V708: Partial Nephrectomy for Small Renal Masses: An Emerging Quality of Care Concern?

2006 ◽  
Vol 175 (4S) ◽  
pp. 229-229
Author(s):  
David C. Miller ◽  
John M. Hollingsworth ◽  
Khaled S. Hafez ◽  
Stephanie Daignault ◽  
Brent K. Hollenbeck
Keyword(s):  
Quality Of Care ◽  
Partial Nephrectomy ◽  
Small Renal Masses ◽  
Renal Masses

Partial Nephrectomy for Small Renal Masses: An Emerging Quality of Care Concern?

2006 ◽  
Vol 175 (3) ◽  
pp. 853-858 ◽  
Author(s):  
David C. Miller ◽  
John M. Hollingsworth ◽  
Khaled S. Hafez ◽  
Stephanie Daignault ◽  
Brent K. Hollenbeck
Keyword(s):  
Quality Of Care ◽  
Partial Nephrectomy ◽  
Small Renal Masses ◽  
Renal Masses

PARTIAL NEPHRECTOMY FOR RENAL MASSES: CAN WE APPLY THE QUALITY OF CARE CONCERN ADDRESSED BY THE UROLOGICAL COMMUNITY, TO THE EUROPEAN POPULATION?

2008 ◽  
Vol 179 (4S) ◽  
pp. 215-215
Author(s):  
Laurent Zini ◽  
Jean-Jacques Patard ◽  
Maxime Crepel ◽  
Nazareno Suardi ◽  
John S Lam ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Partial Nephrectomy ◽  
European Population ◽  
Renal Masses

scholarly journals Active Surveillance of Small Renal Masses: A Systematic Review

Kidney Cancer ◽  
2021 ◽  
pp. 1-14
Author(s):  
Elizabeth E. Ellis ◽  
Edward Messing
Keyword(s):  
Active Surveillance ◽  
Meta Analysis ◽  
Cost Effective ◽  
Management Approach ◽  
Small Renal Masses ◽  
Cancer Specific Survival ◽  
Renal Masses ◽  
Review Current ◽  
Delayed Intervention

Background: Our goal is to review current literature regarding active surveillance (AS) of small renal masses (SRMs) and identify trends in survival outcomes, factors that predict the need for further intervention, and quality of life (QOL). Methods: We performed a comprehensive literature search in PubMed and EMBASE and identified 194 articles. A narrative summary was performed in lieu of a meta-analysis due to the heterogeneity of selected studies. Results: Seventeen articles were chosen to be featured in this review. Growth rate (GR) was not an accurate predictor of malignancy, although it was the characteristic most commonly used to trigger delayed intervention (DI). The mean 5-year overall survival (OS) of all studies was 73.6% ±1.7% for AS groups. The combined cancer specific survival (CSS) for AS is 97.1% ±0.6% , compared to 98.6% ±0.4% for the primary intervention (PI) groups, (p = 0.038). Conclusions: Short and intermediate-term data demonstrate that AS with the option for DI is a management approach whose efficacy (in terms of CSS) approaches that of PI at 5 years, is cost effective, and prevents overtreatment, especially in patients with significant comorbidities.

scholarly journals Intraoperative ultrasound in robot-assisted partial nephrectomy: State of the art

2018 ◽  
Vol 90 (3) ◽  
pp. 195-198 ◽  
Author(s):  
Giacomo Di Cosmo ◽  
Enrica Verzotti ◽  
Tommaso Silvestri ◽  
Andrea Lissiani ◽  
Roberto Knez ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
State Of The Art ◽  
Short Review ◽  
Robot Assisted ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Ischemia Time ◽  
Oncological Safety ◽  
Nephron Sparing ◽  
Operative Ultrasound

Introduction: Nephron-sparing surgery (NSS) is of one of the most studied fields in urology due to the balancing between renal function preservation and oncological safety of the procedure. Aim of this short review is to report the state of the art of intra-operative ultrasound as an operative tool to improve localization of small renal masses partially or completely endophytic during robotassisted partial nephrectomy (RAPN). Material and methods: We performed a literature review by electronic database on Pubmed about the use of intra-operative US in RAPN to evaluate the usefulness and the feasibility of this procedure. Results: Several studies analyzed the use of different US probes during RAPN. Among them some focused on using contrastenhanced ultra sonography (CEUS) for improving the dynamic evaluation of microvascular structure allowing the reduction of ischemia time (IT). We reported that nowaday the use of intraoperative US during RAPN could be helpful to improve the preservation of renal tissue without compromising oncological safety. Moreover, during RAPN there is no need for assistant to hand the US probe increasing surgeon autonomy. Conclusions: The use of a robotic ultrasound probe during partial nephrectomy allows the surgeon to optimize tumor identification with maximal autonomy, and to benefit from the precision and articulation of the robotic instrument during this key step of the partial nephrectomy procedure. Moreover US could be useful to reduce ischemia time (IT). The advantages of nephron-sparing surgery over radical nephrectomy is well established with a pool of data providing strong evidence of oncological and survival equivalency. With the progressive growth of robot-assisted partial nephrectomy (RAPN) techniques, the use of several tools has been progressively developed to help the surgeon in the identification of masses and its vascular net. In this short review we tried to analyze the current use of intra-operative ultrasound as an operative tool to improve localization of small renal masses partially or completely endophytic during RAPN.

scholarly journals Multivariate analysis of the factors involved in loss of renal differential function after laparoscopic partial nephrectomy: a role for warm ischemia time

2013 ◽  
Vol 5 (2) ◽  
pp. 89
Author(s):  
Frédéric Pouliot ◽  
Allan Pantuck ◽  
Annie Imbeault ◽  
Brian Shuch ◽  
Brian Calimlim ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Partial Nephrectomy ◽  
Tumour Size ◽  
Significant Loss ◽  
Differential Function ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Factors Associated ◽  
Before And After ◽  
Tomography Scan

Background: Partial nephrectomy (PN) is now the gold standardfor the surgical treatment of small renal masses. We evaluated theeffect of WIT and other factors on RDF assessed by preoperativeand postoperative renal scintigraphy.Methods: Between 2003 and 2008, 182 consecutive laparoscopicPN (LPN) were performed in an academic centre. Among those,56 had mercaptoacetyl triglycine (MAG3) lasix renal scintigraphypreoperatively and postoperatively.Results: Medians for age, preoperative estimated glomerular filtrationrate and computed tomography scan tumour size were 62years, 82 mL/min/1.73m2 and 26 mm, respectively. Median WITand preoperative RDF were 30 minutes and 50%, respectively.Median loss of RDF after surgery was 14%. Linear regression curvesshowed that loss in RDF rate was 0.2% per minute when WIT was<30 minutes and 0.7% per minute when WIT was ≥30 minutes.In multivariate analysis, length of WIT and endophytic tumourlocation were associated with a statistically significant loss of RDF(p < 0.05), but only in the group who experienced >30 minutesof WIT.Interpretation: Our results suggest that the factors associated withloss of RDF are not the same before and after 30 minutes of WITand that the rate of loss in RDF increases after 30 minutes. Since,the effect of WIT is small up to 30 minutes, we believe that surgeryshould focus on limiting the resection of normal parenchymaand to ensure negative margins and hemostasis, rather than onpremature unclamping.

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