Partial Nephrectomy in Low Pressure

NCT ID: NCT05404685

Last Updated: 2025-06-13

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

280 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-10-04

Study Completion Date

2024-04-29

Brief Summary

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The main objective is to prospectively assess the impact of low insufflation pressure using AirSeal system (7mm Hg) during RAPN on post-operative patient pain (main location and intensity), 24 hours after surgery. The study will be conducted among 15 centers of the French research network on kidney cancer UroCCR.

Detailed Description

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Minimally invasive route for PN is recommended to offer patients ERAS and day-case pathways leading to the best possible recovery. In this setting, pain management is crucial and every innovation supposed to offer a benefit has to be assessed. For transperitoneal laparoscopic procedures, the level and stability of the insufflation pressure will influence the quality of the pneumoperitoneum and may impact the feasibility of the surgery as well as intra and post-operative outcomes. It is universally recognized that the lower insufflation pressure, the better. However, a balance has usually to be found between technical feasibility of the surgery and lowest acceptable insufflation pressure. The AirSeal system aims to generate a stable pneumoperitoneum even in case of active gaz succion by the surgeon's assistant. The investigators then hypothesize that RAPN would be feasible and safe even in low pressure (7mm Hg) and may decrease post-operative patients' pain.

The investigators plan to describe the feasibility of Low Pressure RAPN at 7mm Hg (LP-RAPN) and assess its intra and post-operative outcomes including pain and recovery on a patient perspective. This will be achieved comparatively to RAPN performed at standard insufflation pressure of 12 mm Hg and through a single blinded randomized trial design.

The project has been developed and will be conducted within the framework of the French research network on kidney cancer UroCCR (www.uroccr.fr). INCa has been supporting this multidisciplinary network since 2011 and the web-based shared clinical and biological national database on kidney cancer UroCCR will be used.

Conditions

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Kidney Tumors Treated With Minimally Invasive Surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Outcome Assessors
The randomization list is drawn up by the statistician of the Center for Methodology and Data Management (USMR of the Bordeaux University Hospital) before starting the research.

The numbers of the 2 strategy groups are balanced with a 1:1 ratio. The randomization will be stratified on the study centers and a detailed description of the analgesia practices of each center will be made at the beginning of the study.

The randomization will be done when the patient is under general anesthesia. Patients will not be told which group they have been randomized to.

Study Groups

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Transperitoneal RAPN with AirSeal system set to 7mmH.

Patient with Low Pressure Robotic Assisted Partial Nephrectomy at 7mm Hg

Group Type EXPERIMENTAL

Low insufflation pressure (7mm Hg) for Robotic Assisted Partial Nephrectomy

Intervention Type DEVICE

Use of insufflation pressure at 7 mm Hg. The groups will differ only with respect to the insufflation pressure level set on the AirSeal® system.

The level of pressure will be adjusted at the beginning of the surgery, after placement of the trocars, in accordance with the result of the randomization.

transperitoneal RAPN with AirSeal system set to standard insufflation pressure (12mmHg)

Control arm : Patient with standard insufflation pressure of 12 mm Hg

Group Type ACTIVE_COMPARATOR

Standard insufflation pressure (12mm Hg) for Robotic Assisted Partial Nephrectomy

Intervention Type DEVICE

Use of insufflation pressure at 12 mm Hg. The groups will differ only with respect to the insufflation pressure level set on the AirSeal® system.

The level of pressure will be adjusted at the beginning of the surgery, after placement of the trocars, in accordance with the result of the randomization.

Interventions

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Low insufflation pressure (7mm Hg) for Robotic Assisted Partial Nephrectomy

Use of insufflation pressure at 7 mm Hg. The groups will differ only with respect to the insufflation pressure level set on the AirSeal® system.

The level of pressure will be adjusted at the beginning of the surgery, after placement of the trocars, in accordance with the result of the randomization.

Intervention Type DEVICE

Standard insufflation pressure (12mm Hg) for Robotic Assisted Partial Nephrectomy

Use of insufflation pressure at 12 mm Hg. The groups will differ only with respect to the insufflation pressure level set on the AirSeal® system.

The level of pressure will be adjusted at the beginning of the surgery, after placement of the trocars, in accordance with the result of the randomization.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Male or Female aged of 18 and over
* Planned transperitoneal RAPN for tumor with AirSeal system.
* Affiliation to or beneficiary of the French social security
* Patient in capacity and willing to accurately report pain-killer intakes in the first postoperative 7 days.
* Free, informed and written consent signed by the patient and the investigating physician (at the latest on the day of inclusion and before any examination required by the research).

Exclusion Criteria

* Daily chronic pain-killers intake for another indication than the kidney tumor and intended to be maintained at the time of surgery
* Person deprived of liberty
* Person under trusteeship, curatorship or legal guardianship
* Refusal of consent or participation in the UroCCR project and the P-NeLoP ancillary trial


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Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Bordeaux

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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CHU d'Angers

Angers, , France

Site Status

Centre Hospitalier Universitaire de Bordeaux

Bordeaux, , France

Site Status

CHU de Caen

Caen, , France

Site Status

Hopital Henri-Mondor

Créteil, , France

Site Status

Hôpital Claude Huriez

Lille, , France

Site Status

Institut Paoli-Calmettes

Marseille, , France

Site Status

CHU de Nice

Nice, , France

Site Status

Hôpital Pitié-Salpétrière

Paris, , France

Site Status

Hôpital bicêtre

Paris, , France

Site Status

Polyclinique Francheville Périgueux

Périgueux, , France

Site Status

CHU de Poitiers

Poitiers, , France

Site Status

Clinique La Croix du Sud

Quint-Fonsegrives, , France

Site Status

CHU de Rennes

Rennes, , France

Site Status

CHRU de Strasbourg

Strasbourg, , France

Site Status

CHU de Tours

Tours, , France

Site Status

Countries

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France

References

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Margue G, Bigot P, Ingels A, Roupret M, Waeckel T, Long JA, Pignot G, Bensalah K, Lang H, Olivier J, Bruyere F, Durand M, Beauval JB, Mallet R, Parier B, De La Taille A, Bernhard JC. Clinical trial protocol for P-NeLoP: a randomized controlled trial comparing the feasibility and outcomes of robot-assisted partial nephrectomy with low insufflation pressure using AirSeal versus standard insufflation pressure (UroCCR no. 85 study). Trials. 2023 Aug 19;24(1):545. doi: 10.1186/s13063-023-07533-4.

Reference Type DERIVED
PMID: 37596613 (View on PubMed)

Other Identifiers

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CHUBX 2020/62

Identifier Type: -

Identifier Source: org_study_id

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