Factors affecting renal function preservation among patients not achieving trifecta after laparoscopic partial nephrectomy for clinical T1a renal masses

2019 ◽  
Vol 13 (4) ◽  
pp. 526-531
Author(s):  
Toshikazu Takeda ◽  
Akari Komatsuda ◽  
Yoshinori Yanai ◽  
Nobuyuki Tanaka ◽  
Kazuhiro Matsumoto ◽  
...  
Keyword(s):  
Renal Function ◽  
Partial Nephrectomy ◽  
Laparoscopic Partial Nephrectomy ◽  
Renal Masses ◽  
Factors Affecting ◽  
Function Preservation

scholarly journals Ipsilateral renal function preservation following minimally invasive partial nephrectomy: The effect of tumour characteristics and warm ischemic time

2017 ◽  
Vol 11 (10) ◽  
pp. 344-9 ◽  
Author(s):  
Ernest Chan ◽  
Shawna L. Boyle ◽  
Jeffrey Campbell ◽  
Patrick P.W. Luke
Keyword(s):  
Renal Function ◽  
Minimally Invasive ◽  
Partial Nephrectomy ◽  
Renal Parenchyma ◽  
Renal Masses ◽  
Ischemic Time ◽  
Warm Ischemic Time ◽  
Nephrometry Score ◽  
Function Preservation ◽  
Collecting System

Introduction: The relative impact of preoperative and perioperative variables on renal function following partial nephrectomy (PN) is controversial. To further investigate, we assess the effects of tumour complexity, warm ischemic time (WIT), and volume of resected renal parenchyma on ipsilateral renal function (IRF) outcomes following minimally invasive PN.Methods: Of patients who underwent laparoscopic or roboticassisted PN between 2002 and 2011 at our institution, 99 met our inclusion criteria. The effects of preoperative tumour complexity (using RENAL nephrometry score), perioperative WIT, and pathological tumour volumes on ipsilateral renal function preservation (%IRF) were analyzed. %IRF was defined as the proportion of postoperative to preoperative ipsilateral renal function calculated using MAG3 nuclear renography.Results: Increasing RENAL nephrometry score (RNS) and WIT were independently predictive of inferior %IRF at 6‒12-week postoperative followup in univariate and multivariate analyses. Of RNS properties, masses that were endophytic, near the collecting system, or central in location were associated with inferior %IRF, with nearness to collecting system as the strongest predictor; however, RNS was no longer predictive of %IRF in cases requiring more than 30 minutes of WIT.Conclusions: In renal masses amenable to resection by minimally invasive PN, longer WIT was the most important predictor of inferior %IRF. Although increasing RNS score influenced %IRF, the overall clinical significance of RNS is limited and should not influence operative decision-making in efforts to preserve renal function. Furthermore, small volumes of renal parenchyma can be safely resected without impairment of long-term IRF.

scholarly journals Early vascular unclamping reduces warm ischaemia time in robot-assisted laparoscopic partial nephrectomy

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 108 ◽  
Author(s):  
Kevin Lah ◽  
Devang Desai ◽  
Charles Chabert ◽  
Christian Gericke ◽  
Troy Gianduzzo
Keyword(s):  
Renal Function ◽  
Partial Nephrectomy ◽  
Positive Margin ◽  
Laparoscopic Partial Nephrectomy ◽  
Robot Assisted ◽  
Renal Masses ◽  
Warm Ischaemia ◽  
Ischaemia Time ◽  
Patient Series ◽  
Warm Ischaemia Time

Introduction: The aim of this study was to assess the outcomes of early vascular release in robot-assisted laparoscopic partial nephrectomy (RAPN) to reduce warm ischaemia time (WIT) and minimise renal dysfunction. RAPN is increasingly utilised in the management of small renal masses. To this end it is imperative that WIT is kept to a minimum to maintain renal function.Methods: RAPN was performed via a four-arm robotic transperitoneal approach. The renal artery and vein were individually clamped with robotic vascular bulldog clamps to allow cold scissor excision of the tumour. The cut surface was then sutured with one or two running 3-0 V-LocTM sutures, following which the vascular clamps were released. Specific bleeding vessels were then selectively oversewn and the collecting system repaired. Renorrhaphy was then completed using a running horizontal mattress 0-0 V-LocTM suture.Results: A total of 16 patients underwent RAPN with a median WIT of 15 minutes (range: 8-25), operative time 230 minutes (range: 180-280) and blood loss of 100 mL (range: 50-1000). There were no transfusions, secondary haemorrhages or urine leaks. There was one focal positive margin in a central 5.5 cm pT3a renal cell carcinomas (RCC). Long-term estimated glomerular filtration rate (eGFR) was not significantly different to pre-operative values.Conclusion: In this patient series, early vascular release effectively minimised WIT and maintained renal function without compromising perioperative safety.

FACTORS AFFECTING RENAL FUNCTION AFTER LAPAROSCOPIC PARTIAL NEPHRECTOMY

2008 ◽  
Vol 179 (4S) ◽  
pp. 476-476
Author(s):  
Kazumi Kamoi ◽  
Monish Aron ◽  
Burak Turna ◽  
Georges-Pascal Haber ◽  
Andre Berger ◽  
...  
Keyword(s):  
Renal Function ◽  
Partial Nephrectomy ◽  
Laparoscopic Partial Nephrectomy ◽  
Factors Affecting

scholarly journals Split renal function after treatment of small renal masses: comparison between radiofrequency ablation and laparoscopic partial nephrectomy

2020 ◽  
pp. 028418512095628
Author(s):  
Vanessa Acosta Ruiz ◽  
Sarah Båtelsson ◽  
Elina Onkamo ◽  
Lisa Wernroth ◽  
Thomas Nilsson ◽  
...  
Keyword(s):  
Renal Function ◽  
Radiofrequency Ablation ◽  
Partial Nephrectomy ◽  
Ct Images ◽  
Laparoscopic Partial Nephrectomy ◽  
Renal Tumors ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Split Renal Function ◽  
Pre Treatment

Background Radiofrequency ablation (RFA) and laparoscopic partial nephrectomy (LPN) are used to treat small renal masses (SRM; ≤4 cm), although there are conflicting results in the changes in creatinine and estimated glomerular filtration rate (eGFR) after treatment. On contrast-enhanced computed tomography (CE-CT) images, the quantity and quality of renal function can be evaluated by calculating the split renal function (SRF). Purpose To compare renal function after RFA or LPN treatment of SRMs through evaluation of the SRF in the affected kidney. Material and Methods Single T1a renal tumors successfully treated with RFA (n = 60) or LPN (n = 31) were retrospectively compared. The SRF was calculated on pre-treatment CE-CT images and the first follow-up exam after completed treatment. Serum creatinine and eGFR values were collected simultaneously. To compare renal function outcomes, Student’s t-test and multivariable linear regression models (adjusted to RFA/LPN treatment, pre-treatment SRF/eGFR, BMI, age, tumor characteristics, and Charlson Comorbidity Index) were used. Results SRF was reduced in both groups, although reduction was greater in the LPN group (LPN –5.7%) than in the RFA group (RFA –3.5%; P = 0.013). After adjusted analysis, the LPN group still had greater SRF reduction (difference 3.2%, 95% confidence interval 1.3–1.5; P = 0.001). There was no difference between groups in the change of creatinine/eGFR after treatment. Conclusion Both RFA and LPN are nephron-sparing when treating SRMs. However, in this series, reduction of SRF in the affected kidney was smaller after RFA, having a more favorable preservation of renal function than LPN.

875: The Effect of Warm Ischemic Time on the Ipsilateral Renal Function after Laparoscopic Partial Nephrectomy

2006 ◽  
Vol 175 (4S) ◽  
pp. 282-283
Author(s):  
Shigeta Masanobu ◽  
Koji Mita ◽  
Tsuguru Usui ◽  
Kazushi Marukawa ◽  
Toshihiro Tachikake
Keyword(s):  
Renal Function ◽  
Partial Nephrectomy ◽  
Laparoscopic Partial Nephrectomy ◽  
Ischemic Time ◽  
Warm Ischemic Time

scholarly journals Comparison of Video-Assisted Minilaparotomy, Open, and Laparoscopic Partial Nephrectomy for Renal Masses

2012 ◽  
Vol 53 (1) ◽  
pp. 151 ◽  
Author(s):  
Hwang Gyun Jeon ◽  
Kyung Hwa Choi ◽  
Kwang Hyun Kim ◽  
Koon Ho Rha ◽  
Seung Choul Yang ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Laparoscopic Partial Nephrectomy ◽  
Renal Masses ◽  
Video Assisted
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