scholarly journals V07-05 ROBOTIC-ASSISTED PARTIAL NEPHRECTOMY WITH INTRACORPOREAL HYPOTHERMIA AFTER PAZOPANIB TREATMENT IN A SOLITARY KIDNEY WITH SEGMENTAL VEIN THROMBOSIS

2018 ◽  
Vol 199 (4S) ◽  
Author(s):  
Juan Garisto ◽  
Julien Dagenais ◽  
Daniel Sagalovich ◽  
Brian Rini ◽  
Jihad Kaouk
2020 ◽  
Vol 13 (5) ◽  
pp. 349-355
Author(s):  
Zain A Abedali ◽  
M Francesca Monn ◽  
Brent E Cleveland ◽  
Jay Sulek ◽  
Clinton D Bahler ◽  
...  

Introduction and objective: Traditionally, patients with renal masses in solitary kidneys were managed with an open partial nephrectomy. With improving techniques, robotic-assisted partial nephrectomy in the setting of a solitary kidney is increasingly utilized. The objective of this study was to compare open partial nephrectomy and robotic-assisted partial nephrectomy outcomes in solitary kidney patients. Methods: A retrospective study of 536 total patients who underwent partial nephrectomy between 2004–2016 was performed. Of these patients, 23 had a renal mass in a solitary kidney. Patient demographics, perioperative values, and surgical outcomes were analyzed using descriptive statistics to compare open partial nephrectomy to robotic-assisted partial nephrectomy. Results: Of the 23 patients in the cohort, 52% ( n=12) underwent open partial nephrectomy and 48% ( n=11) underwent robotic-assisted partial nephrectomy. Patient characteristics were not significantly different. The mean (standard deviation) nephrometry score was 6.9 (1.8) for open partial nephrectomy and 6.1 (1.9) for robotic-assisted partial nephrectomy ( p=0.290). The mean (standard deviation) pre-operative creatinine was 1.2 (0.3) in open partial nephrectomy and 1.5 (0.4) in robotic-assisted partial nephrectomy, which did not reach statistical significance ( p=0.110). No difference in postoperative kidney function, Clavien grade 3 or higher complication rate, blood loss, or hospitalization length was noted. Conclusion: Although traditionally patients with a tumor in a solitary kidney are counseled to undergo open partial nephrectomy, robotic-assisted partial nephrectomy is a safe alternative with no decrease in postoperative renal function when compared with a similar cohort of patients undergoing open partial nephrectomy in a solitary kidney. Level of evidence: Level II


2021 ◽  
pp. 205141582110002
Author(s):  
Lorenz Berger ◽  
Aziz Gulamhusein ◽  
Eoin Hyde ◽  
Matt Gibb ◽  
Teele Kuusk ◽  
...  

Objective: Surgical planning for robotic-assisted partial nephrectomy is widely performed using two-dimensional computed tomography images. It is unclear to what extent two-dimensional images fully simulate surgical anatomy and case complexity. To overcome these limitations, software has been developed to reconstruct three-dimensional models from computed tomography data. We present the results of a feasibility study, to explore the role and practicality of virtual three-dimensional modelling (by Innersight Labs) in the context of surgical utility for preoperative and intraoperative use, as well as improving patient involvement. Methods: A prospective study was conducted on patients undergoing robotic-assisted partial nephrectomy at our high volume kidney cancer centre. Approval from a research ethics committee was obtained. Patient demographics and tumour characteristics were collected. Surgical outcome measures were recorded. The value of the three-dimensional model to the surgeon and patient was assessed using a survey. The prospective cohort was compared against a retrospective cohort and cases were individually matched using RENAL (radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, location relative to polar lines) scores. Results: This study included 22 patients. Three-dimensional modelling was found to be safe for this prospective cohort and resulted in good surgical outcome measures. The mean (standard deviation) console time was 158.6 (35) min and warm ischaemia time was 17.3 (6.3) min. The median (interquartile range) estimated blood loss was 125 (50–237.5) ml. Two procedures were converted to radical nephrectomy due to the risk of positive margins during resection. The median (interquartile range) length of stay was 2 (2–3) days. No postoperative complications were noted and all patients had negative surgical margins. Patients reported improved understanding of their procedure using the three-dimensional model. Conclusion: This study shows the potential benefit of three-dimensional modelling technology with positive uptake from surgeons and patients. Benefits are improved perception of vascular anatomy and resection approach, and procedure understanding by patients. A randomised controlled trial is needed to evaluate the technology further. Level of evidence: 2b


2016 ◽  
Vol 27 (2) ◽  
pp. S12
Author(s):  
Yi-Chia Lin ◽  
Chao-Yen Ho ◽  
Te-Fu Tsai ◽  
Chung-Hsin Yeh ◽  
Guang-Dar Juang ◽  
...  

2018 ◽  
Vol 17 (7) ◽  
pp. e2400
Author(s):  
M. Covas Moschovas ◽  
R. Ferreira Coelho ◽  
G. Xavier Ebaid ◽  
L. Henrique Tanure

2018 ◽  
Vol 17 (8) ◽  
pp. 251-252
Author(s):  
G. Primiceri ◽  
M. Marchioni ◽  
C. D’Orta ◽  
A. Rizzoli ◽  
P. Castellan ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document