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Ureteral Reimplantation for the Treatment of Extrinsic Malignant Ureteral Obstruction

Conditions
Ureteral Obstruction
Interventions
Procedure: Laparoscopic ureteral re-implantation.
Registration Number
NCT02160652
Lead Sponsor
Rabin Medical Center
Brief Summary

A single center single arm prospective study, assessing the outcome of ureteral re-implantation for malignant ureteral obstruction.

Detailed Description

The Research Question: Is laparoscopic ureteral re-implantation, for the treatment of malignant ureteral obstruction, associated with high patency rates, low complication rates, and a significant improvement in quality of life?

Study design: A single center single arm prospective study, assessing the outcome of ureteral re-implantation for malignant ureteral obstruction.

Study population: Patients with malignant ureteral obstruction, treated with laparoscopic ureteral re-implantation, who have a life expectancy of over 6 months and are willing and able to participate in the study.

Intervention: Laparoscopic ureteral re-implantation.

Study Time line: This will be a 1 year study. At initiation a baseline physical exam, blood test, and ultrasonography will be performed. Baseline quality of life questionnaires will be filled. After the operation, Follow-up visits will occur at 1, 3, 6 and 12 months after surgery. At each follow up visit a medical history and physical examination, blood tests and quality of life questionnaires will be performed. At 3, 6 and 12 months renal ultrasonography will be performed.

Primary Endpoint: Ureteral patency at 6 months following treatment - assessed by stable or improved hydronephrosis and estimated glomerular filtration rate (eGFR) according to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation.

Study impact: Current treatments for malignant ureteral obstruction with nephrostomy tubes negatively impact the patient's quality of life. The findings of the current study may support the use of laparoscopic ureteral re-implantation for the treatment of malignant ureteral obstruction, if patency is preserved, and quality of life is improved, following the procedure.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
50
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
PatientsLaparoscopic ureteral re-implantation.Patients with malignant ureteral obstruction, treated with laparoscopic ureteral re-implantation, who have a life expectancy of over 6 months and are willing and able to participate in the study.
Primary Outcome Measures
NameTimeMethod
Ureteral patency - 6 months6 months following the operation

Ureteral patency at 6 months following the operation- assessed by stable or improved hydronephrosis and estimated GFR according to the CKD-EPI equation.

Secondary Outcome Measures
NameTimeMethod
Ureteral patency - 12 months12 months following the operation

Ureteral patency at 12 months following the operation.

Post-operative complications1, 3, 6, and 12-months following the operation

Post-operative complications 1, 3, 6, and12-months following the operation

Quality of life1,3,6, and 12 months following the operation

Changes in quality of life at 1,3, 6 and 12 months following the operation. Quality of life will be evaluated using two questionnaires:

* Functional Assessment of Cancer Therapy scale - General (FACT-G).

* Intervention specific questionnaire based on Joshi et al. ()

Re-intervention12 months following the operation

Re-interventions following the operation.

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