A CCafU-UroCCR Randomized Trial: 3D Image-Guided Robot-AssisTEd Partial Nephrectomy for Renal Complex Tumor (UroCCR N°99)
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: Robot assisted partial nephrectomy with 3D image guidance.
- Кому может быть актуально
- Состояния в реестре: Renal Tumor, Renal Cancer. Базовые параметры: от 18 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- Франция
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Обзор
The goal of this clinical trial is to evaluate peri and post-operative outcomes as well as long-term survival of 3D IGRAPN compared to conventional Robot-Assisted Partial Nephrectomy (RAPN) for moderate and highly complex renal tumors. The main questions aim to answer: * peri-operative complications * oncological safety * long term renal function Participants will be asked to do undergo 3D-IGRAPN. Researchers will compare 3D-IGRAPN to RAPN to see if peri-operative outcomes are better in the experimental group.
Подробное описание
Robot-assisted partial nephrectomy (RAPN) is the standard treatment for localized kidney tumors. New 3D modeling and reconstruction technologies have enabled the development of real time imageguided surgery using virtual reality (VR). In view of advances in artificial intelligence and surface recognition based on deep-learning, augmented reality (AR) by merging a 3D reconstructed virtual image onto the real per-operative view represents the next step in image-guided surgery.
3D IG-RAPN using Synapse 3D (Fujifilm) and DaVinci Tile-Pro display (Intuitive Surgical) vs conventional RAPN without 3D navigation in 12 high-volume urological centers from the UroCCR Network.
Outcoume : Primary endpoint is a composite validated score (TRIFECTA) evaluating peri-operative complications as well as oncological safety and long-term renal function preservation. Secondary endpoints assess long-term survival, ergonomics and surgeon satisfaction. A medico-economic evaluation will be performed.
Methodology: ACCURATE is a nation-wide, single-blind, multicentric, prospective randomized controlled trial enrolling 694 patients with a single complex renal mass, defined as RENAL NS≥7.
Randomization (1:1) between the experimental and the conventional group will take place on day of inclusion and will be stratified by center.
Вмешательства
- Процедура Robot assisted partial nephrectomy with 3D image guidance
patient have a partial nephrectomy for renal complex tumor
Первичные конечные точки
- TRIFECTA score [Срок оценки: 1 month]
Вторичные конечные точки (9)
- Recurrence free survival [Срок оценки: 2 and 5 years]
- Overall survival [Срок оценки: 2 and 5 years]
- Number of Conversion to radical nephrectomy [Срок оценки: Intraopertively]
- rate of Off clamp or superselective ischemia [Срок оценки: Intraoperatively]
- Amount of parenchyma preserved (according to CT scan) [Срок оценки: Month 6]
- Blood loss [Срок оценки: Intra-operatively]
- NASA TLX [Срок оценки: at the end of the surgery]
- Warm ischemia time [Срок оценки: Intra-operatively]
- Medico-economic evaluation [Срок оценки: Month 1 and 6]
Критерии участия
Критерии включения
- Patients over 18 years
- Indication of RAPN for suspicious renal tumor
- Moderate or high complexity renal tumor (RENAL Nephrometry Score (NS) >7)
- Da Vinci® surgical system available for the surgery
- Patient affiliated to the French social security system or an equivalent system
- Signed informed consent form UroCCR and ACCURATE
Критерии исключения
- Medical contraindication to RAPN
- Renal insufficiency forbidding iodine injection
- Patient with allergy to iodinated contrast products
- Patient concerned by articles L1121-5 to 8 of the French public health code (protected persons)
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Распределение
- Рандомизированное
- Модель
- Параллельные группы
- Маскирование
- Простое слепое
- Основная цель
- Лечение
Центры проведения
Франция · 2 центра
- University Hospital Grenoble — Grenoble
- university HospitalGrenoble — Grenoble
Публикации
- Michiels C, Khene ZE, Prudhomme T, Boulenger de Hauteclocque A, Cornelis FH, Percot M, Simeon H, Dupitout L, Bensadoun H, Capon G, Alezra E, Estrade V, Bladou F, Robert G, Ferriere JM, Grenier N, Doumerc N, Bensalah K, Bernhard JC. 3D-Image guided robotic-assisted partial nephrectomy: a multi-institutional propensity score-matched analysis (UroCCR study 51). World J Urol. 2023 Feb;41(2):303-313. d PMID 33811291
- Porpiglia F, Checcucci E, Amparore D, Piramide F, Volpi G, Granato S, Verri P, Manfredi M, Bellin A, Piazzolla P, Autorino R, Morra I, Fiori C, Mottrie A. Three-dimensional Augmented Reality Robot-assisted Partial Nephrectomy in Case of Complex Tumours (PADUA >/=10): A New Intraoperative Tool Overcoming the Ultrasound Guidance. Eur Urol. 2020 Aug;78(2):229-238. doi: 10.1016/j.eururo.2019.11.024. E PMID 31898992
- Long JA, Fiard G, Giai J, Teyssier Y, Fontanell A, Overs C, Poncet D, Descotes JL, Rambeaud JJ, Moreau-Gaudry A, Ittobane T, Bouzit A, Bosson JL, Lanchon C. Superselective Ischemia in Robotic Partial Nephrectomy Does Not Provide Better Long-term Renal Function than Renal Artery Clamping in a Randomized Controlled Trial (EMERALD): Should We Take the Risk? Eur Urol Focus. 2022 May;8(3):769-776. doi: PMID 33931361
Идентификаторы
NCT: NCT05572216 · EssaiClinique_ACCURATE