Renal function is the same 6 months after robot-assisted partial nephrectomy regardless of clamp technique: analysis of outcomes for off-clamp, selective arterial clamp and main artery clamp techniques, with a minimum follow-up of 1 year

2015 ◽  
Vol 115 (6) ◽  
pp. 921-928 ◽  
Author(s):  
Christos Komninos ◽  
Tae Young Shin ◽  
Patrick Tuliao ◽  
Woong Kyu Han ◽  
Byung Ha Chung ◽  
...  
2013 ◽  
Vol 7 (9-10) ◽  
pp. 348 ◽  
Author(s):  
Guillaume Ploussard ◽  
Richard Haddad ◽  
Evan Kovac ◽  
Patrick Richard ◽  
Maurice Anidjar ◽  
...  

Background: Although robot-assisted partial nephrectomy (RALPN) has been increasingly adopted, open procedures continue to be the reference nephron-sparing technique. We describe our initial surgical outcomes of RALPN in our single institution robotic program.Methods: Between January 2011 and February 2013, 65 consecutive patients underwent a RALPN by 2 surgeons. Preoperative characteristics, including the R.E.N.A.L. nephrometry score, perioperative parameters, and postoperative course, including renal function, were assessed from a retrospective database. The mean follow-up was 12 months.Results: The mean age was 60.2 years and the mean tumour size was 3.9 cm. According to the R.E.N.A.L. nephrometry score, the tumours were classified moderately and highly complex tumours in 51% and 18.5% of cases, respectively. Median warm ischemia time (WIT) was 21 minutes. Factors associated with WIT were R.E.N.A.L. nephrometry score, tumour size, complication rates and surgeon experience. No conversion or grade 4 to 5 complications were reported. The mean hospital stay was 3 days. The overall complication rate was 24.6% (re-admission rate 7.7%), and decreased to 12% after 20 cases. After these initial 20 cases, a trifecta rate (no margins, preserved renal function, no complications) of 64.3% was achieved in moderately and highly complex tumours. The mean change in estimated glomerular filtration rate was 6.7 mL/min without severe postoperative renal failure.Interpretation: RALPN is a safe and feasible procedure with low specific morbidity, even in moderately or highly complex renal masses. The WIT depends on tumour characteristics, mainly determined by the R.E.N.A.L. nephrometry score and is improved by surgeon experience. Longer follow-up is needed to assess the oncologic mid-term safety of the procedure. 


2015 ◽  
Vol 29 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Kazushi Tanaka ◽  
Junya Furukawa ◽  
Katsumi Shigemura ◽  
Nobuyuki Hinata ◽  
Takeshi Ishimura ◽  
...  

2014 ◽  
Vol 8 (11-12) ◽  
pp. 810 ◽  
Author(s):  
Jeong Woo Lee ◽  
Sung Yong Cho ◽  
Chanhoo Jeon ◽  
Kyungtae Ko ◽  
Hyeon Hoe Kim

Introduction: We evaluated the the association between PADUA scores and postoperative renal function (after robot-assisted partial nephrectomy [RAPN]) and between PADUA scores and warm ischemic time (during RAPN).Methods: We reviewed the clinical records of 106 patients who underwent RAPN for a single localized renal tumour between April 2009 and June 2012. Postoperative renal function was evaluated using estimated glomerular filtration rate (eGFR) in 85 patients who were followed for at least 6 months. PADUA scores for renal tumours were calculated using contrast-enhanced computed tomography images, if needed, along with magnetic resonance images in some cases.Results: A PADUA score ≥10 and WIT ≥30 minutes were observed in 18 (17.0%) and 51 (48.1%) cases, respectively. PADUA scores were significantly correlated with WIT (p = 0.019) and percent change in eGFR at 6 months postoperatively (p = 0.005). PADUA score (continuous variable, odds ratio [OR] 1.694, p = 0.007) and the high-risk group (PADUA score ≥10) (OR 5.429; p = 0.020) were significantly associated with a WIT of ≥30 minutes by multivariate analysis. A 1-point increase in the PADUA score was associated with an eGFR decrease of >20% at 6 months after RAPN (OR 1.799; p = 0.076). In addition, a PADUA score ≥10, or high risk, (OR 13.965; p = 0.003) was an independent predictor of an eGFR decrease of >20% at 6 months after RAPN.Conclusions: The PADUA classification can reliably predict WIT and postoperative renal functional outcome after RAPN. Furthermore, the study suggests that anatomical aspects of renal tumours are associated with functional outcome after RAPN.


2018 ◽  
Vol 26 (3) ◽  
pp. 377-384 ◽  
Author(s):  
Young Dong Yu ◽  
Ngoc Ha Nguyen ◽  
Ho Young Ryu ◽  
Sung Kyu Hong ◽  
Seok‐Soo Byun ◽  
...  

2019 ◽  
Vol 201 (Supplement 4) ◽  
Author(s):  
Takashi Ikeda* ◽  
Toshio Takagi ◽  
Hiroki Ishihara ◽  
Hironori Fukuda ◽  
Kazuhiko Yoshida ◽  
...  

Cureus ◽  
2021 ◽  
Author(s):  
Deepak Raghavan ◽  
Mathisekaran Thangarasu ◽  
Sanjay Prakash J ◽  
Rajesh Paul ◽  
Nivash Selvaraj

2007 ◽  
Vol 6 (2) ◽  
pp. 266
Author(s):  
C. Schwentner ◽  
A. Lunacek ◽  
A. Pelzer ◽  
H. Steiner ◽  
R. Neururer ◽  
...  

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