Cabestany

Minimally invasive surgery has greatly changed surgical practices since the 1980s, especially in urology where laparoscopy and robot-assisted surgery have advanced treatment of conditions like prostate cancer. In France and other countries, robotic surgery became widespread without strong studies confirming its benefits or guidelines on quality and access. This trial aims to carefully evaluate robot-assisted prostate removal compared to traditional laparoscopic and open surgery techniques to provide clear evidence for patients and healthcare decision-makers. Participants will undergo radical prostatectomy using one of three approaches: robot-assisted laparoscopy, conventional laparoscopy, or open surgery (laparotomy). Urinary and erectile functions will be assessed before and after surgery to compare outcomes across the three groups. This large prospective study is conducted at multiple centers to gather reliable data on the benefits and impacts of each surgical method. During the study, patients will be evaluated for urinary function using the EPIC 50 score 45 days after surgery. Researchers will also assess erectile and urinary functions before and after the prostatectomy. The study focuses on understanding how each surgical technique affects recovery and function, helping to inform patients and health authorities about the real advantages of robot-assisted surgery. Participants must be hospitalized for planned radical prostatectomy and will be monitored throughout their treatment and recovery.

Kidney cancer accounts for 2 to 3% of solid cancers in adults, with around 431,288 new cases worldwide yearly. In France alone, 13,500 patients undergo total or partial nephrectomy annually. Advances in minimally invasive surgery and enhanced recovery programs have shortened hospital stays, but this has changed the care experience for kidney tumor patients, often leading to feelings of decreased care quality and disrupted medical follow-up. The study aims to evaluate a new approach to coordinate perioperative care for patients having nephrectomy for kidney tumors across several French centers, focusing on benefits for patients, caregivers, and the healthcare system. The study is assessing the UroConnect remote monitoring medical device, which includes a patient interface with self-questionnaires and educational materials, and a caregiver interface designed to improve nurse coordination during the perioperative period. This device supports the formalization of a nurse coordinator role that is tailored to the needs of oncological surgery. The intervention involves implementing UroConnect to optimize patient support and nursing coordination throughout the surgical care pathway. Participants will be monitored for 30 days after surgery, with researchers measuring the number of unplanned and uncoordinated healthcare visits during this time. The study collects data through the device and nursing coordination activities to assess its impact on care quality. This approach aims to improve the surgical care pathway for kidney tumor patients by digitizing nursing coordination and enhancing support during recovery.

Researchers are evaluating the use of a capillary medical device to measure C-reactive protein (CRP) in children with fever aged between 0.25 months and 15 years. Fever is a common reason for outpatient visits among children, and distinguishing between viral and bacterial infections can be challenging. Since current CRP test results take several hours and cause delays in treatment, this study aims to assess whether rapid CRP measurement in primary care can reduce unnecessary referrals to emergency laboratories and ease overcrowding in emergency rooms and clinics. The study involves using the ACTIM-CRP device for semi-quantitative measurement of capillary CRP levels in febrile children during primary care visits. Children with fever meeting specific criteria related to fever duration and concern for bacterial infection are included. The intervention is designed to streamline the care pathway for these children by providing faster test results directly in primary care settings. Participants will be monitored for referral rates to facilities equipped for emergency laboratory testing on Day 1 and Day 7 after the initial consultation. The study also tracks treatment decisions and the impact on healthcare utilization. Parents and children will be informed about the study, and consent will be obtained. The overall goal is to improve fever management in children and reduce unnecessary emergency visits, benefiting both families and healthcare systems.

Researchers are investigating whether managing robot-assisted radical prostatectomy as an outpatient procedure is as safe as doing it as an inpatient procedure by comparing early post-operative complications. The study focuses on men with prostate cancer who have been recommended for this surgery and aims to confirm that outpatient care is not inferior to inpatient care in terms of complications occurring within the first 8 days after surgery. The intervention involves robot-assisted radical prostatectomy performed either as outpatient or inpatient care. Participants will undergo the surgical procedure and then follow the assigned care method. The study evaluates early complications occurring from the day of surgery up to 8 days afterward to determine safety and effectiveness between the two groups. Participants will visit the clinic once after the operation at 45 days, 6 months, and then yearly for up to 5 years for ongoing check-ups and tests. During the first 6 months, they will complete surveys on urinary and erectile functions, stress, anxiety, satisfaction, and quality of life. Additionally, participants will keep a diary to record procedures and treatments related to their care. These measures help researchers assess recovery, well-being, and long-term outcomes while monitoring safety throughout the study period.

Thrombotic Micro-angiopathy (TMA) is a serious condition that includes Haemolytic and Uraemic Syndrome (HUS), requiring quick diagnosis and treatment. This study evaluates a therapeutic orientation test designed to detect the involvement of the complement system in TMA diagnosis. The test measures complement deposits on endothelial cells in a lab setting and aims to improve early detection of complement activation, which is important for timely treatment with drugs like Eculizumab that block the complement pathway. The therapeutic orientation test is performed on blood samples collected at three points: at the start of the study, at one month, and at six months. The study compares the test results with patients' clinical outcomes and the presence of abnormalities in complement regulation. This approach helps to assess the test's sensitivity and specificity over an average follow-up period of three years. Participants will undergo diagnostic testing and clinical monitoring throughout the study. Researchers will evaluate how well the test predicts complement involvement and patient evolution, especially in relation to treatment with Eculizumab. The study will use blood tests and clinical data to measure outcomes, tracking participants' health over several years to determine the test’s accuracy and usefulness in managing TMA.

Researchers are investigating kidney cancer through the UroCCR project, a national registry and research network in France dedicated to renal cell carcinoma (RCC). This platform collects detailed clinical, imaging, biological, and patient-reported data on kidney cancer from over 21,000 cases across 58 centers. The study aims to improve understanding of RCC management by integrating multidisciplinary care data, biological samples, and linking with national health datasets to support translational research, clinical evaluation, and social science studies. The study compares two surgical treatments for kidney cancer: radical nephrectomy and partial nephrectomy, with the choice of surgery made according to surgeon judgment. It follows patients over long periods, monitoring outcomes and complications after surgery. This national collaboration includes digital tools like perioperative monitoring and machine learning models to predict recurrence and survival. The network also supports ancillary studies, including retrospective and prospective clinical trials, to advance personalized treatment strategies. Participants provide comprehensive data on their clinical status, treatments, and quality of life. Researchers assess complications at multiple time points: 3, 6, and 12 months post-surgery, then yearly for 5 years, and every 2 years for up to 10 years. The study evaluates real-world outcomes in kidney cancer care, linking clinical information with biological samples and national health data, while ensuring standardized procedures, ethical oversight, and high data quality through robust governance.