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Stapler Hepatectomy for Elective Liver Resection (CRUNSH)

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ClinicalTrials.gov Identifier: NCT01049607
Recruitment Status : Completed
First Posted : January 14, 2010
Last Update Posted : May 17, 2013
Information provided by (Responsible Party):
Nuh Rahbari, Heidelberg University

Brief Summary:
There is clinical uncertainty and ongoing discussion among liver surgeons regarding the optimal method of parenchymal transection in patients undergoing elective hepatic resection. While the clamp-crushing technique still represents the reference technique for routine liver resections, transection of liver parenchyma using vascular staplers may offer a new and safe technique potentially reducing intraoperative blood loss, operation time as well as peri-operative morbidity. As morbidity of patients undergoing hepatic resection remains high, approaches to lower peri-operative complications are urgently required. Due to the lack of evidence it has to be evaluated, if the technique of stapler hepatectomy decreases intraoperative blood loss as a highly relevant predictor of peri-operative complications, patients' hospital stay and finally health care expenditures. These advantages would favor stapler hepatectomy to be applied in routine liver resections. As RCTs are generally considered to generate the most valid scientific evidence on a treatment's effects, the present trial evaluates potential benefits of stapler hepatectomy in a randomized fashion.

Condition or disease Intervention/treatment Phase
Hepatic Resection Procedure: Clamp-Crush technique Procedure: Stapler hepatectomy Phase 3

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 130 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Clamp-Crushing vs. Stapler Hepatectomy for Transection of the Parenchyma in Elective Hepatic Resection: CRUNSH - A Randomized Controlled Trial
Study Start Date : January 2010
Actual Primary Completion Date : October 2011
Actual Study Completion Date : March 2012

Arm Intervention/treatment
Active Comparator: Clamp-Crush technique Procedure: Clamp-Crush technique
The transectional line is marked and the liver capsule is cauterized. The liver parenchyma is then crushed stepwise using a regular Pèan clamp. Vessels and bile ducts are ligated or clipped. Vessels of less than 2mm diameter are coagulated with the irrigated bipolar forceps.

Experimental: Stapler hepatectomy Procedure: Stapler hepatectomy
The transectional line is marked and the liver capsule is cauterized. For subsequent transection of the hepatic parenchyma, the liver tissue is fractured with a vascular clamp in a stepwise fashion and subsequently divided with endo GIA vascular staplers.

Primary Outcome Measures :
  1. Intraoperative blood loss [ Time Frame: 2.5 hours ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patients scheduled for elective hepatic resection
  • Stapler hepatectomy and clamp-crushing feasible based on preoperative imaging
  • Age equal or greater than 18 years
  • Informed consent

Exclusion Criteria:

  • Participation in concurrent intervention trials
  • Expected lack of compliance
  • Impaired mental state or language problems

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01049607

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Department of General, Visceral and Transplantation Surgery, University of Heidelberg
Heidelberg, BW, Germany, 69120
Sponsors and Collaborators
Nuh Rahbari
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Principal Investigator: Jürgen Weitz, MD, MSc Department of General, Visceral and Transplantation Surgery, University of Heidelberg
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Nuh Rahbari, M.D. Resident, Heidelberg University
ClinicalTrials.gov Identifier: NCT01049607    
Other Study ID Numbers: NNR-03
First Posted: January 14, 2010    Key Record Dates
Last Update Posted: May 17, 2013
Last Verified: May 2013
Keywords provided by Nuh Rahbari, Heidelberg University:
Patients undergoing hepatic resection