Benefit of the Use of 3D Models and Tools in Hepatectomy Planning for Hepatocarcinomas

NCT ID: NCT03382327

Last Updated: 2021-02-10

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

COMPLETED

Clinical Phase

NA

Total Enrollment

136 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-10-16

Study Completion Date

2020-10-16

Brief Summary

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The aim of this study is to assess the benefit of 3D models in the planning of hepatic resection by comparing the changes in the surgical plan based on the analysis of conventional preoperative images (CT-scan and MRI), compared to the surgical plan based on the analysis of 3D reconstruction.

Detailed Description

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The detailed anatomical description of the liver described by Couinaud in 1954 is the basis for hepatic surgery. Surgical resection is the approach leading to the best survival rate in case of liver cancer. In hepatocarcinomas, systematic removal of the infected liver segment is considered the most effective technique to eliminate tumour, potential satellite nodules and avoid vascular spread. Resectability rate highly depends on the analysis of preoperative images. However, in 20% of cases, there are modifications compared with the initial surgical plan leading to an increase in morbidity rate.

In 2002, Couinaud highlighted the difficulty of identifying portal pedicles, especially because of anatomical variations, and recommended the use of a three-dimensional reconstruction from images provided by a helical scanner.

The hypothesis of the study is that 3D models would improve surgical planning leading to a decrease in intra-operative adjustments and mortality.

The aim of this multicentric, prospective study is to assess the benefit of 3D models in the surgical management of hepatocarcinomas, more specifically in the detailed analysis of 3D vascular structures and in the surgery planning with resection merges evaluation. The validation of this virtual method will be built on the comparison of the surgical plan based on the analysis of conventional preoperative images (CT-scan and MRI) and the surgical plan based on the analysis of 3D reconstruction.

Conditions

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Hepatocarcinoma

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Surgical planning

Two surgical plans will be established preoperatively. The first plan will be based on standard preoperative images (CT-scan, MRI) review. The second plan will be based on the 3D model review.

Group Type EXPERIMENTAL

Surgical planning

Intervention Type PROCEDURE

Two surgical plans will be established preoperatively. The first plan will be based on standard preoperative images (CT-scan, MRI) review. The second plan will be based on the 3D model review. Both will be compared to the actual surgery performed in the operating room.

Interventions

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Surgical planning

Two surgical plans will be established preoperatively. The first plan will be based on standard preoperative images (CT-scan, MRI) review. The second plan will be based on the 3D model review. Both will be compared to the actual surgery performed in the operating room.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patient with a hepatocarcinoma, eligible for surgical resection
* Patient over 18 years old
* Patient able to understand the study and provide written informed consent
* Patient affiliated to the French social security system.

Exclusion Criteria

* Patient with other liver tumours
* Patient whose general condition is not suitable for study participation (WHO ≥ 3)
* Patient with a condition preventing its participation to study procedures, according to investigator's judgment
* Patient with contraindications to injected CT-scan or MRI: allergic reaction to contrast agents, kidney failure, pacemaker, claustrophobia
* Pregnancy or breastfeeding
* Patient in exclusion period (determined by a previous study or in progress)
* Patient in custody
* Patient under guardianship.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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IHU Strasbourg

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Patrick Pessaux, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Service de Chirurgie Digestive et Endocrinienne - Nouvel Hôpital Civil - Strasbourg

Locations

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Service de Chirurgie Digestive - Hôpital Beaujon

Clichy, , France

Site Status

Hôpital Henri Mondor - Service de Chirurgie Digestive et Hépatobiliaire -

Créteil, , France

Site Status

Service de Chirurgie Digestive et Transplantation - Hôpital Claude Huriez

Lille, , France

Site Status

Service de Chirurgie Digestive et Transplantation Hépatique - Hôpital universitaire de la Croix-Rousse

Lyon, , France

Site Status

Service de Chirurgie Digestive - CH Emile Muller

Mulhouse, , France

Site Status

Chirurgie Viscérale et Digestive - Polyclinique de Gentilly

Nancy, , France

Site Status

Chirurgie Digestive, Hépato-bilio-pancréatique et Transplantation - La Pitié Sâlpêtrière

Paris, , France

Site Status

Service de Chirurgie Digestive - CHU Robert Debré

Reims, , France

Site Status

Service de Chirurgie Digestive Hôpital Charles Nicolle - CHU Rouen

Rouen, , France

Site Status

Institut de Chirurgie Viscérale - Clinique de l'Orangerie

Strasbourg, , France

Site Status

Service de Chirurgie Digestive et Endocrinienne - Nouvel Hôpital Civil

Strasbourg, , France

Site Status

Centre Hépato-Biliaire - Hôpital Paul Brousse

Villejuif, , France

Site Status

Countries

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France

References

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Gauss T, Merckx P, Brasher C, Kavafyan J, Le Bihan E, Aussilhou B, Belghiti J, Mantz J. Deviation from a preoperative surgical and anaesthetic care plan is associated with increased risk of adverse intraoperative events in major abdominal surgery. Langenbecks Arch Surg. 2013 Feb;398(2):277-85. doi: 10.1007/s00423-012-1028-3. Epub 2012 Nov 13.

Reference Type BACKGROUND
PMID: 23149461 (View on PubMed)

Couinaud C. [Errors in the topographic diagnosis of liver diseases]. Ann Chir. 2002 Jun;127(6):418-30. doi: 10.1016/s0003-3944(02)00802-7. French.

Reference Type BACKGROUND
PMID: 12122715 (View on PubMed)

Mutter D, Dallemagne B, Bailey Ch, Soler L, Marescaux J. 3D virtual reality and selective vascular control for laparoscopic left hepatic lobectomy. Surg Endosc. 2009 Feb;23(2):432-5. doi: 10.1007/s00464-008-9931-y. Epub 2008 Apr 29.

Reference Type BACKGROUND
PMID: 18443871 (View on PubMed)

Mutter D, Soler L, Marescaux J. Recent advances in liver imaging. Expert Rev Gastroenterol Hepatol. 2010 Oct;4(5):613-21. doi: 10.1586/egh.10.57.

Reference Type BACKGROUND
PMID: 20932146 (View on PubMed)

Other Identifiers

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16-003

Identifier Type: -

Identifier Source: org_study_id

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