROCEDURE

Ligation of the dorsal vascular complex during robot-assisted radical prostatectomy

Interventions

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DVC ligation

Ligation of the dorsal vascular complex during robot-assisted radical prostatectomy

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* male patients, aged 18-80 years
* patients willing and able to provide written informed consent
* voluntary partecipation
* clinical indication to robot-assisted radical prostatectomy

Exclusion Criteria

* coagulation impairment at the time of surgery
* salvage radical prostatectomy
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia

OTHER

Sponsor Role lead

Responsible Party

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Alessandro Antonelli

Dirigente medico

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Clinical Department of Urology, university Hospital Spedali Civili di Brescia

Brescia, , Italy

Site Status

Countries

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Italy

Other Identifiers

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DVC

Identifier Type: -

Identifier Source: org_study_id