Blocking the descending branch of uterine artery in cervical conization

ISRCTN ISRCTN50443832
DOI https://doi.org/10.1186/ISRCTN50443832
Secondary identifying numbers N/A
Submission date
15/09/2013
Registration date
15/10/2013
Last edited
16/10/2013
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Urological and Genital Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Cervical cancer is the third most common gynecological cancer but the stage called Cervical intraepithelial neoplasia (CIN) is curable with resection. Screening tests have become more common and are the main way of preventing cervical cancer. The microscopic examination of cells scraped off the cervical epithelium (Pap smear test) gives important screening information and grades CIN from 1 to 3. The removal of a cone-shaped section of the cervix with a blade (called a cold knife conization) is the main surgical procedure for premalignant lesions of the cervix, especially for those young patients who wish to have children later.
Bleeding is an important aspect of the procedure. The descending branch of the uterine artery is the main blood supply for the cervix. Conization normally takes about 10-15 minutes, so blocking the descending branch of uterine artery temporarily may be a simple but convenient, effective and safe way of reducing bleeding and facilitating the procedure. This is the aim of the study.

Who can participate?
Our trial aims to recruit about 100 female patients in the Department of Obstetrics and Gynecology of Shengjing Hospital, aged between 18 and 65, who have CIN2 with a large area of lesion or invading the glands, or who have CIN3 and want to have children.

What does the study involve?
The study will involve 100 female patients who will randomly allocated to one of two groups: a control group or an experimental group. The control group will receive conventional cold knife conization only. The experimental group will receive cold knife conization and blocking of the descending branch of uterine artery
During the procedure, we will compare the amount of blood loss in each group. After the operation and at follow-up, we will compare the cure rate, recurrence rate, and the rate of complications (such as abnormal post-operative bleeding, infection, bladder injury, incompetent cervix and cervical stenosis) in each group.

What are the possible benefits and risks of participating?
There will be no immediate direct benefit to those taking part. But patients in the experimental group will benefit from the modification of the procedure (less blood loss, shorter operation time and fewer post-operative complications). This may also help standardize cold knife conization.
Risks involve damage to the arterial branches by mistake, leading to bleeding and hematomas and damage to the bladder but measures are in place to minimize such risks.

Where is the study run from?
This study has been set up by the Department of Obstetrics and Gynecology of Shengjing Hospital of China Medical University (China).

When is the study starting and how long is it expected to run for?
The study will start in November 2013 and will run for 8 months, or until the required number of 100 participants have been recruited. The study will continue as we follow up participants’ long-term prognosis and complications.

Who is funding the study?
New Technology Project of Shengjing Hospital of China Medical University (China).

Who is the main contact?
Professor Dan-Bo Wang
wangdbsj@gmail.com

Contact information

Prof Dan-Bo Wang
Scientific

Department of Obstetrics and Gynecology
Shengjing Hospital of China Medical University
36 Sanhao Street
Shenyang
110004
China

Study information

Study designProspective randomized trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleBlocking the descending branch of uterine artery in cervical conization: a randomized controlled trial
Study objectivesBlocking the descending branch of uterine artery temporarily is an effective measure to reduce bleeding and to facilitate surgery during cold knife conization of the cervix.
Ethics approval(s)Approved by Ethics Committee of Shengjing Hospital of China Medical University
Health condition(s) or problem(s) studiedCervical intraepithelial neoplasia
InterventionBlocking the descending branch of uterine artery.The study will involve 100 female patients who will be randomized to either a control group or an experimental group:

1. The control group will receive conventional cold knife conization only.
2. The experimental group will receive cold knife conization and blocking of the descending branch of uterine artery.

Follow-up is required for all participants. Repeat Pap smears, colposcopy and HPV DNA testing are carried out 2 months after the operation. Pap smear and HPV DNA testing are carried out every 6 months for 2 years.
Intervention typeOther
Primary outcome measureHemorrhage during surgery measured by evaluating the volume (ml) of blood loss during procedure
Secondary outcome measures1. Operation time
2. The cure rate at follow-up
3. The recurrence rate at follow-up
4. The rate of postoperative complications: abnormal post-operative bleeding, infection, bladder injury, incompetent cervix and cervical stenosis
Overall study start date01/11/2013
Completion date01/07/2014

Eligibility

Participant type(s)Patient
Age groupAdult
SexFemale
Target number of participants100
Key inclusion criteriaAll cases that meet the criteria for cold knife conization:
1. Patients who have CIN2 with a large area of lesion or invading the glands
2. Patients who have CIN3 and want to have children
Key exclusion criteria1. Patients with contraindications
2. Patients who have previously undergone cervical surgery (which has an impact on the anatomy of the cervix and the ureter)
Date of first enrolment01/11/2013
Date of final enrolment01/07/2014

Locations

Countries of recruitment

  • China

Study participating centre

Department of Obstetrics and Gynecology
Shenyang
110004
China

Sponsor information

Shengjing Hospital of China Medical University (China)
Hospital/treatment centre

36 Sanhao Street
Shenyang
110004
China

ROR logo "ROR" https://ror.org/0202bj006

Funders

Funder type

Hospital/treatment centre

New Technology Project of Shengjing Hospital of China Medical University, China

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan