Department of Urology, Nanjing First Hospital, Nanjing Medical University, Nangjing, Jiangsu, China.
Nuclear Medicine Center, Nanjing First Hospital, Nanjing Medical University, Nangjing, Jiangsu, China.
BMJ Open. 2020 May 26;10(5):e032002. doi: 10.1136/bmjopen-2019-032002.
Renal ischaemia reperfusion injury is an inevitable pathophysiology in different clinical situations including laparoscopic partial nephrectomy (LPN), which can obviously decrease the renal function after surgery. Pneumoperitoneum preconditioning (PP) is a promising approach that can yield a protective effect on kidney, which has already been demonstrated in some animal models. The present study is designed to assess whether the PP can yield a clinical renoprotective role after LPN.
This study is a randomised, prospective, double-blind and parallel controlled clinical trial. Eligible participants will be patients with renal tumours and willing to choose elective LPN. Patients randomised to the treatment arm will receive PP consisted of three cycles of 5 min insufflation and 5 min desufflation before LPN, while the control arm will receive a sham operation. The primary endpoints are glomerular filtration rate and the level of serum cystatin C within 6 months after desufflation. The secondary endpoints are serum creatinine, estimated glomerular filtration rate, alanine transaminase, serum amylase, intestinal fatty acid binding protein, postoperative hospital stay, the incidence of adverse events and mortality in postoperative 6 months.
This study has been approved by the institutional ethics committee of Nanjing First Hospital. The results of this study will be reported faithfully through scientific conferences or published articles.
NCT03822338.
肾缺血再灌注损伤是包括腹腔镜部分肾切除术(LPN)在内的不同临床情况下不可避免的病理生理学过程,它会明显降低术后的肾功能。气腹预处理(PP)是一种很有前途的方法,可以对肾脏产生保护作用,这在一些动物模型中已经得到了证实。本研究旨在评估 PP 是否能在 LPN 后产生临床肾脏保护作用。
这是一项随机、前瞻性、双盲、平行对照的临床试验。符合条件的参与者将是患有肾肿瘤并愿意选择择期 LPN 的患者。随机分到治疗组的患者将接受三次 5 分钟充气和 5 分钟放气的 PP,而对照组将接受假手术。主要终点是充气后 6 个月内肾小球滤过率和血清胱抑素 C 水平。次要终点是血清肌酐、估算肾小球滤过率、丙氨酸氨基转移酶、血清淀粉酶、肠脂肪酸结合蛋白、术后住院时间、术后 6 个月内不良事件和死亡率。
本研究已获得南京第一医院机构伦理委员会的批准。研究结果将通过科学会议或发表文章如实报告。
NCT03822338。