Laparoscopic versus open resections in the posterosuperior liver segments within an enhanced recovery programme (ORANGE Segments): study protocol for a multicentre randomised controlled trial.
Author
Kuemmerli, ChristophFichtinger, Robert S
Moekotte, Alma
Aldrighetti, Luca A
Aroori, Somaiah
Besselink, Marc G H
D'Hondt, Mathieu
Díaz-Nieto, Rafael
Edwin, Bjørn
Efanov, Mikhail
Ettorre, Giuseppe M
Menon, Krishna V
Sheen, Aali J
Soonawalla, Zahir
Sutcliffe, Robert
Troisi, Roberto I
White, Steven A
Brandts, Lloyd
van Breukelen, Gerard J P
Sijberden, Jasper
Pugh, Siân A
Eminton, Zina
Primrose, John N
van Dam, Ronald
Hilal, Mohammed Abu
Publication date
2022-03-09
Metadata
Show full item recordAbstract
Background: A shift towards parenchymal-sparing liver resections in open and laparoscopic surgery emerged in the last few years. Laparoscopic liver resection is technically feasible and safe, and consensus guidelines acknowledge the laparoscopic approach in the posterosuperior segments. Lesions situated in these segments are considered the most challenging for the laparoscopic approach. The aim of this trial is to compare the postoperative time to functional recovery, complications, oncological safety, quality of life, survival and costs after laparoscopic versus open parenchymal-sparing liver resections in the posterosuperior liver segments within an enhanced recovery setting. Methods: The ORANGE Segments trial is an international multicentre randomised controlled superiority trial conducted in centres experienced in laparoscopic liver resection. Eligible patients for minor resections in the posterosuperior segments will be randomised in a 1:1 ratio to undergo laparoscopic or open resections in an enhanced recovery setting. Patients and ward personnel are blinded to the treatment allocation until postoperative day 4 using a large abdominal dressing. The primary endpoint is time to functional recovery. Secondary endpoints include intraoperative outcomes, length of stay, resection margin, postoperative complications, 90-day mortality, time to adjuvant chemotherapy initiation, quality of life and overall survival. Laparoscopic liver surgery of the posterosuperior segments is hypothesised to reduce time to functional recovery by 2 days in comparison with open surgery. With a power of 80% and alpha of 0.04 to adjust for interim analysis halfway the trial, a total of 250 patients are required to be randomised. Discussion: The ORANGE Segments trial is the first multicentre international randomised controlled study to compare short- and long-term surgical and oncological outcomes of laparoscopic and open resections in the posterosuperior segments within an enhanced recovery programme. Trial registration: ClinicalTrials.gov NCT03270917 . Registered on September 1, 2017. Before start of inclusion. Protocol version: version 12, May 9, 2017.Citation
Kuemmerli C, Fichtinger RS, Moekotte A, Aldrighetti LA, Aroori S, Besselink MGH, D'Hondt M, Díaz-Nieto R, Edwin B, Efanov M, Ettorre GM, Menon KV, Sheen AJ, Soonawalla Z, Sutcliffe R, Troisi RI, White SA, Brandts L, van Breukelen GJP, Sijberden J, Pugh SA, Eminton Z, Primrose JN, van Dam R, Hilal MA; ORANGE trials collaborative. Laparoscopic versus open resections in the posterosuperior liver segments within an enhanced recovery programme (ORANGE Segments): study protocol for a multicentre randomised controlled trial. Trials. 2022 Mar 9;23(1):206. doi: 10.1186/s13063-022-06112-Type
ArticleAdditional Links
https://trialsjournal.biomedcentral.com/PMID
35264216Journal
TrialsPublisher
BioMed Centralae974a485f413a2113503eed53cd6c53
10.1186/s13063-022-06112-3