scholarly journals The Application of Internal Suspension Technique in Retroperitoneal Laparoscopic Partial Nephrectomy for Renal Ventral Tumors

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Wenlong Zhong ◽  
Yicong Du ◽  
Lei Zhang ◽  
Xuesong Li ◽  
Cuijian Zhang ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Renal Tumor ◽  
Tumor Resection ◽  
Patient Characteristics ◽  
Tumor Location ◽  
Warm Ischemia ◽  
Laparoscopic Partial Nephrectomy ◽  
Safe Procedure ◽  
Nephrometry Score ◽  
Baseline Characteristics

Objective. To evaluate the feasibility of an internal suspension technique in retroperitoneal laparoscopic partial nephrectomy for the management of renal ventral tumors. Methods. Between January 2013 and July 2016, a total of 145 patients underwent retroperitoneal laparoscopic partial nephrectomy with or without internal suspension technique. For patients who underwent internal suspension technique, the surgeons preserved the external fat of the renal tumor as a suspension traction measure when separating the kidney. Propensity score matching (PSM) was performed according to age, gender, body mass index, tumor size, tumor location, and RENAL nephrometry score. Patient characteristics and intraoperative and postoperative outcomes were compared between the groups. Results. After PSM, 32 patients treated with the internal suspension technique were compared with 32 cases treated without such technique. Baseline characteristics were statistically similar for the cohorts. The use of our new technique resulted in shorter warm ischemia time (WIT: 15.0 versus 19.0 minutes, P=.002) and tumor resection time (4.0 versus 7.5 minutes, P<0.001). The rate of WIT >25 minutes decreased (6.3% versus 25%, P=.04) and the trifecta outcomes were significantly improved (87.5% versus 62.5%, P=.02). Conclusion. Internal suspension technique is a feasible and safe procedure in retroperitoneal laparoscopic partial nephrectomy for renal ventral tumors.

scholarly journals Impact of Robotic Fellowship Experience on Perioperative Outcomes of Robotic-Assisted Laparoscopic Partial Nephrectomy

2015 ◽  
Vol 9 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Michael A. Moriarty ◽  
Kenneth G. Nepple ◽  
Chad R. Tracy ◽  
Michael E. Strigenz ◽  
Daniel K. Lee ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Perioperative Complications ◽  
Positive Margin ◽  
Warm Ischemia ◽  
Laparoscopic Partial Nephrectomy ◽  
Perioperative Outcomes ◽  
Initial Experience ◽  
Robotic Assisted ◽  
Nephrometry Score ◽  
Significant Difference

Background: We analyzed differences in patient selection and perioperative outcomes between robotic-fellowship trained and non-fellowship trained surgeons in their initial experience with robotic-assisted laparoscopic partial nephrectomy. Methods: Data through surgeon case 10 was analyzed. Forty patients were identified from two fellowship trained surgeons (n = 20) and two non-fellowship trained surgeons (n = 20). Results: Fellowship trained surgeons performed surgery on masses of higher nephrometry score (8.0 vs. 6.0, p = 0.007) and more posterior location (60 vs. 25%, p = 0.03). Retroperitoneal approach was more common (50 vs. 0%, p = 0.0003). Fellowship trained surgeons trended toward shorter warm ischemia time (25.5 vs. 31.0 min, p = 0.08). There was no significant difference in perioperative complications (35 vs. 35%, p = 0.45) or final positive margin rates (0 vs. 15%, p = 0.23). Conclusion: Fellowship experience may allow for treating more challenging and posterior tumors in initial practice and significantly more comfort performing retroperitoneal robotic-assisted laparoscopic partial nephrectomy.

Periprocedural outcome after laparoscopic partial nephrectomy versus radiofrequency ablation for T1 renal tumors: a modified R.E.N.A.L nephrometry score adjusted comparison

2018 ◽  
Vol 60 (2) ◽  
pp. 260-268 ◽  
Author(s):  
Vanessa Acosta Ruiz ◽  
Sam Ladjevardi ◽  
Einar Brekkan ◽  
Michael Häggman ◽  
Maria Lönnemark ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Partial Nephrectomy ◽  
Renal Tumor ◽  
Laparoscopic Partial Nephrectomy ◽  
Renal Tumors ◽  
Efficacy Rate ◽  
Tumor Diameter ◽  
Technical Success ◽  
Nephrometry Score ◽  
Hospitalization Time

Background Comparable oncological outcomes have been seen after surgical nephrectomy and thermal ablation of renal tumors recently. However, periprocedural outcome needs to be assessed for aiding treatment decision. Purpose To compare efficacy rates and periprocedural outcome (technical success, session time, hospitalization time, and complications) after renal tumor treatment with laparoscopic partial nephrectomy (LPN) or radiofrequency ablation (RFA). Material and Methods The initial experience with 49 (treated with LPN) and 84 (treated with RFA) consecutive patients for a single renal tumor (diameter ≤ 5 cm, limited to the kidney) during 2007–2014 was evaluated. Patient and tumor characteristics, efficacy rates, and periprocedural outcome were collected retrospectively. The stratified Mantel Haenzel and Van Elteren tests, adjusted for tumor complexity (with the modified R.E.N.A.L nephrometry score [m-RNS]), were used to assess differences in treatment outcomes. Results Primary efficacy rate was 98% for LPN and 85.7% for RFA; secondary efficacy rate was 93.9% for LPN and 95.2% for RFA; and technical success rate was 87.8% for LPN and 100% for RFA. Median session (m-RNS adjusted P < 0.001; LPN 215 min, RFA 137 min) and median hospitalization time were longer after LPN (m-RNS adjusted P < 0.001; LPN 5 days, RFA 2 days). Side effects were uncommon (LPN 2%, RFA 4.8%). Complications were more frequent after LPN (m-RNS adjusted P < 0.001; LPN 42.9%, RFA 10.7%). Conclusion Both methods achieved equivalent secondary efficacy rates. RFA included several treatment sessions, but session and hospitalization times were shorter, and complications were less frequent than for LPN. The differences remained after adjustment for renal tumor complexity.

V218: Eliminating Knot Tying During Warm Ischemia Time for Laparoscopic Partial Nephrectomy: The Video

2004 ◽  
Vol 171 (4S) ◽  
pp. 57-58
Author(s):  
Marcelo A. Orvieto ◽  
Gary W. Chien ◽  
R. Matthew Galocy ◽  
Mitchell H. Sokoloff ◽  
Gregory P. Zagaja ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Warm Ischemia ◽  
Warm Ischemia Time ◽  
Laparoscopic Partial Nephrectomy ◽  
Knot Tying ◽  
Ischemia Time

Effect of Warm Ischemia Time During Laparoscopic Partial Nephrectomy on Early Postoperative Glomerular Filtration Rate

2009 ◽  
Vol 181 (6) ◽  
pp. 2438-2445 ◽  
Author(s):  
Guilherme Godoy ◽  
Vigneshwaran Ramanathan ◽  
Jamie A. Kanofsky ◽  
Rebecca L. O'Malley ◽  
Basir U. Tareen ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Partial Nephrectomy ◽  
Filtration Rate ◽  
Warm Ischemia ◽  
Warm Ischemia Time ◽  
Laparoscopic Partial Nephrectomy ◽  
Ischemia Time

Early Experience of Laparoscopic Partial Nephrectomy for Renal Tumor

2007 ◽  
Vol 48 (1) ◽  
pp. 1 ◽  
Author(s):  
Ill Young Seo ◽  
Byung Jun Bae ◽  
Joung Sik Rim
Keyword(s):  
Partial Nephrectomy ◽  
Renal Tumor ◽  
Early Experience ◽  
Laparoscopic Partial Nephrectomy

scholarly journals Analysis of predictors of adherent perinephric fat and its impact on perioperative outcomes in laparoscopic partial nephrectomy: a retrospective case–control study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Lu Fang ◽  
Huan Li ◽  
Tao Zhang ◽  
Rui Liu ◽  
Taotao Zhang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Partial Nephrectomy ◽  
Univariate Analysis ◽  
Warm Ischemia ◽  
Laparoscopic Partial Nephrectomy ◽  
Renal Tumors ◽  
Perioperative Outcomes ◽  
Transfusion Rate ◽  
Estimated Blood Loss ◽  
Perinephric Fat

Abstract Background Adherent perinephric fat (APF), characterized by inflammatory fat surrounding the kidney, can limit the isolation of renal tumors and increase the operative difficulty in laparoscopic partial nephrectomy (LPN). The aim of this study was to investigate the predictors of APF and its impact on perioperative outcomes during LPN. Methods A total of 215 consecutive patients undergoing LPN for renal cell carcinoma (RCC) from January 2017 to June 2019 at our institute were included. We divided these patients into two groups according to the presence of APF. Radiographic data were retrospectively collected from preoperative cross-sectional imaging. The perioperative clinical parameters were compared between the two groups. Univariate and multivariate analyses were performed to evaluate the predictive factors of APF. Results APF was identified in 41 patients (19.1%) at the time of LPN. Univariate analysis demonstrated that APF was significantly correlated with the male gender (P = 0.001), higher body mass index (P = 0.002), lower preoperative estimated glomerular filtration rate (P = 0.004), greater posterior perinephric fat thickness (P< 0.001), greater perinephric stranding (P< 0.001), and higher Mayo Adhesive Probability (MAP) score (P< 0.001). The MAP score (P< 0.001) was the only variable that remained an independent predictor for APF in multivariate analysis. We found that patients with APF had longer operative times (P< 0.001), warm ischemia times (P = 0.001), and greater estimated blood loss (P = 0.003) than those without APF. However, there were no significant differences in surgical approach, transfusion rate, length of postoperative stay, complication rate, or surgical margin between the two groups. Conclusions Several specific clinical and radiographic factors including the MAP score can predict APF. The presence of APF is associated with an increased operative time, warm ischemia time, and greater estimated blood loss but has no impact on other perioperative outcomes in LPN.

scholarly journals Retroperitoneal Robot-Assisted Laparoscopic Partial Nephrectomy for Horseshoe Kidney: A Case Report

2021 ◽  
Author(s):  
Dongxu Zhang ◽  
Youyi Lu ◽  
Fengze Sun ◽  
Di Wang ◽  
Xingjun Bao ◽  
...  
Keyword(s):  
Case Report ◽  
Partial Nephrectomy ◽  
Tumor Resection ◽  
Three Dimensional ◽  
Horseshoe Kidney ◽  
Laparoscopic Partial Nephrectomy ◽  
Robot Assisted ◽  
3D Reconstructions ◽  
Case Presentations ◽  
The Right

Abstract Background: Horseshoe kidney (HSK) have always been a challenge for urologists depending on its particular anatomy. We report a case of renal tumor in a patient with HSK, who underwent tumor resection by retroperitoneal robot-assisted laparoscopic partial nephrectomy. Case Presentations: A 47-year-old man presented to our hospital with a solid renal mass. Computed tomography urography (CTU) showed a 4.3 × 4.4 cm mass in the upper pole of the right kidney. Patients received a retroperitoneal robot-assisted laparoscopic partial nephrectomy on basis of three-dimensional (3D) reconstructions.Conclusion: The present case report highlights the feasibility of robot-assisted laparoscopic partial nephrectomy for horseshoe kidney, and the advantages of preoperative 3D reconstructions.

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