Efficacy and Safety of Posterior Retroperitoneoscopic Adrenalectomy: A Comparative Study (PostLapAdrnl)
|ClinicalTrials.gov Identifier: NCT02618694|
Recruitment Status : Completed
First Posted : December 1, 2015
Last Update Posted : March 3, 2017
|Condition or disease||Intervention/treatment|
|Adrenal Mass Adrenal Disease Pheochromocytoma Cushing Syndrome||Procedure: Posterior retroperitoneoscopic adrenalectomy Procedure: Transperitoneal laparoscopic adrenalectomy|
Show Detailed Description
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||13 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||Double (Participant, Investigator)|
|Official Title:||Posterior Retroperitoneoscopic Approach Versus Transperitoneal Laparoscopic Approach in Management of Adrenal Tumors: A Randomized Comparative Study|
|Study Start Date :||April 2015|
|Primary Completion Date :||June 2016|
|Study Completion Date :||December 2016|
Experimental: Group 1
patient had posterior retroperitoneoscopic adrenalectomy
Procedure: Posterior retroperitoneoscopic adrenalectomy
Patient is in prone, half Jack-knife position, and hips and knees are fixed in 75-90°. A 15 mm trocar incision just below the tip 12th rib. Prepare a small retroperitoneal space with finger and insert two 5 mm trocars about 5 cm lateral and medial to the first trocar with digital guidance. Medial trocar will be inserted upward. Lateral one will be lateral and below the 11th rib. Dissect inferior to diaphragm and retraction of the kidney downward. Mobilize the adrenal gland. At right side, start medial and caudally. Control the adrenl arteries crossing the IVC posteriorly. Prepare adrenal vein posterolaterally. Control between two clips. Continue gland dissection laterally and cranially. At left side, prepare the adrenal vein between the gland and diaphragm medial to the upper pole of the kidney. Dissect medial, lateral and cranially. Retrieve the mass through middle incision. Insert a drain and close skin incisions (Walz M. K., 2005).
Other Name: Posterior retroperitoneal laparoscopic adrenalectomy
Active Comparator: Group 2
patient had Transperitoneal laparoscopic adrenalectomy
Procedure: Transperitoneal laparoscopic adrenalectomy
On right side, patient is on supine position. Put a trocar at umbilicus for the camera. Put 4 trocars 1-2 cm subcostal from subxiphoid (10-12 mm) for liver retractor, to far lateral (5 mm) and two 10 mm trocars inbetween. Retract liver, incise the retroperitoneum, and identify right adrenal gland between upper pole of the kidney and IVC. Dissect gland from the kidney than laterally and posteriorly from the diaphragm. Expose, apply clips to, and divide the adrenal vein. On left side, patient is on lateral decubitus. Put a trocar at umbilicus for the camera, 4 trocars 1-2 cm subcostal from the midline to the far most lateral possible (the last is 5 mm the rest are 10 mm). Mobilize colon flexure and expose the kidney. Separate kidney from the pancreas and spleen. Mobilize the tumor, starting by posterior surface, superior border then from the renal surface. Divide the adrenal vein. Retrieve the mass (Suzuki, Tsuru, & Ihara, 2012; Linos, 2005; George & Kavoussi, 2010).
- Mean operative time [ Time Frame: 1 year ]total time from the first abdominal incision to the last suture, and the time elapsed to identify the adrenal vein, a critical step at the operation.
- Mean amount of intraoperative blood loss [ Time Frame: 1 year ]measured in milliliters.
- Mean days of postoperative hospital stay [ Time Frame: 1 year ]include the number of days to full diet, to mobilization and to complete recovery; i.e. return to usual daily activity.
- Rate of complications [ Time Frame: 1.5 year ]classified by Clavien-Dindo classification system
- Mean of postoperative pain score [ Time Frame: 1 year ]using visual analogue scale or face scale score (according to participant's level of education)
- mean of scar cosmetic assessment score [ Time Frame: 1.1 year ]The patient satisfaction of the scar will be assessed by THE SUM of scores of three questionnaires; body image questionnaire score + photo series questionnaire score + future surgical procedure preference questionnaire score
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02618694
|Alexandria Main University Hospital|
|Alexandria, Egypt, 21500|
|Suez Canal University Hospital|
|Study Chair:||Sami M Shaaban, Professor||Suez Canal University - Department of Urology and Andrology|
|Study Director:||Haitham M Badawy, PhD||Alexandria University - Department of Urology|
|Study Director:||Tamer H Abou-Youssif, PhD||Alexandria University - Department of Urology|