Percutaneous ablation or minimally invasive partial nephrectomy for cT1a renal masses? A propensity score‐matched analysis

2021 ◽  
Author(s):  
Lorenzo Bianchi ◽  
Francesco Chessa ◽  
Pietro Piazza ◽  
Amelio Ercolino ◽  
Angelo Mottaran ◽  
...  
Keyword(s):  
Propensity Score ◽  
Minimally Invasive ◽  
Partial Nephrectomy ◽  
Percutaneous Ablation ◽  
Renal Masses

scholarly journals Minimally invasive partial nephrectomy for cT2a Renal Masses: myth or reality?

2020 ◽  
Vol 20 ◽  
pp. S120
Author(s):  
D. Amparore ◽  
F. Piramide ◽  
E. Checcucci ◽  
M. Manfredi ◽  
P. Verri ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Partial Nephrectomy ◽  
Renal Masses

scholarly journals Canadian Update on Surgical Procedures (CUSP) Urology Group consensus for intraoperative hemostasis during minimally invasive partial nephrectomy

2020 ◽  
Vol 14 (9) ◽  
Author(s):  
Douglas C. Cheung ◽  
Christopher J.D. Wallis ◽  
Simon Possee ◽  
Camilla Tajzler ◽  
Maurice Anidjar ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Partial Nephrectomy ◽  
Surgical Procedures ◽  
Delphi Method ◽  
Tumor Resection ◽  
Renal Masses ◽  
Steep Learning Curve ◽  
Modified Delphi ◽  
Laparoscopic Equipment ◽  
Survey Questionnaires

Introduction: Partial nephrectomy remains the gold standard in the management of small renal masses. However, minimally invasive partial nephrectomy (MIPN) is associated with a steep learning curve, and optimal, standardized techniques for time-efficient hemostasis are poorly described. Given the relative lack of evidence, the goal was to describe a set of actionable guiding principles, through an expert working panel, for urologists to approach hemostasis without compromising warm ischemia or oncological outcomes. Methods: A three-step modified Delphi method was used to achieve expert agreement on the best practices for hemostasis in MIPN. Panelists were recruited from the Canadian Update on Surgical Procedures (CUSP) Urology Group, which represent all provinces, academic and community practices, and fellowship- and non-fellowship-trained surgeons. Thirty-two (round 1) and 46 (round 2) panellists participated in survey questionnaires, and 22 attended the in-person consensus meeting. Results: An initial literature search of 945 articles (230 abstracts) underwent screening and yielded 24 preliminary techniques. Through sequential survey assessment and in-person discussion, a total of 11 strategies were approved. These are temporally distributed prior to tumor resection (five principles), during tumor resection (two principles), and during renorrhaphy (four principles). Conclusions: Given the variability in tumor size, depth, location, and vascularity, coupled with limitations of laparoscopic equipment, achieving consistent hemostasis in MIPN may be challenging. Despite over two decades of MIPN experience, limited evidence exists to guide clinicians. Through a three-step Delphi method and rigorous iterative review with a panel of experts, we ascertained a guiding checklist of principles for newly beginning and practicing urologists to reference.

scholarly journals Cryoablation for Small Renal Masses

2008 ◽  
Vol 2008 ◽  
pp. 1-10 ◽  
Author(s):  
J. L. Dominguez-Escrig ◽  
K. Sahadevan ◽  
P. Johnson
Keyword(s):  
Minimally Invasive ◽  
Partial Nephrectomy ◽  
Imaging Techniques ◽  
Rapid Development ◽  
High Intensity Focused Ultrasound ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Invasive Approach ◽  
Open Partial Nephrectomy ◽  
Ablative Techniques

Advances in imaging techniques (CT and MRI) and widespread use of imaging especially ultrasound scanning have resulted in a dramatic increase in the detection of small renal masses. While open partial nephrectomy is still the reference standard for the management of these small renal masses, its associated morbidity has encouraged clinicians to exploit the advancements in minimally invasive ablative techniques. The last decade has seen the rapid development of laparoscopic partial nephrectomy and novel ablative techniques such as, radiofrequency ablation (RFA), high-intensity focused ultrasound (HIFU), and cryoablation (CA). In particular, CA for small renal masses has gained popularity as it combines nephron-sparing surgery with a minimally invasive approach. Studies with up to 5-year followup have shown an overall and cancer-specific 5-year survival of 82% and 100%, respectively. This manuscript will focus on the principles and clinical applications of cryoablation of small renal masses, with detailed review of relevant literature.

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